Tango case

Which of the following are a part of the static examination?

1. history taking

2. conformation assessment

3. palpation

4. hoof examination

5. range of motion testing

Which of the following are a part of the dynamic examination?

1. baseline gait evaluation

2. flexion tests

3. lunging

4. diagnostic analgesia

Where is the cassette placed for a lateromedial view of stifle?

medial to the limb and perpendicular to the ground

Where is the beam traveling for lateromedial view of stifle?

parallel to the ground and centered at the proximal intertarsal joint

Where is the casette placed for a dorsoplantar view of the stifle?

plantar aspect of the limb and perpendicular to the ground

Where is the beam traveling for dorsoplantar view of stifle?

slightly proximodistal angled and centered at the proximal intertarsal joint

Where is the cassette placed for a DLPMO or DMPLO view of the stifle?

plantaromedial/lateral to the limb

Where is the beam traveling for a DLPMO or DMPLO view of stifle?

parallel to floor and 45 degrees off the DP view and centered at the proximal intertarsal joint

What is lameness?

clinical sign characterized by an abnormal gait or stance

Which of the following can cause lameness?

1. pain

2. mechanical dysfunction

3. neurological issues

What are ways that lameness can manifest?

1. altered gait

2. pain indicators

3. localized signs

4. behavioral signs

What are some diagnostic tools for hock osteochondrosis?

1. joint block

2. radiograph

3. ultrasound

4. arthrocentesis

What are some diagnostic tools for hock osteoarthritis?

1. joint block

2. radiograph

3. ultrasound

4. arthrocentesis

What are some diagnostic tools for suspensory desmitis?

1. nerve blocks

2. ultrasound

What are some diagnostic tools for chip fracture?

1. joint blocks

2. radiographs

What are some diagnostic tools for joint infections?

1. arthrocentesis

2. radiograph

3. ultrasound

What is the order that nerve blocks are performed?

distal to proximal

What does the abaxial sesamoid nerve block block?

medial and lateral palmar nerves

What structures are desensitized with abaxial sesamoid nerve block?

fetlock, coffin, pastern joints

What nerves does the low 4 point block target?

medial and lateral plantar nerves and medial and lateral plantar metatarsal nerves

What structures are desensitized by the low 4 point block?

fetlock and tissues distal to it

What is the landmark used to identify location for low 4 point block?

distal to the button of the splint bone, one inch proximal between the suspensory and flexor tendons

What are the nerves targeted in the high 4 point block?

1. medial and lateral plantar metatarsal nerves

2. dorsal metatarsal nerve

3. deep branch of the lateral plantar nerve

What is desensitized during the high 4 point block?

proximal metatarsal region and distal structures

What is arthrocentesis?

medical procedure in which a sterile needle is inserted into a joint space to collect synovial sample or inject medication

What does decreased viscosity, increased protein concentration, increased cells and neutrophils indicate from an arthrocentesis?

non-septic, degenerative joint disease

What tube color is most appropriate for collecting synovial fluid samples?

red top

What type of disease is osteochondrosis dissecans?

developmental orthopedic disorder

What type of disease is osteoarthritis?

degenerative joint disease

What is the cause of osteochondrosis dissecans?

failure of endochondral ossification

What is the cause of osteoarthritis?

progressive cartilage wear, synovial inflammation, subchondral changes

What is the age of onset with osteochondrosis dissecans?

young horses

What is the age of onset with osteoarthritis?

older horses usually >10 years or earlier if post-traumatic

What are the common locations for osteochondrosis dissecans?

tarsocrural joint

What is the common location for osteoarthritis?

distal intertarsal and tarsometatarsal joints

Which disease affects mostly low motion joints?

osteoarthritis

Which disease affects mostly high motion joints?

osteochondrosis dissecans

What are clinical signs for osteochondrosis dissecans?

1. joint effusion

2. mild to moderate lameness

What are clinical signs for osteoarthritis?

1. chronic lameness

2. stiffness

3. reduced range of motion

4. joint thickening

What are the expected radiographic findings for osteochondrosis dissecans?

1. flattening or irregularity of articular surfaces

2. subchondral bone defects

3. osteochondral fragments or loose bodies

What are the expected radiographic findings for osteoarthritis?

1. osteophyte formation

2. joint space narrowing

3. subchondral sclerosis

4. bone remodeling

5. ankylosis

What leads to inflammation in the joint with osteochondrosis dissecans?

cartilage and bone flaps or joint mice in the joint

What can osteochondrosis dissecans lead to?

arthritis

What are the nutrition factors for OCD?

diets with very high energy or have an imbalance in trace minerals

What is an example of a diet that can cause OCD?

low copper diets

What are the genetic factors for OCD?

may be partially inherited

What are the hormonal factors for OCD?

insulin and thyroid hormones during gestation

What are some other factors for OCD?

1. rapid growth and large body size

2. trauma and exercise

What is the best treatment option for OCD?

arthroscopy with removal of joint mice

What is the percentage of horses that return to work post arthroscopy?

81%

What is the post-op plan for 0-10 days after?

stall rest and pain management with NSAIDs

What do you begin doing on day 10 of post-op?

hand walking 5-10 minutes twice daily

What is the post-op plan for 2 weeks after?

suture removal, increase hand walking duration, physiotherapy exercises, vet reassessment

When is regenerative therapy administered post op?

2 weeks

What occurs 6-8 weeks post-op?

follow-up radiographs, transition to light exercise under saddle

Irregular contour to lateral trochlear ridge to talus, joint mice - osteochondrosis dissecans

What is abnormal in the radiograph?