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Lenoir A, Schramme M, Segard‐Weisse E, Zimmerman M, Lepage OM. Tenectomy of the superficial digital flexor tendon as a treatment of suspected septic tendinitis and tenosynovitis of the digital flexor tendon sheath followed by rehabilitation with an orthotic device. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A. Lenoir
- Centre for Equine Health Ecole Nationale Vétérinaire de Lyon VetAgro Sup University of Lyon Marcy‐l’Etoile France
| | - M. Schramme
- Centre for Equine Health Ecole Nationale Vétérinaire de Lyon VetAgro Sup University of Lyon Marcy‐l’Etoile France
| | - E. Segard‐Weisse
- Centre for Equine Health Ecole Nationale Vétérinaire de Lyon VetAgro Sup University of Lyon Marcy‐l’Etoile France
| | - M. Zimmerman
- Centre for Equine Health Ecole Nationale Vétérinaire de Lyon VetAgro Sup University of Lyon Marcy‐l’Etoile France
| | - O. M. Lepage
- Centre for Equine Health Ecole Nationale Vétérinaire de Lyon VetAgro Sup University of Lyon Marcy‐l’Etoile France
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Magri C, Schramme M, Nottrott K, Schweizer‐Gorgas D, Segard E, Kelly G, Schumacher J. Coronoidectomy as a treatment for mandibular immobility caused by fracture of the coronoid process in three horses. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C. Magri
- Clinéquine VetAgro Sup Marcy l’Etoile France
| | - M. Schramme
- Clinéquine VetAgro Sup Marcy l’Etoile France
| | - K. Nottrott
- Clinéquine VetAgro Sup Marcy l’Etoile France
| | - D. Schweizer‐Gorgas
- Section of Diagnostic Imaging Vetsuisse Faculty University of Berne Berne Switzerland
| | - E. Segard
- Clinéquine VetAgro Sup Marcy l’Etoile France
| | - G. Kelly
- Fethard Equine Hospital Fethard Tipperary Ireland
| | - J. Schumacher
- Department of Large Animal Clinical Sciences College of Veterinary Medicine University of Tennessee Knoxville Tennessee USA
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Adair S, Baus M, Bell R, Boero M, Bussy C, Cardenas F, Casey T, Castro J, Davis W, Erskine M, Farr R, Fischer A, Forbes B, Ford T, Genovese R, Gottschalk R, Hoge M, Honnas C, Hunter G, Joyce J, Kaneps A, Keegan K, Kramer J, Labens R, Lischer C, Marshall J, Oosterlinck M, Radue P, Redding R, Reed S, Rick M, Santschi E, Schoonover M, Schramme M, Schumacher J, Stephenson R, Thaler R, Nielsen JV, Wilson D. Letter to the Editor: A response to 'What is lameness and what (or who) is the gold standard to detect it?'. Equine Vet J 2018; 51:270-272. [PMID: 30570777 DOI: 10.1111/evj.13043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Adair
- University of Tennessee, Knoxville, Tennessee, USA
| | - M Baus
- Gran Prix Equine, Hawleyville, Connecticut, USA
| | - R Bell
- Park Equine Hospital, Lexington, Kentucky, USA
| | | | - C Bussy
- Clinique Vétérinaire du Grand Renaud, Saint Saturnin, France
| | - F Cardenas
- 3H Equine Hospital and Mobile Veterinary Services, New Hill, North Carolina, USA
| | - T Casey
- Fourways Equine Clinic, Johannesburg, South Africa
| | - J Castro
- Davie County Large Animal Hospital, Mocksville, North Carolina, USA
| | - W Davis
- Palm Beach Equine Clinic, Wellington, Florida, USA
| | - M Erskine
- Virginia Tech, Leesburg, Virginia, USA
| | - R Farr
- Farr and Pursey Equine Veterinary Services, Aldbury, Hertfordshire, UK
| | - A Fischer
- Chino Valley Equine Hospital, Chino Hills, California, USA
| | - B Forbes
- Singapore Turf Club, Singapore, Singapore
| | - T Ford
- Ford Veterinary Surgery Center, Clovis, California, USA
| | - R Genovese
- Cleveland Equine Clinic, Ravenna, Ohio, USA
| | - R Gottschalk
- Witbos Veterinary Clinic, Blue Hills AH, South Africa
| | - M Hoge
- Murrieta Equine, Murrieta, California, USA
| | - C Honnas
- Texas Equine Hospital, Bryan, Texas, USA
| | - G Hunter
- Ardene House Veterinary Practice, Aberdeen, UK
| | - J Joyce
- Total Equine Veterinary Associates, Leesburg, Virginia, USA
| | - A Kaneps
- Kaneps Equine Sports Medicine and Surgery, Beverly, Massachusetts, USA
| | - K Keegan
- University of Missouri, Columbia, Missouri, USA
| | - J Kramer
- University of Missouri, Columbia, Missouri, USA
| | - R Labens
- Charles Sturt University, Albury, New South Wales, Australia
| | - C Lischer
- Freie Universität Berlin, Berlin, Germany
| | | | | | - P Radue
- Damascus Equine Associates, Mount Airy, Maryland, USA
| | - R Redding
- North Carolina State University, Raleigh, North Carolina, USA
| | - S Reed
- Ohio State University, Columbus, Ohio, USA
| | - M Rick
- Alamo Pintado Equine Medical Centre, Los Olivos, California, USA
| | - E Santschi
- Kansas State University, Manhattan, Kansas, USA
| | - M Schoonover
- Oklahoma State University, Stillwater, Oklahoma, USA
| | | | | | | | - R Thaler
- Metamora Equine PC, Metamora, Michigan, USA
| | - J V Nielsen
- Ansager Veterinary Hospital, Ansager, Denmark
| | - D Wilson
- University of Missouri, Columbia, Missouri, USA
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Adair S, Baus M, Belknap J, Bell R, Boero M, Bussy C, Cardenas F, Casey T, Castro J, Davis W, Erskine M, Farr R, Fischer T, Forbes B, Ford T, Genovese R, Gottschalk R, Hoge M, Honnas C, Hunter G, Joyce J, Kaneps A, Keegan K, Kramer J, Lischer C, Marshall J, Oosterlinck M, Radue P, Redding R, Reed SK, Rick M, Santschi E, Schoonover M, Schramme M, Schumacher J, Stephenson R, Thaler R, Vedding Neilsen J, Wilson DA. Response to Letter to the Editor: Do we have to redefine lameness in the era of quantitative gait analysis. Equine Vet J 2018; 50:415-417. [PMID: 29633362 DOI: 10.1111/evj.12820] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S Adair
- University of Tennessee, USA
| | - M Baus
- Gran Prix Equine, Connecticut, USA
| | | | - R Bell
- Park Equine Hospital, Kentucky, USA
| | | | | | - F Cardenas
- 3H Equine Hospital and Mobile Veterinary Services, North Carolina, USA
| | - T Casey
- Fourways Equine Clinic, South Africa
| | | | - W Davis
- Palm Beach Equine Clinic, Florida, USA
| | | | - R Farr
- Farr and Pursey Equine Veterinary Services, Hertfordshire, UK
| | - T Fischer
- Chino Valley Equine Hospital, California, USA
| | | | - T Ford
- Ford Veterinary Surgery Center, California, USA
| | | | | | - M Hoge
- Murrieta Equine, California, USA
| | | | - G Hunter
- Ardene House Veterinary Practice, Aberdeen, UK
| | - J Joyce
- Total Equine Veterinary Associates, Virginia, USA
| | - A Kaneps
- Kaneps Equine Sports Medicine and Surgery, Massachusetts, USA
| | | | | | | | | | | | - P Radue
- Damascus Equine Associates, Maryland, USA
| | - R Redding
- North Carolina State University, USA
| | | | - M Rick
- Alamo Pintado Equine Medical Centre, California, USA
| | | | | | | | | | | | - R Thaler
- Metamora Equine PC, Michigan, USA
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Moulin N, Schramme M, François I, Castelijns G, Belluco S. Long‐term outcome of treatment of a squamous cell carcinoma of the foot by amputation of the distal limb in a pony. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.12925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- N. Moulin
- Pole Equin VetAgro Sup Université de Lyon Marcy L'Etoile France
| | - M. Schramme
- Pole Equin VetAgro Sup Université de Lyon Marcy L'Etoile France
| | | | - G. Castelijns
- Equihealth Veterinarios La Roca del Vallés, Barcelona Spain
| | - S. Belluco
- Pole Equin VetAgro Sup Université de Lyon Marcy L'Etoile France
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Affiliation(s)
- M. Schramme
- Clinéquine; VetAgro Sup; Campus Vétérinaire de Lyon; University of Lyon; France
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Nottrott K, De Guio C, Khairoun A, Schramme M. An ultrasound-guided, tendon-sparing, lateral approach to injection of the navicular bursa. Equine Vet J 2017; 49:655-661. [PMID: 28128875 DOI: 10.1111/evj.12673] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 01/16/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Navicular disease in the horse often requires injection of the navicular bursa. We have developed an ultrasound-guided, lateral needle approach to navicular bursocentesis, which avoids penetration of the deep digital flexor tendon (DDFT) and the need for radiographic control. OBJECTIVES To describe and evaluate the feasibility and efficacy of an ultrasound-guided, lateral bursocentesis technique. STUDY DESIGN Cadaveric and in vivo experiments. METHODS The navicular bursa in 62 cadaveric forelimbs of 31 horses and in both forelimbs of 26 live horses, positioned with the foot flexed in a navicular block, were submitted to lateral, ultrasound-guided injection of 1.5 ml radiocontrast agent. Lateromedial radiographs were taken to locate the contrast. A second injection of 0.5 ml methylene blue was administered during needle withdrawal in cadaveric limbs to investigate the needle pathway during dissection. RESULTS Contrast agent was successfully deposited in the navicular bursa in 104 of 114 (91%) limbs and in the navicular bursa alone in 89 of 114 (78%) limbs. Dissection showed no evidence of penetration of the DDFT in cadaver limbs. Failure to inject the navicular bursa was significantly associated with poor quality of the ultrasound image (P = 0.04) and resulted in aberrant injection of the distal interphalangeal joint in five of 114 (4%) limbs, the peribursal soft tissues in four of 114 (4%) limbs and the digital flexor tendon sheath in one of 114 (0.9%) limbs. Synovial fluid was observed at the needle hub in 58% of live horses. MAIN LIMITATIONS It is unknown whether injection results obtained in the limbs of horses without disease can be extrapolated to horses with clinical disease of the podotrochlear apparatus. The localisation of contrast medium on radiographs may not accurately reflect the behaviour of local anaesthetic solution or therapeutic medications injected in the navicular bursa. CONCLUSIONS This lateral, ultrasound-guided technique for injecting the navicular bursa is effective, does not penetrate the DDFT and avoids exposure of personnel to radiation.
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Affiliation(s)
- K Nottrott
- Pole Equin, VetAgro Sup, Marcy L'Étoile, France
| | - C De Guio
- Pole Equin, VetAgro Sup, Marcy L'Étoile, France
| | - A Khairoun
- Pole Equin, VetAgro Sup, Marcy L'Étoile, France
| | - M Schramme
- Pole Equin, VetAgro Sup, Marcy L'Étoile, France
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Sava MM, Boulocher C, Matei C, Munteanu B, Schramme M, Viguier E, Roger T, Berthier Y, Blanchin MG, Trunfio-Sfarghiu AM. Structural and tribological study of healthy and biomimetic SF. Comput Methods Biomech Biomed Engin 2013; 16 Suppl 1:216-8. [DOI: 10.1080/10255842.2013.815866] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Close K, Gerard M, Davidson G, Schramme M. Successful treatment of infectious (Salmonella type III: 44) polyarthritis and osteomyelitis in a 4-week-old foal. EQUINE VET EDUC 2010. [DOI: 10.1111/j.2042-3292.2010.00152.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Blunden A, Dyson S, Murray R, Schramme M. Histopathology in horses with chronic palmar foot pain and age-matched controls. Part 2: The deep digital flexor tendon. Equine Vet J 2010; 38:23-7. [PMID: 16411582 DOI: 10.2746/042516406775374342] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY Causes of palmar foot pain and the aetiopathogenesis of navicular disease remain poorly understood, despite the high incidence of foot-related lameness. HYPOTHESES Abnormalities of the deep digital flexor tendon (DDFT) may contribute to palmar foot pain; ageing degenerative changes may be seen in horses free from lameness; and horses with lameness are likely to have a greater severity of abnormalities than age-matched horses with no history of foot pain. METHODS Feet were selected from horses with a history of uni- or bilateral forelimb lameness of at least 2 months' duration. Histology of the DDFT from the level of the proximal interphalangeal joint to its insertion were examined and the severity of lesions for each site graded. Associations between lesions of the navicular bone, collateral sesamoidean ligaments (CSL), distal sesamoidean impar ligament, navicular bursa, distal interphalangeal (DIP) joint synovium and collateral ligaments of the DIP joint and DDFT were assessed. RESULTS There was no relationship between age and grade of histological abnormality of the DDFT. There were significant histological differences between groups for lesions of the dorsal layers of the DDFT, but not for lesions of the palmar aspect. There were significant associations between histological grades for the superficial dorsal layer of the DDFT and flexor aspect of the navicular bone; and between the deep dorsal layer of the DDFT and the proximal border and medulla of the navicular bone. The navicular bursa grade was correlated with grades for the superficial dorsal, deep dorsal and deep palmar layers of the DDFT. The histological grades for the CSL and the superficial dorsal layer of the DDFT were also associated. CONCLUSIONS Pathological abnormalities in lame horses often involved the DDFT in addition to the navicular bone. Vascular and matrix changes may precede changes in the fibrocartilage of the navicular bone. POTENTIAL RELEVANCE Identification of factors leading to vascular changes within the interstitium of the DDFT and changes in matrix composition, may help in future management of palmar foot pain.
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Affiliation(s)
- A Blunden
- Centre for Preventive Medicine, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK
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Schumacher J, Schumacher J, de Graves F, Steiger R, Schramme M, Smith R, Coker M. A comparison of the effects of two volumes of local analgesic solution in the distal interphalangeal joint of horses with lameness caused by solar toe or solar heel pain. Equine Vet J 2010; 33:265-8. [PMID: 11352348 DOI: 10.2746/042516401776249778] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The response of horses, with solar pain in the dorsal or palmar aspect of the foot, to 6 or 10 ml local analgesic solution administered into the distal interphalangeal (DIP) joint was examined. Lameness was induced in 7 horses by creating solar pain in the dorsal aspect of one forefoot and, at another time, the palmar aspect of the other forefoot with set-screws inserted into a custom-made shoe. Horses were videotaped trotting before and after application of set-screws and, in separate trials, after 6 or 10 ml local analgesic solution was administered into the DIP joint. Lameness scores were assigned by examining videotaped gaits. Scores were significantly lower (P < 0.05) for horses with set-screws applied to the angles of the sole and receiving 10 ml, but not 6 ml, local analgesic solution into the DIP joint. Scores were significantly lower (P < 0.05) for all horses with set-screws in the dorsal margin of the sole receiving either volume of local analgesic solution. Analgesia of the DIP joint was less effective in desensitising the angles of the sole than in desensitising the dorsal margin of the sole, and 10 ml local analgesic solution was more effective than 6 ml in desensitising these regions. The response of horses with solar pain to local analgesic solution in the DIP joint was influenced by the volume administered and the region of sole affected.
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Affiliation(s)
- J Schumacher
- Department of Large Animal Surgery and Medicine, College of Veterinary Medicine, Auburn University, Alabama 36849-5522, USA
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Abstract
REASONS FOR PERFORMING STUDY There have been no previously published case series of horses examined using either scintigraphy or MRI to diagnose collateral ligament injuries not detectable using ultrasonography or radiography, nor have other concurrent soft tissue lesions been described. OBJECTIVES To describe the clinical features of horses with desmitis of the collateral ligaments of the distal interphalangeal (DIP) joint and to evaluate the results of radiographic, ultrasonographic, scintigraphic and magnetic resonance imaging (MRI) examinations. METHODS Horses were examined between January 2001 and January 2003 and were selected for inclusion in the study if there was unequivocal evidence of collateral desmitis of the DIP joint based on ultrasonography or MRI. Subject details, case history, results of clinical examination and responses to local analgesic techniques were reviewed. The results of radiographic, ultrasonographic, scintigraphic and MRI examinations were assessed. RESULTS Eighteen horses were identified with desmitis of a collateral ligament of the DIP joint, 3 horses (Group 1) based on ultrasonography alone, 7 (Group II) with positive ultrasonographic and magnetic resonance images and 8 (Group III) with no lesion detectable using ultrasonography, but lesions identified using MRI. Seventeen horses had forelimb injuries and one a hindlimb injury. The medial collateral ligament was injured most frequently (13 horses). In the majority of horses, no localising clinical signs were seen. Lameness was invariably worse in circles compared with straight lines. Lameness was improved by palmar digital analgesia in 16 horses (87%), but only 6 were nonlame. Intra-articular analgesia of the DIP joint produced improvement in lameness in 6/15 horses (40%). In 16 horses, no radiographic abnormality related to the DIP joint or collateral ligament attachments was identified. Eight of 14 horses (57%) had focal, moderately or intensely increased radiopharmaceutical uptake (IRU) at the site of insertion of the injured collateral ligament on the distal phalanx. Alteration in size and signal in the injured collateral ligament was identified using MRI. In addition, 5 horses had abnormal mineralisation and fluid in the distal phalanx at the insertion of the ligament. Eleven horses had concurrent soft tissue injuries involving the deep digital flexor tendon, distal sesamoidean impar ligament, navicular bursa or collateral ligament of the navicular bone. CONCLUSIONS AND POTENTIAL RELEVANCE Collateral desmitis of the DIP joint should be considered as a cause of foot lameness. Although some injuries are detectable ultrasonographically, false negative results occur. Focal IRU at the ligament insertion on the distal phalanx may be indicative of injury in some horses. MRI is useful for both characterisation of the injury and identification of any concurrent injuries. Further follow-up information is required to determine factors influencing prognosis.
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Affiliation(s)
- S J Dyson
- Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK
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Abstract
This case report describes a rare epitrichial sweat gland ductal carcinoma in a 14-year-old horse and is the first report of multiple carcinomas of this type in horses. Although several tumours developed, mostly on the distal extremities, over a 2-year period, the horse remained otherwise healthy. Topical treatment with imiquimod was successful for many of them.
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Affiliation(s)
- L M Cihocki
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York 14853, USA
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Blunden A, Dyson S, Murray R, Schramme M. Histopathology in horses with chronic palmar foot pain and age-matched controls. Part 1: Navicular bone and related structures. Equine Vet J 2006; 38:15-22. [PMID: 16411581 DOI: 10.2746/042516406775374298] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY Causes of palmar foot pain and the aetiopathogenesis of navicular disease remain poorly understood, despite the high incidence of foot-related lameness. HYPOTHESES Abnormalities of the collateral sesamoidean ligaments (CSLs), distal sesamoidean impar ligament (DSIL), deep digital flexor tendon (DDFT), navicular bone, navicular bursa, distal interphalangeal (DIP) joint or collateral ligaments (CLs) of the DIP joint may contribute to palmar foot pain. METHODS Feet were selected from horses with a history of unilateral or bilateral forelimb lameness of at least 2 months' duration that was improved by perineural analgesia of the palmar digital nerves, immediately proximal to the cartilages of the foot (Group 1, n = 32); or from age-matched control horses (Group 2, n = 19) that were humanely destroyed for other reasons and had no history of forelimb foot pain. Eight units of tissue were collected for histology: the palmar half of the articular surface of the distal phalanx, including the insertions of the DDFT and DSIL; navicular bone and insertion of the CSLs; DDFT from the level of the proximal interphalangeal (PIP) joint to 5 mm proximal to its insertion; synovial membrane from the palmar pouch of the DIP joint and the navicular bursa; CLs of the DIP joint and DSIL. The severity of histological lesions for each site were graded. Results were compared between Groups 1 and 2. RESULTS There was no relationship between age and grade of histological abnormality. There were significant histological differences between groups for lesions of the flexor aspect, proximal and distal borders, and medulla of the navicular bone; the DSIL and its insertion and the navicular bursa; but not for lesions of the CSLs, the dorsal aspect of the navicular bone, distal phalanx and articular cartilage, synovium or CLs of the DIP joint. CONCLUSIONS Pathological abnormalities in lame horses often involved not only the navicular bone, but also the DSIL and navicular bursa. Abnormalities of the navicular bone medulla were generally only seen dorsal to lesions of the FFC. POTENTIAL RELEVANCE Adaptive and reactive change may be occurring in the navicular apparatus in all horses to variable degrees and determination of the pathogenesis of lesions that lead to pain and biomechanical dysfunction should assist specific preventative or treatment protocols.
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Affiliation(s)
- A Blunden
- Centre for Preventive Medicine, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK
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Dyson S, Murray R, Schramme M, Branch M. Lameness in 46 horses associated with deep digital flexor tendonitis in the digit: diagnosis confirmed with magnetic resonance imaging. Equine Vet J 2004; 35:681-90. [PMID: 14649360 DOI: 10.2746/042516403775696294] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY The differential diagnosis of foot pain has long proved difficult and the use of magnetic resonance imaging (MRI) offers the opportunity to further the clinical understanding of the subject. OBJECTIVES To determine the incidence of deep digital flexor tendon (DDFT) injuries in a series of 75 horses with lameness associated with pain localised to the digit, with no significant detectable radiographic or ultrasonographic abnormalities, using MRI; and to describe a variety of lesion types and relate DDF tendonitis with anamnesis, clinical features, response to local analgesic techniques and nuclear scintigraphic and ultrasonographic findings. METHODS All horses undergoing MRI of the front feet between January 2001 and October 2002 were reviewed and those with DDFT injuries categorised according to lesion type; horses with primary tendonitis (Group I) and those with concurrent abnormalities of the navicular bone considered to be an important component of the lameness (Group II). The response to perineural analgesia of the palmar digital nerves and palmar (abaxial sesamoid) nerves, intra-articular analgesia of the distal interphalangeal (DIP) joint and analgesia of the navicular bursa were reviewed. The result of ultrasonography of the pastern and foot was recorded. Lateral, dorsal and solar pool and bone phase nuclear scintigraphic images were assessed subjectively and objectively using region of interest (ROI) analysis. RESULTS Forty-six (61%) of 75 horses examined using MRI had lesions of the DDFT considered to be a major contributor to lameness. Thirty-two horses (43%) had primary DDFT injuries and 14 (19%) a combination of DDF tendonitis and navicular bone pathology. Lesions involved the insertional region of the tendon alone (n = 3), were proximal to the navicular bone (n = 23) or were at a combination of sites (n = 20). Lesion types included core lesions, focal and diffuse dorsal border lesions, sagittal plane splits, insertional injuries and lesions combined with other soft tissue injuries. Many horses had a combination of lesion types. Lameness was abolished by palmar digital analgesia in only 11 of 46 horses (24%). Twenty-one of 31 horses (68%) in Group I showed > 50% improvement in lameness after intra-articular analgesia of the DIP joint, whereas 11 of 12 horses (92%) in Group II had a positive response. Twelve of 18 horses (67%) in Group I had a positive response to analgesia of the navicular bursa. Nineteen horses had lesions of the DDFT extending proximal to the proximal interphalangeal joint seen using MRI, but these were identified ultrasonographically in only 2 horses. Scintigraphic abnormalities suggestive of DDFT injury were seen in 16 of 41 horses (41%), 8 in pool phase images and 8 in bone phase images. CONCLUSIONS AND POTENTIAL RELEVANCE DDFT injuries are an important cause of lameness associated with pain arising from the digit in horses without detectable radiographic abnormalities. Lameness is not reliably improved by palmar digital analgesia, but may be improved by intra-articular analgesia of the DIP joint in at least 68% of horses. Ultrasonography is not sensitive in detecting lesions of the DDFT in the distal pastern region, but a combination of pool and bone phase scintigraphic images of the digit is helpful in some horses. Further follow-up information is required to determine the prognosis for horses with lesions of the DDFT in the digit and to establish whether this is related to lesion severity and/or location.
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Affiliation(s)
- S Dyson
- Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK
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Schumacher J, Schumacher J, Gillette R, DeGraves F, Schramme M, Smith R, Perkins J, Coker M. The effects of local anaesthetic solution in the navicular bursa of horses with lameness caused by distal interphalangeal joint pain. Equine Vet J 2003; 35:502-5. [PMID: 12875330 DOI: 10.2746/042516403775600460] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY Analgesia of the palmar digital (PD) nerves has been demonstrated to cause analgesia of the distal interphalangeal (DIP) joint as well as the sole. Because the PD nerves lie in close proximity to the navicular bursa, we suspected that that analgesia of the navicular bursa would anaesthetise the PD nerves, which would result in analgesia of the DIP joint. OBJECTIVES To determine the response of horses with pain in the DIP joint to instillation of local anaesthetic solution into the navicular bursa. METHODS Lameness was induced in 6 horses by creating painful synovitis in the DIP joint of one forefoot by administering endotoxin into the joint. Horses were videorecorded while trotting, before and after induction of lameness, at three 10 min intervals after instilling 3.5 ml local anaesthetic solution into the navicular bursa and, finally, after instilling 6 ml solution into the DIP joint. Lameness scores were assigned by grading the videorecorded gaits subjectively. RESULTS At the 10 and -20 min observations, median lameness scores were not significantly different from those before administration of local anaesthetic solution into the navicular bursa (P > or = 0.05), although lameness scores of 3 of 6 horses improved during this period, and the 20 min observation scores tended toward significance (P = 0.07). At the 30 min observation, and after analgesia of the DIP joint, median lameness scores were significantly improved (P < or = 0.05). CONCLUSIONS These results indicate that pain arising from the DIP joint can probably be excluded as a cause of lameness, when lameness is attenuated within 10 mins by analgesia of the navicular bursa. POTENTIAL RELEVANCE Pain arising from the DIP joint cannot be excluded as a cause of lameness when lameness is attenuated after 20 mins after analgesia of the navicular bursa.
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Affiliation(s)
- John Schumacher
- Department of Large Animal Surgery and Medicine, College of Veterinary Medicine, Auburn University, Alabama, USA
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Cardwell J, Smith K, Whitwell K, Thomas R, Schramme M, Montesso F. 32. Intersexuality in three foals: clinical, pathological and cytogenetic investigations. Res Vet Sci 2003. [DOI: 10.1016/s0034-5288(03)90031-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
REASONS FOR PERFORMING STUDY Foot pain is a common cause of equine lameness and there have been significant limitations of the methods available for the diagnosis of the causes of foot pain (radiography, nuclear scintigraphy and ultrasonography). Until recently, magnetic resonance imaging (MRI) in the horse has been limited to examination of cadaver limbs. OBJECTIVES Our purpose was to 1) describe MRI of the foot in live horses, 2) describe MRI findings in horses with foot pain in which a definitive diagnosis could not be established by alternative means and 3) correlate MRI findings with other methods of clinical investigation. METHODS The feet of 15 horses with unilateral (12) or bilateral (3), forelimb (14) or hindlimb (1) lameness associated with foot pain of previously ill-defined origin were examined using MRI. The horses were examined in right lateral recumbency under general anaesthesia, with the feet positioned in the isocentre of a flared end 1.5 Tesla GE Signa Echospeed magnet. Images were obtained in sagittal, transverse and dorsal planes using 3-dimensional (3D) T2* gradient echo (GRE), spoiled gradient echo, fat-saturated 3D T2* GRE and short inversion recovery sequences. Image acquisition took approximately 1 h. RESULTS Abnormalities of the distal interphalangeal joint (DIP) cartilage and/or subchondral bone, periarticular osteophyte formation, distension of the DIP joint capsule with or without synovial proliferation, distension of the navicular bursa with or without evidence of chronic inflammation, surface and core lesions in the deep digital flexor tendon, abnormal signal within the navicular bone, evidence of mineralised fragments in the distal sesamoidean impar ligament, irregular outline of and signal in the medial cortex of the distal phalanx, and an abnormal signal on the dorsal aspect of the distal phalanx consistent with laminitis were identified. CONCLUSIONS MRI permits the diagnosis of a variety of lesions involving different structures within the foot that cannot be diagnosed using other means, thus enhancing our knowledge of the causes of foot pain. POTENTIAL RELEVANCE With further experience it is likely that lesions involving other structures will also be identified. Long-term follow-up data is required to determine the prognosis for the injuries described.
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Affiliation(s)
- S Dyson
- Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU
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Abstract
The purpose of this study was to investigate biochemical changes in synovial fluid in navicular disease, and to establish if synovial fluid from the distal interphalangeal joint (DIP) could be used diagnostically to assess alterations in the synovial fluid of the navicular bursa. Cartilage oligomeric matrix protein (COMP), total glycosaminoglycans (GAG), hyaluronan (HA), metalloproteinases 2 and -9 (MMP-2 and MMP-9) and total protein (TP) levels were determined in synovial fluids obtained from 18 navicular bursae and 35 DIP -joints from animals suffering from navicular disease, and the same synovial structures in 16 joints of horses with no evidence of abnormalities involving the foot. To avoid dilution effects, GAG/COMP, HA/COMP, MMP-2/ COMP and MMP-9/COMP ratios were also calculated for different synovial cavities. There was a good correlation, for COMP, GAG, HA, MMP-2 and TP levels, between synovial fluid from the navicular bursa and fluid from the DIP -joint in healthy animals. However, in animals with navicular disease, only COMP levels showed no difference between the navicular bursal fluid and the DIP-joint fluid concentration. Thus, enabling the use of COMP to standardise other biochemical concentration measurements from the synovial joint fluids. In horses with navicular disease, there was a significantly lower absolute concentration of GAG, and a significantly lower GAG/COMP ratio, in the synovial fluid of the navicular bursa and the DIP-joint compared to synovial fluid from the same joints from healthy horses. In contrast, the absolute HA concentration and HA/ COMP, MMP-2/COMP and MMP-9/COMP ratios were higher in synovial fluid from the DIP-joint of horses with navicular disease, and MMP-2 and MMP-9 relative activity levels and MMP-2/COMP and MMP-9/ COMP ratios were increased in fluid from navicular bursae in horses with navicular disease when compared to a control group.
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Affiliation(s)
- M Viitanen
- Farm Animal and Equine Medicine and Surgery, Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Herts, AL 9 7 TA, UK.
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Schramme M. Equine magnetic resonance imaging research. Vet Rec 2001; 149:96. [PMID: 11497410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Schumacher J, Schumacher J, de Graves F, Schramme M, Smith R, Coker M, Steiger R. A comparison of the effects of local analgesic solution in the navicular bursa of horses with lameness caused by solar toe or solar heel pain. Equine Vet J 2001; 33:386-9. [PMID: 11469772 DOI: 10.2746/042516401776249543] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We hypothesised that analgesia of the navicular bursa is not selective for the navicular apparatus; and that solar pain in some horses can be temporarily abolished or attenuated by analgesia of the navicular bursa. To test this hypothesis, we caused lameness in horses by inducing pain in the dorsal margin or the angles of the sole and then evaluated the ability of a local analgesic solution administered into the navicular bursa to attenuate lameness. The response of horses with solar pain in the dorsal or palmar aspect of the foot to 3.5 ml local analgesic solution administered into the navicular bursa was examined. Lameness was induced in 6 horses by creating solar pain in the dorsal aspect of one forefoot and, at another time, the palmar aspect of the other forefoot, with set-screws inserted into a custom-made shoe. Horses were videotaped trotting before and after application of set-screws and after administering 3.5 ml local analgesic solution into the navicular bursa. Lameness scores were assigned by examining videotaped gaits. Scores were significantly lower (P<0.05) for all horses with set-screws applied to the dorsal margin of the sole after administration of local analgesic solution into the navicular bursa. In conclusion, analgesia of the navicular bursa was less effective in desensitising the angles of the sole than in desensitising the dorsal margin of the sole. Pain arising from the sole should not be excluded as a cause of lameness when lameness is attenuated by analgesia of the navicular bursa.
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Affiliation(s)
- J Schumacher
- Department of Large Animal Surgery and Medicine, College of Veterinary Medicine, Auburn University Alabama 36849-5522, USA
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Vandaele MM, Richert B, Van der Endt JD, Boyden B, Brochez L, del Marmol V, De Boulle K, Garmyn M, Laporte M, Maselis I, Pirard C, Roseeuw D, Schramme M, Tromme I. Melanoma screening: results of the first one-day campaign in Belgium ('melanoma Monday'). J Eur Acad Dermatol Venereol 2000; 14:470-2. [PMID: 11444268 DOI: 10.1046/j.1468-3083.2000.00127.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Although the incidence of melanoma is increasing and many informative campaigns have been organized. The general population is still little informed about this tumour. AIMS To organize a media campaign, with more relevant information and the opportunity for free skin inspections. METHODS A 'Task Force' organized a media campaign in April 1999 and convinced 65% of the Belgian dermatologists to give up 4 h of their time to do free skin examinations for skin cancer on Monday 26 April 1999; it was called 'Melanoma Monday'. RESULTS A total 2767 patients were screened. We found 25 melanomas and suspected 59 basal cell carcinomas. In the following 4 weeks another 141 melanomas were found. These 166 melanomas found in one month represent 15-20% of the total number of melanomas per year in Belgium. SUMMARY A media campaign with relevant information combined with screening opportunities can lead to the early detection of melanomas in a large number of patients and can continue to alert people at risk in the following weeks.
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Schumacher J, Steiger R, Schumacher J, de Graves F, Schramme M, Smith R, Coker M. Effects of analgesia of the distal interphalangeal joint or palmar digital nerves on lameness caused by solar pain in horses. Vet Surg 2000; 29:54-8. [PMID: 10653495 DOI: 10.1111/j.1532-950x.2000.00054.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine if pain of the dorsal margin of the sole in horses can be attenuated by anesthesia of either the distal interphalangeal (DIP) joint or the palmar digital (PD) nerves. STUDY DESIGN A unilateral forelimb lameness was induced by creating solar pain. Response to administration of local anesthetic or saline solution into the DIP joint and to administration of local anesthetic around the PD nerves was evaluated. ANIMALS Six horses. METHODS Lameness was induced by creating pressure on the dorsal margin of the sole by screwing set-screws into a nut welded to the inside of each branch of a shoe. Gaits were evaluated before and after application of set-screws and after a local anesthetic or saline solution was administered into the DIP joint and, in a second trial, after a local anesthetic was injected around the PD nerves. Gaits recorded on videotape were evaluated, and lameness scores were assigned to each gait. RESULTS Lameness scores were high after application of set-screws and remained high after saline solution was administered into the DIP joint. Scores decreased significantly (P < or = .05) after a local anesthetic was administered into the DIP joint or around the PD nerves. CONCLUSIONS Analgesia of the DIP joint or the PD nerves desensitizes at least a portion of the sole. CLINICAL RELEVANCE Pain arising from the sole should not be excluded as a cause of lameness when lameness is attenuated by analgesia of the DIP joint or PD nerves.
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Affiliation(s)
- J Schumacher
- Department of Large Animal Surgery and Medicine, College of Veterinary Medicine, Auburn University, AL 36849-5522, USA
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