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Occult Subchondral Osseous Cyst-like Lesions as reason for lameness
Lameness is a very common problem in horses, and it can be hard to find the origin of the problem. One possibility for lameness affecting the hind legs are cysteous lesions in the tarsus which are invisible on X-rays. They need CT or scintigraphy to become diagnosed...

In this retrospective study, clinical signs, diagnosis, management, and outcome of horses with occult sub-chondral osseous cyst-like lesions of the tarsocrural joint are evaluated.
Twelve horses with subchondral osseous cyst-like lesions (SOCLs) in the tarsocrural joint were included.

Information about history, examination findings, diagnostic techniques, and surgical procedures as obtained from medical records. Outcome was determined by patient re-evaluation and telephone communication with the referring veterinarian, owner, or trainer.

Results: Horses were aged from 3 to 29 years. Lameness (2 weeks to 1 year) varied from moderate to severe.
Synovial fluid analyses (9 horses) yielded changes consistent with suppurative inflammation and positive bacterial culture was obtained in 4 horses.
Eight of 9 horses that had intra-articular analgesia had a dramatic reduction in lameness.

No abnormalities were detected on tarsal radiographs in 10 horses.

Scintigraphy identified foci of increased radiopharmaceutical uptake in the distal tibia or talus of all horses, and the lesion was further characterized by computed tomography in 7 horses.

SOCLs were identified in the medial malleolus (5), intertrochlear groove of the talus (4), lateral malleolus (2), and distal intermediate ridge of the tibia (1).

One horse was euthanatized, 6 horses had surgical debridement, and 5 horses were managed conservatively.

Four horses treated surgically (67%) returned to soundness. Conservatively treated horses continued to exhibit lameness but 2 were sufficiently sound for light pleasure riding.

Conclusions: Occult lesions of the tarsus not visible on radiographs can be detected by computed tomography and scintigraphy and may be a source of lameness.

Thus, SOCL, possibly of septic origin, should be a differential diagnosis for persistent lameness localized to the tarsocrural joint without radiographic abnormalities. Surgical debridement of the lesions may offer the best prognosis for a return to athletic soundness.



Source: García-López, José M. & Kirker-Head, Carl A. (2004): Occult Subchondral Osseous Cyst-like Lesions of the Equine Tarsocrural Joint. In: Veterinary Surgery 33 (5), 557-564.




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EQUINE

CT diagnosis of fatigue fracture of Mt 3 in young adult horsesmembers
Two young adult endurance horses were presented for investigation of sudden-onset forelimb lameness during competition. Clinical examination revealed a severe forelimb lameness and pain on palpation of the proximal palmar metacarpal area. Initial radiographic survey of the affected forelimb was unremarkable in both cases. A week of box rest resulted in only a mild improvement in the lameness. A second radiographic examination did not reveal any significant abnormalities. The history is very suspicious for a fracture, especially a fatigue fracture. How was it diagnosed and treated finally?

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