Primary osteosarcoma of the synovium in a dog

An eight-year-old, spayed female Labrador retriever was presented for evaluation of left thoracic limb lameness. Radiographs of the left elbow revealed mineralization of the soft tissues surrounding the joint, with no evidence of periarticular bony lysis. Biopsy of the synovial tissues of the left radiohumeral joint yielded a diagnosis of osteosarcoma (OSA). The dog was treated with palliative radiotherapy, piroxicam, and carboplatin chemotherapy, which resulted in excellent pain control for approximately eight months. Amputation of the affected limb was then performed. Six months later, the dog developed multiple subcutaneous OSA metastases, and the dog was euthanized 15 months after diagnosis due to refractory vomiting. This report documents the first known case of primary OSA of the synovium in any species.     

Shifting subjects of health-care: placing "medical tourism" in the context of Malaysian domestic health-care reform

"Medical tourism" has frequently been held to unsettle naturalised relationships between the state and its citizenry. Yet in casting "medical tourism" as either an outside "innovation" or "invasion," scholars have often ignored the role that the neoliberal retrenchment of social welfare structures has played in shaping the domestic health-care systems of the "developing" countries recognised as international medical travel destinations. While there is little doubt that "medical tourism" impacts destinations' health-care systems, it remains essential to contextualise them. This paper offers a reading of the emergence of "medical tourism" from within the context of ongoing health-care privatisation reform in one of today's most prominent destinations: Malaysia. It argues that "medical tourism" to Malaysia has been mobilised politically both to advance domestic health-care reform and to cast off the country's "underdeveloped" image not only among foreign patient-consumers but also among its own nationals, who are themselves increasingly envisioned by the Malaysian state as prospective health-care consumers.     

ELASTOGRAPHIC EVALUATION OF NATURALLY OCCURING TENDON AND LIGAMENT INJURIES OF THE EQUINE DISTAL LIMB

Compression elastography is an ultrasonographic technique that estimates tissue strain and may have utility in diagnosing and monitoring soft tissue injuries in the equine athlete. Recently, elastography has been proven to be a feasible and repeatable imaging modality for evaluating normal tendons and ligaments of the equine distal forelimb. The purposes of this prospective study were to investigate the ability of elastography to detect spontaneously occurring lesions of equine tendons and ligaments diagnosed with magnetic resonance imaging (MRI) and gray‐scale ultrasound (US) and to characterize the differences in the elastographic appearance of acute vs. chronic injuries. Fifty seven horses with a total of 65 lesions were evaluated. Images were assessed quantitatively and qualitatively. Acute lesions were found to be significantly softer (P < 0.0001) than chronic lesions (P < 0.0001) and the stiffness of lesions increased with progression of healing (P = 0.0138). A negative correlation between lesion hypoechogenicity and softness was appreciated with more hypoechoic lesions appearing softer (P = 0.0087) and more hyperechoic regions harder (P = 0.0002). A similar finding occurred with increased signal intensity on short tau inversion recovery (STIR) and proton density (PD) MRI sequences correlating with increased softness on elastography (P = 0.0164). Using US and MRI as references, commonly encountered soft tissue injuries of the equine distal limb could be detected with elastography. However, elastography was limited for detecting small, proximal injuries of the hindlimb proximal suspensory ligament. Elastographic evaluation of equine tendons and ligaments may allow better characterization of lesion chronicity and severity, and sequential examinations may optimize lesion management, rehabilitation, and return to training.     

Surgical treatment of synovial osteochondromatosis in the middle carpal joint of a pony

A 9‐year‐old Paint pony gelding presented for signs of left carpal swelling of 1–2 weeks' duration. Radiographic, ultrasonographic and arthroscopic evaluation of the left carpus was consistent with synovial osteochondromatosis. This presumptive clinical diagnosis was confirmed histopathologically. Arthroscopic removal of the osteochondral bodies resulted in resolution of the carpal effusion and return to previous athletic activity by 4.5 months post operatively. Arthroscopic removal of osteochondral bodies is the treatment of choice in cases of suspected synovial osteochondromatosis.