Equine Joint Disease

what can cause osteochondrosis

biomechanical influences

failure of vascularization

exercise

nutrition

GR and genetics

what horses commonly get osteochondrosis

thoroughbred, QH

present as yearlings or when go into training

What are clinical signs of osteochondrosis

joint effusion!!

bilateral is common

what is the most important diagnostic tool for osteochondrosis

radiographs

where are OCD lesions often found

tibiotarsal joint

DIRT > distal lat trochlear ridge, medial malleolus

where are OCD lesions of femoropatellar joint

lateral femoral trochlear ridge > medial femoral trochlear ridge, trochlear groove, distal end of patella

where are OCD lesions of MCP/MTP joint

dorsal sagittal ridge > dorsal P1 > plantar P1

where are OCD lesions of scapulohumeral joint

glenoid and humeral head

where is lesion most commonly found in bone

medial femoral condyle

t/f osteochondrosis lesions are static

false

how is OCD treated

arthroscopic removal **

small lesions can be managed conservatively if no lameness or effusion

how are cysts treated

surgery** most common

• cyst debridement and intralesional corticosteroids

what can cause osteoarthritis

abnormal mechanical loads from athletic use or poor conformation

metabolic tissue failure

can cartilage repair itself

no

what is the single greatest economic loss to equine injury

articular disorders (osteoarthritis)

what are clinical signs of osteoarthritis

joint effusion

loss of ROM

lameness, may be subtle

axial muscle soreness

hard swelling around joint

how is osteoarthritis diagnosed

lameness exam

positive flexion tests

radiographs

response to treatment

what are the goals of OA treatment

decrease inflammation

prevent further articular cartilage damage!!

alleviate pain

return to function

what is systemic hyaluronic acid used for

treating multiple OA joints at once

anti-inflammatory

what are examples of systemic osteoclast inhibitors

tiludronate (tildren)

clondronate (osphos)

what are side effects of using systemic osteoclast inhibitors

colic, usually transient

renal issues, dont give with NSAID

what are corticosteorids

long acting anti-inflammatories

COST EFFECTIVE

what are risks to cordicosteroids

potential to cause laminitis

could cause septic arthritis

what corticosteroids are used in high motion joints

Vetlog/Kenalog

Betavet

what corticosteroid is used in low motion joints

Depo-Medrol

what are disadvantages to corticosteroids

steroid arthopathy

immunosuppression, aspectic very important

post injection flare

what is IRAP

use horses own serum to reproduce IL-1 Ra to block IL1

Platelet-rich plasma is used more commonly in

tendons than in joints

what is mesenchymal stem cells

place cells at site of pathology, they will differentiate themselves, takes 3-4 weeks

how can OA be treated medically

exercise

shoeing/trimming

diet

how can OA be treated surgically

arthrodesis

facilitated anklyosis

what is the most common cause of equine septic arthritis

traumatic!!

what can increase risk of iatrogenic SA

PSGAG medications

clipping

large gauge needle

reusing needles

how can hematogenous SA occur

partial or complete failure of passive transfer

bacteremia from immunocompromised foal

bacteria settle in joints

how is septic arthritis diagnosed

arthrocentesis ± pressurization

radiography

ultrasound

what will be seen in normal arthrocentesis

pale yellow and clear

does not clot

TP <2

viscous

what fluid can be used in fluid pressurization

sterile saline

methylene blue (new)

most fluid in fluid pressurization will be used in what joint

tibiotarsal

bone involvement in septic arthritis will

decrease prognosis

how can ultrasound be used for septic arthritis diagnosis

communication with wound

evaluate effusion and nature of fluid

assess synovial inflammation

good for joints hard to palpate or image

what is the gold standard for treating septic arthritis

arthroscopic lavage!!

what are advantages of local antimicrobials

high concentrations

• decrease systemic toxicity

  • cost effective

what is a disadvantage of local antimicrobials

harmful vascular or cartilage sequela

when is systemic antimicrobials indicated

anytime infection is suspected

broad spectrum until results of culture

what are ancillary treatments of septic arthritis

pain management

wound care

hyperbaric oxygen therpy

ancillary surgical procedures

rest and PT

why is prognosis of septic arthritis worse in foals

multisystem disease associated with short term survival