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[[Category:To Do - Steph]]
Also Known As – '''''Phalangeal cartilage necrosis – Lateral cartilage necrosis - Third Phalanx cartilage necrosis – Distal phalanx cartilage necrosis – Subcoronary abscess – Coronary sinus injury'''''
==Introduction==
Quittor is a '''chronic, purulent inflammatory disease of the lateral cartilages of the [[Equine Phalanges – Anatomy & Physiology|third (distal) phalanx]].'''
Infection of the cartilage is '''caused by injury to the coronet, sole, heel or pastern regions''', allowing deep introduction of infection. This causes '''abscesses to form and sinus tracts''' to extend from the diseased cartilage, breaking through the '''skin in the coronary region.'''
==Distribution==
Quittor is now '''rare.'''
==Signalment==
Quittor was historically common in '''working draft horses.'''
==Clinical Signs==
The first sign of quittor is '''inflammation and swelling over the alar cartilage'''. The consequent abscess may be visible or pain may be exhibited on palpation of the area. Quantity of ''purulent discharge''' varies, so may only be detectable as '''matting of the hair or may stream freely down the hoof.'''
Lameness occurs during the acute stage of disease although both '''pain and lameness may be intermittent''', particularly early in disease progression.
Without treatment, infection, abscessation and necrosis will extend to deeper structures and prognosis is grave.
==Diagnosis==
Diagnosis is often based on '''clinical signs, history of injury''' to relevant areas and the absence of any other cause of lameness.
'''Plain and contrast radiography''' will assist in assessing the extent of the damage.
'''MRI and [[Computed Tomography|CT]] imaging''' may be diagnostic if available.
Diagnosis is often confirmed at '''surgery'''.
==Treatment==
'''Surgery is required to remove the diseased tissue and all infected cartilage under general anaesthesia'''.
'''Antibiotics and specialised dressings''' such as those impregnated with '''silver''' may assist more rapid healing.
Early lesions treated aggressively often respond well but involvement of the coronary band or joint capsule involvement and chronic lesions carry a poor prognosis.
{{Learning
|flashcards = [[Quittor Flashcards]]
}}
==References==
<references/>
Knottenbelt, D. C., McGarry, J. W (2009) '''Pascoe’s Principles & Practice of Equine Dermatology 2nd ed'''. ''Elsevier, UK'', 372-373.
Merck Veterinary Manual, '''Quittor''', accessed online 24/07/2011 at http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/90727.htm
[[Category:To Do - Manson review]] [[Category: Musculoskeletal Diseases - Horse]]