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Walter LJ, Stack JD, Winderickx K, Davies HMS, Simon O, Franklin SH. Review of the clinical diagnosis of sacroiliac dysfunction in horses - Challenges and limitations. Vet J 2024; 305:106106. [PMID: 38556191 DOI: 10.1016/j.tvjl.2024.106106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/06/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
Sacroiliac dysfunction (SID) is a condition seen in horses associated with poor performance that affects hind limb gait and impulsion. The condition comprises pain and dysfunction but there lacks clarity around the aetiopathogenesis and whether SID encompasses abnormal joint pathology, abnormal joint movement, abnormal regional biomechanical function, joint laxity and pain, or various combinations of these that may vary over time. Clinical assessment remains challenging for equine clinicians due to the deep location of the sacroiliac joint (SIJ) and surrounding structures which limits access for palpation, diagnostic imaging and joint-specific injection. There is no recognised single reference standard diagnostic test for SID. Clinical diagnosis has been based on ruling out other causes of hind limb lameness, along with combinations of ultrasonography, scintigraphy and periarticular anaesthesia of the SIJ. Recent studies have highlighted the lack of specificity of injections targeting the SIJ, with significant dispersal of injectate into surrounding structures including around the lumbosacral joint (LSJ). Advanced imaging modalities such as computed tomography offers promise for assessment of the structure and pathology of the SIJ and surrounding bony structures. However, there is a need to improve the understanding of the significance of anatomic variation of the sacroiliac region structures, with recent studies reporting detailed anatomic variation in groups of horses with and without SID. There are also limitations around functional assessment of the joint which is still largely reliant on a thorough clinical examination. This review aims to present an update on clinical approaches to the diagnosis of horses with SID, and to consider the challenges and limitations.
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Affiliation(s)
- L J Walter
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, 5371 SA, Australia.
| | - J D Stack
- Phillip Leverhulme Equine Hospital, Department of Equine Clinical Science, University of Liverpool, Wirral CH64 7TE, UK
| | - K Winderickx
- Lingehoeve Diergeneeskunde, Veldstraat 3a, Lienden 4033 AK, the Netherlands
| | - H M S Davies
- Department of Veterinary BioSciences, University of Melbourne, Parkville, VIC 3010, Australia
| | - O Simon
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, 5371 SA, Australia
| | - S H Franklin
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, 5371 SA, Australia
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Scilimati N, Schiavo S, Lauteri E, Beccati F, Angeli G, Di Meo A, Pepe M. Computed tomographic diagnosis of a fracture of the floor of the pelvis in a Thoroughbred foal. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Nicola Scilimati
- Department of Veterinary Medicine Veterinary Teaching Hospital University of Perugia Perugia Italy
| | | | | | - Francesca Beccati
- Department of Veterinary Medicine Veterinary Teaching Hospital University of Perugia Perugia Italy
| | - Giovanni Angeli
- Department of Veterinary Medicine Veterinary Teaching Hospital University of Perugia Perugia Italy
| | - Antonio Di Meo
- Department of Veterinary Medicine Veterinary Teaching Hospital University of Perugia Perugia Italy
| | - Marco Pepe
- Department of Veterinary Medicine Veterinary Teaching Hospital University of Perugia Perugia Italy
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Spoormakers TJP, Bergmann W, Veraa S, van Weeren PR, Brommer H. The existence of intertransverse joints in young warmblood foals. J Am Vet Med Assoc 2022; 260:1206-1210. [PMID: 35482562 DOI: 10.2460/javma.22.02.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To verify the existence of intertransverse joints (ITJs) in young foals. ANIMALS 11 warmblood foals. PROCEDURES Postmortem examination of the lumbar area in foals < 200 days old using CT, MRI, dissection, and histomorphology. Data were analyzed with descriptive statistics. RESULTS Age of foals varied between 1 and 200 days (median, 11 days). Ten foals had 6 lumbar (L) vertebrae, and 1 foal had 5. All 11 foals, irrespective of age, had ITJs between the first sacral and last lumbar vertebrae and between the last and second-to-last lumbar vertebrae. In 6 foals (all with 6 L vertebrae), ITJs also existed between the fourth and fifth L vertebra. One foal, also with 6 L vertebrae, additionally had a unilateral (right) ITJ between the transverse processes of the third and fourth L vertebra. Based on CT, width of ITJs was seemingly greater in young (< 1 month old) foals because of the incomplete ossification of the transverse processes. The ITJs were confirmed and further characterized by MRI, dissection, and histomorphology. CLINICAL RELEVANCE ITJs already exist in very young warmblood foals and are present at birth. During the first months of life, these juvenile ITJs develop similarly to other synovial joints with increasing ossification and concomitant decrease of thickness of the cartilage layer. Knowledge of the presence of these ITJs in young animals is clinically relevant, as they should be recognized as nonpathologic when for instance a young foal is presented for presumed arthropathy and examined with advanced imaging techniques.
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Affiliation(s)
- T J P Spoormakers
- 1Department of Clinical Sciences, Equine Division, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - W Bergmann
- 2Department of Biomolecular Health Sciences, Division of Pathology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - S Veraa
- 3Department of Clinical Sciences, Division of Diagnostic Imaging, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - P R van Weeren
- 1Department of Clinical Sciences, Equine Division, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - H Brommer
- 1Department of Clinical Sciences, Equine Division, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
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Fairburn AJ, Fews D, Mair TS. Acquired scoliosis of the cervical spine secondary to vertebral neoplasia in an aged pony gelding. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | - D. Fews
- Abbey Veterinary Services Newton Abbot Devon UK
| | - T. S. Mair
- Bell Equine Veterinary Clinic Mereworth Kent UK
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Scilimati N, Pepe M, Pressanto MC, Angeli G, Beccati F. Multimodal Diagnostic Imaging to Identify Septic Apophysitis of the Proximal Humerus in a Thoroughbred Foal. J Equine Vet Sci 2021; 101:103448. [PMID: 33993941 DOI: 10.1016/j.jevs.2021.103448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/06/2021] [Accepted: 03/10/2021] [Indexed: 11/19/2022]
Abstract
A 4-month-old Thoroughbred filly was referred for evaluation of severe left forelimb lameness of 24 hours duration. Radiographic projections of the shoulder revealed mild irregularity and sclerosis of the proximal humeral apophysis. Ultrasonographic examination showed a moderate increase in the amount of anechogenic synovial fluid within the intertubercular bursa and scapulohumeral joint, and irregularity of the ossifying bone surface of the intermediate tubercle of the humerus. Computed tomographic (CT) examination revealed a circular hypoattenuating area at the level of the proximal apophysis of the humerus. CT imaging in this case was essential for an early identification of the septic foci and it allowed ultrasound-guided sample from the lesion for the selection of targeted antibiotic therapy.
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Affiliation(s)
- Nicola Scilimati
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy.
| | - Marco Pepe
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
| | - Maria Chiara Pressanto
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
| | - Giovanni Angeli
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
| | - Francesca Beccati
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
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Sage SE, Olive J, Lavoie JP. Occipital condyle defects assessed by radiography or CT can be a normal finding in foals. Vet Radiol Ultrasound 2020; 62:218-224. [PMID: 33315284 DOI: 10.1111/vru.12940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 11/29/2022] Open
Abstract
Age of complete ossification of equine occipital condyles has not been published. Consequently, clinical significance of occipital condyle defects on radiographs or CT scans of young horses remains unknown. The goals of this single-center, retrospective, cross-sectional study were to characterize incidental occipital condyle defects and to define the age of complete ossification. The margin of occipital condyles was classified as regular or with defect(s). Analyses were made on 121 horses, including 106 radiographic and 19 CT studies showing the occipital condyles of horses less than 5 years of age obtained over 6 years in a referral hospital. Neurological signs and outcome were not associated with occipital defects. Horses with regular occipital condyles on radiographs had a median age of 974 days (median interquartile range = 707) compared with 47 days (interquartile range = 106) in the defect group. The odds of finding radiographically regular occipital condyles were 2.6% higher for each additional day of age (P = .011, 95% CI, 0.6-4.7%). In the CT group, univariate analyses demonstrated a significant effect of age on the aspect of occipital condyles (P = .016). Horses with regular occipital condyles were older (median age = 881 days; interquartile range = 1054) than horses with a defect (median age = 109 days, interquartile range = 318). All horses above 156 days (5.1 months) of age and 550 days (18.1 months) of age had regular occipital condyles on radiographic and CT images, respectively. This study describes occipital condyle defects as a potential normal finding in young horses and provides guidelines for interpretation of the occipital condyle ossification process.
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Affiliation(s)
- Sophie Elena Sage
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Julien Olive
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada.,Vet-CT Specialists, Cambridge, UK
| | - Jean-Pierre Lavoie
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
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Lindegaard C, Galen G, Aarsvold S, Berg LC, Verwilghen D. Haematogenous septic arthritis, physitis and osteomyelitis in foals: A tutorial review on pathogenesis, diagnosis, treatment and prognosis. Part 1. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C. Lindegaard
- Department of Veterinary Clinical Sciences Faculty of Health Sciences University of Copenhagen Taastrup Denmark
| | - G. Galen
- School of Veterinary Sciences Faculty of Science University of Sydney Sydney New South Wales Australia
| | - S. Aarsvold
- Puchalski Equine Imaging Petaluma California USA
| | - L. C. Berg
- Department of Veterinary Clinical Sciences Faculty of Health Sciences University of Copenhagen Taastrup Denmark
| | - D. Verwilghen
- School of Veterinary Sciences Faculty of Science University of Sydney Sydney New South Wales Australia
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Clements PE, Jones B, Coomer R. Septic epiphysitis and sequestrum formation in the glenoid of the scapula in a five‐month‐old foal diagnosed by computed tomography. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2019-000837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Becky Jones
- Veterinary Diagnostic ImagingB & W Equine VetsGloucestershireUK
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Pressanto MC, Beccati F, Stefanetti V, Passamonti F, Pilati N, Pepe M. Septic pyomyositis, multiple pelvic osteomyelitis and thrombosis in a Thoroughbred foal. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.13002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. C. Pressanto
- Department of Veterinary Medicine Veterinary Teaching Hospital of the University of Perugia Perugia Italy
| | - F. Beccati
- Department of Veterinary Medicine Veterinary Teaching Hospital of the University of Perugia Perugia Italy
- Sport Horse Study Center Department of Veterinary Medicine University of Perugia Perugia Italy
| | - V. Stefanetti
- Department of Veterinary Medicine Veterinary Teaching Hospital of the University of Perugia Perugia Italy
| | - F. Passamonti
- Department of Veterinary Medicine Veterinary Teaching Hospital of the University of Perugia Perugia Italy
- Sport Horse Study Center Department of Veterinary Medicine University of Perugia Perugia Italy
| | - N. Pilati
- Department of Veterinary Medicine Veterinary Teaching Hospital of the University of Perugia Perugia Italy
| | - M. Pepe
- Department of Veterinary Medicine Veterinary Teaching Hospital of the University of Perugia Perugia Italy
- Sport Horse Study Center Department of Veterinary Medicine University of Perugia Perugia Italy
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Wright L, Puchalski SM, Kristoffersen M, Lindegaard C. Arthroscopic approach and intra-articular anatomy of the equine atlanto-occipital joint. Vet Surg 2018; 47:756-767. [PMID: 30004116 DOI: 10.1111/vsu.12932] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 05/12/2018] [Accepted: 05/30/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To develop arthroscopic approaches to the atlanto-occipital (A-O) and describe associated arthroscopic anatomy. STUDY DESIGN Experimental ex vivo study and clinical case report. ANIMALS Ten equine cadaver joints and 1 clinical case. METHODS CT arthrograms of 8 A-O joints were performed to determine the placement of an arthroscopic portal. Arthroscopy was performed via dorsal and/or ventral approaches (dorsal or ventral to the longissimus capitis tendon) in 10 cadaveric A-O joints and the A-O joint of a 2-week-old foal with septic arthritis. Accessible cartilage was debrided in 3 cadaver joints. Accessibility and risks were assessed by review of arthroscopic images, postoperative necropsy, and computed tomography (CT). RESULTS Dorsal and ventral outpouchings of the A-O joint were identified with CT. Arthroscopy of the dorsal pouch provided access to 50% of the dorsocranial occipital condyle and 15% of the dorsocranial atlas articular surfaces. Joint distension caused displacement of the dura. Dura perforation occurred with a blind dorsal approach in 2 of 5 joints. Dura perforation did not occur after ultrasonography-guided approaches. Arthroscopic debridement of septic arthritis and osteomyelitis was successful in 1 clinical case. CONCLUSION Approaches to the A-O joint were determined from CT examinations. The cranial aspect of the dorsal pouch of the A-O joint was accessed via arthroscopic triangulation in all horses of this study. Ultrasound-guided joint access prevented perforation of vital structures, including the spinal canal. CLINICAL SIGNIFICANCE Advanced imaging improves the diagnosis of A-O joint pathology. Descriptions of arthroscopic anatomy and accessibility provide important information for surgical intervention.
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Affiliation(s)
- Linda Wright
- Evidensia Equine Hospital Helsingborg, Helsingborg, Sweden
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Lean NE, Perkins NR, Ahern BJ. Comparison of conventional radiography and computed tomography as aids in the diagnosis of osteomyelitis in 11 foals. Aust Vet J 2018; 96:257-261. [PMID: 29944745 DOI: 10.1111/avj.12710] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 12/18/2017] [Accepted: 02/13/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Conventional radiography is currently the most common imaging modality used by veterinarians investigating foals with suspected osteomyelitis. Emerging evidence in adult horses and humans suggests computed tomography (CT) is a superior modality for evaluation of osseous changes in general. This study aimed to evaluate the potential benefits of CT versus conventional radiography in cases of osteomyelitis in foals. METHODS Cases of osteomyelitis in foals under 6 months of age admitted over a 6-year period at a single referral hospital that had both CT and conventional radiography images were retrieved. Case details and measurements of the largest area of bone lysis identified in two planes (lateromedial/sagittal and dorsopalmar/dorsal) were evaluated by three veterinarians with a range of experience. RESULTS A significant difference regarding lesion size was seen on the lateromedial (LM) radiographic projections compared with the equivalent sagittal plane CT image. The LM radiographic evaluation resulted in a 37% underestimation of the area of the lesion. Additionally, use of the LM radiographic projections were 2.5-fold more variable in the measurement area compared with CT. In general, regardless of projection, CT produced more information regarding lesion area and, in some cases, detected osseous changes that were not evident on the radiographs. CLINICAL RELEVANCE LM radiographic projections are less reliable and commonly result in an under-appreciation of lesion size and extent. CT detected lesions that were difficult or impossible to identify on radiographs and may allow improved treatment planning.
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Affiliation(s)
- N E Lean
- University of Queensland Equine Specialist Hospital, Outer Ring Rd, Gatton 4343, Queensland, Australia
| | - N R Perkins
- University of Queensland Equine Specialist Hospital, Outer Ring Rd, Gatton 4343, Queensland, Australia
| | - B J Ahern
- University of Queensland Equine Specialist Hospital, Outer Ring Rd, Gatton 4343, Queensland, Australia
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Ogden N, Doyle C, Fraser B, Norton J. Clinical presentation and surgical repair of traumatic lateral patellar luxation associated with a complete tear of the vastus medialis muscle in a neonatal Cob foal. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12854] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- N. Ogden
- School of Veterinary Science; University of Queensland; Gatton Queensland Australia
| | - C. Doyle
- School of Veterinary Science; University of Queensland; Gatton Queensland Australia
| | - B. Fraser
- School of Veterinary Science; University of Queensland; Gatton Queensland Australia
| | - J. Norton
- School of Veterinary Science; University of Queensland; Gatton Queensland Australia
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Savage VL, Cudmore LA, Russell CM, Railton DI, Begg AP, Collins NM, Adkins AR. Intra-abdominal cystic lymphangiomatosis in a Thoroughbred foal. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- V. L. Savage
- Scone Equine Hospital; Scone New South Wales Australia
| | - L. A. Cudmore
- Scone Equine Hospital; Scone New South Wales Australia
| | - C. M. Russell
- Scone Equine Hospital; Scone New South Wales Australia
| | - D. I. Railton
- Scone Equine Hospital; Scone New South Wales Australia
| | - A. P. Begg
- Vetnostics; North Ryde New South Wales Australia
| | - N. M. Collins
- Scone Equine Hospital; Scone New South Wales Australia
| | - A. R. Adkins
- Scone Equine Hospital; Scone New South Wales Australia
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Koskinen M, Hewetson M. Equine laryngeal dysplasia as a cause of acute respiratory distress in a neonatal foal. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | - M. Hewetson
- Department of Companion Animal Clinical Studies; Faculty of Veterinary Science; University of Pretoria; Onderstepoort South Africa
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Beccati F, Gialletti R, Passamonti F, Nannarone S, Di Meo A, Pepe M. Ultrasonographic findings in 38 horses with septic arthritis/tenosynovitis. Vet Radiol Ultrasound 2014; 56:68-76. [PMID: 25046562 DOI: 10.1111/vru.12183] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 04/06/2014] [Indexed: 11/29/2022] Open
Abstract
Septic arthritis/tenosynovitis in the horse can have life-threatening consequences. The purpose of this cross-sectional retrospective study was to describe ultrasound characteristics of septic arthritis/tenosynovitis in a group of horses. Diagnosis of septic arthritis/tenosynovitis was based on historical and clinical findings as well as the results of the synovial fluid analysis and/or positive synovial culture. Ultrasonographic findings recorded were degree of joint/sheath effusion, degree of synovial membrane thickening, echogenicity of the synovial fluid, and presence of hyperechogenic spots and fibrinous loculations. Ultrasonographic findings were tested for dependence on the cause of sepsis, time between admission and beginning of clinical signs, and the white blood cell counts in the synovial fluid. Thirty-eight horses with confirmed septic arthritis/tenosynovitis of 43 joints/sheaths were included. Degree of effusion was marked in 81.4% of cases, mild in 16.3%, and absent in 2.3%. Synovial thickening was mild in 30.9% of cases and moderate/severe in 69.1%. Synovial fluid was anechogenic in 45.2% of cases and echogenic in 54.8%. Hyperechogenic spots were identified in 32.5% of structures and fibrinous loculations in 64.3%. Relationships between the degree of synovial effusion, degree of the synovial thickening, presence of fibrinous loculations, and the time between admission and beginning of clinical signs were identified, as well as between the presence of fibrinous loculations and the cause of sepsis (P ≤ 0.05). Findings indicated that ultrasonographic findings of septic arthritis/tenosynovitis may vary in horses, and may be influenced by time between admission and beginning of clinical signs.
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Affiliation(s)
- Francesca Beccati
- Centro di Studi del Cavallo Sportivo, Dipartimento di Medicina Veterinaria, Università degli Studi di Perugia, Italy
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