Difference between revisions of "Case Report Experiment"

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* Radiographs or Ultrasounds
 
* Radiographs or Ultrasounds
 
* Scintigraphy
 
* Scintigraphy
−
<font color="none">
+
</font>
  
  
  
 
==Clinical Examination Results==
 
==Clinical Examination Results==
 +
'''A link could be put in here to show you have to perform a clinical exam on a horse'''
 +
 +
* Forelimb palpation:
 +
** Right Forlimb:
 +
*** heat and swelling at proximal metacarpal region
 +
*** mild pain elicited on suspensory ligament palpation
 +
*** mild thickening of lateral branch of SL (no pain)
 +
 +
* Hoof testers: negative
 +
 +
==Gait Analysis==
 +
'''A link could be put in here to show you have to perform gait analysis on a horse'''
 +
 +
* Trot straight line: 2/10 Right Forelimb lame
 +
 +
* Soft lunge:
 +
** right rein: 3/10 Right Forelimb lame
 +
** left rein: 2/10 Right Forelimb lame
 +
 +
* Hard lunge:
 +
** right rein: 2/10 RF lame
 +
** left rein: no lameness
 +
 +
* Proximal forelimb flexion, right and left: negative
 +
 +
* Distal forelimb flexion, right and left: negative
 +
 +
==What is your Problem List and Differential List?==
 +
 +
===Problem List===
 +
<font color="white">
 +
* Pain on palpation
 +
* Swelling
 +
* Lameness
 +
* Thickening of Suspensory Ligament
 +
</font>
 +
 +
===Differential List===
 +
<font color="white">
 +
* ?????????
 +
* ????????
 +
</font>
 +
 +
===What is your revised action plan?===
 +
<font color="white">
 +
* Diagnostic Analgesia
 +
* Radiographs and Ultrasound
 +
* Scintigraphy
 +
</font>
 +
 +
 +
==Diagnostic Imaging Results==
 +
 +
===Ultrasonography===
 +
'''Could put in the video of the ultrasound in here and also a link on how to perform an ultrasound'''
 +
 +
Q: What do you think is going?
 +
 +
A: <font color="white"> There is a focal hypoechoic area on the dorsal border of the suspensory ligament at its proximal insertion </font>
 +
 +
===Radiographs===
 +
'''Put in the actual radiographs and a link on how these radiographs where taken'''
 +
 +
Q; How would you interpret these radiographs?
 +
 +
A: <font color="white"> Small radiolucent area with new bone formation on palmar mid aspect of the MC3 of RF. This has questionable significance. </font>
 +
 +
===Scintigraphy===
 +
'''Put in the scintigraphy images and a link'''
 +
 +
Q: How would you interpret these results?
 +
 +
A: <font color="white"> Mild IRU w/in proximal aspect of left MC2. Mild IRU w/in middle aspect of R MC2 - unlikely to be of clinical significance </font>
 +
 +
What is your diagnosis?
 +
<font color="white">
 +
* '''proximal suspensory ligament desmitis of right forelimb'''
 +
</font>
 +
 +
==Treatment==
 +
'''Insert a link to different treatments'''
 +
 +
What do you feel should be done to treat this case?
 +
 +
This is what actually was done:
 +
* <font color="white"> Box rest – 2 weeks 15 mins in hand walking BID
 +
    - 2 weeks 30 mins in hand walking BID
 +
    - 2 weeks 40 mins in hand walking BID
 +
</font>
 +
 +
 +
[[Category:Lost]]

Latest revision as of 22:19, 24 May 2011

Harvey Saunders

Signalment and Initial Complaint

Harvey Saunders
  • 13 year old, Anglo-Arab Gelding, weighing 559kg.
  • He presented with an intermittent right forelimb lameness of 2 -3 month duration.


What would your work up now consist of?

There are 6 things that could be done to achieve a full work up.... (highlight to reveal answers)

  • Further history
  • Physical Examination
  • Gait Analysis
  • Diagnostic Analgesia
  • Radiographs or Ultrasounds
  • Scintigraphy


Clinical Examination Results

A link could be put in here to show you have to perform a clinical exam on a horse

  • Forelimb palpation:
    • Right Forlimb:
      • heat and swelling at proximal metacarpal region
      • mild pain elicited on suspensory ligament palpation
      • mild thickening of lateral branch of SL (no pain)
  • Hoof testers: negative

Gait Analysis

A link could be put in here to show you have to perform gait analysis on a horse

  • Trot straight line: 2/10 Right Forelimb lame
  • Soft lunge:
    • right rein: 3/10 Right Forelimb lame
    • left rein: 2/10 Right Forelimb lame
  • Hard lunge:
    • right rein: 2/10 RF lame
    • left rein: no lameness
  • Proximal forelimb flexion, right and left: negative
  • Distal forelimb flexion, right and left: negative

What is your Problem List and Differential List?

Problem List

  • Pain on palpation
  • Swelling
  • Lameness
  • Thickening of Suspensory Ligament

Differential List

  • ?????????
  • ????????

What is your revised action plan?

  • Diagnostic Analgesia
  • Radiographs and Ultrasound
  • Scintigraphy


Diagnostic Imaging Results

Ultrasonography

Could put in the video of the ultrasound in here and also a link on how to perform an ultrasound

Q: What do you think is going?

A: There is a focal hypoechoic area on the dorsal border of the suspensory ligament at its proximal insertion

Radiographs

Put in the actual radiographs and a link on how these radiographs where taken

Q; How would you interpret these radiographs?

A: Small radiolucent area with new bone formation on palmar mid aspect of the MC3 of RF. This has questionable significance.

Scintigraphy

Put in the scintigraphy images and a link

Q: How would you interpret these results?

A: Mild IRU w/in proximal aspect of left MC2. Mild IRU w/in middle aspect of R MC2 - unlikely to be of clinical significance

What is your diagnosis?

  • proximal suspensory ligament desmitis of right forelimb

Treatment

Insert a link to different treatments

What do you feel should be done to treat this case?

This is what actually was done:

  • Box rest – 2 weeks 15 mins in hand walking BID

- 2 weeks 30 mins in hand walking BID - 2 weeks 40 mins in hand walking BID

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