The normal anatomical, radiographical and ultrasonographic appearance of the carpal region of one-humped camel (Camelus dromedarius)

The macroscopic, radiographic and ultrasonographic anatomy of the carpal region of eight clinically normal camels (Camelus dromedarius) was determined with the help of a 7.5-MHz linear transducer. At the dorsal aspect of the carpus and distal radius, the extensor carpi radialis, extensor digitorum communis and extensor digitorum lateralis tendons were easily identified. The ulnaris lateralis tendon was observed laterally. The extensor carpi obliqus tendon was identified with difficulty. At the palmar aspect, the flexor carpi radialis, the flexor digitorum superficialis and the flexor digitorum profundus tendons were observed. Other soft structures examined include the lateral collateral ligament and the medial collateral ligament. Ultrasonographic findings correlated with gross anatomy in the dissected limbs. The results of the present study serve as reference data for ultrasonographic investigation of disorders of camel carpus.     

Epidemiologic, clinical and pathologo-anatomic studies of the inflammation of the carpal joint extensors in cattle

A retrospective study of 24 cases of inflammation of carpal extensors (m. extensor carpi radialis, m. extensor digitorum communis, m. abductor digiti I longus) was conducted. The findings of anamnestic, clinical, and post-mortem investigations are described. Half of the patients were first calf heifers at the ages of 2 1/2 to 3 years. The rest of the animals were older cows (with one exception). In all of the young cows the disease had become apparent within 11 weeks post partum. The most striking clinical finding is the posture of the animals when lying down: the affected forelimbs are extended forward. Palpation reveals a homogeneous firm swelling of the cranial portion of the forearm. Most of the patients also had pododermatitis in hind and/or front legs, and exhibited signs of a systemic reaction in the form of "polysynovitis" and raised serum total protein concentrations. Post mortem examination revealed a hemorrhagic edematous impregnation of the distal part of the radial carpal extensor muscle and particularly of its fascia. The tendon and tendon sheath had unclear contours and were swollen. Histologically the lesions are typical of subacute granulating inflammation. As to the cause, it is assumed that the ailment is a significant complication of some other disease of the locomotion system. Type and localization of the lesions suggest a traumatic etiology. Therapeutic results have been unsatisfactory.     

Carpal hyperflexion in a growing dog following neural injury to the distal brachium

A three-month-old dobermann was presented with hyperfiexion of the right carpus. The abnormality had evolved over a three-week period, following circumferential soft tissue trauma to the distal brachium. The carpal joint angle measured at the limit of passive extension was 105 degrees compared with 175 degrees for the left carpus, and prevented placement of metacarpal and digital pads on the ground. Neurological examination revealed marked atrophy of the carpal extensors, an absent extensor carpi radialis reflex and moderate atrophy of the carpal flexors. Spontaneous electromyographic activity consistent with denervation was recorded in the carpal extensor and flexor muscles. Surgical exploration of the distal radial nerve disclosed a region of fibrosis enmeshing the deep branch of the radial nerve. Following relief of the entrapped nerve, carpal hyperflexion, muscle atrophy and the extensor carpi radialis reflex deficit gradually resolved over four months. It is suggested that, In the rapidly growing limb, myoneural dysfunction Induced by trauma was the underlying pathophysiological mechanism for carpal hyperflexion.     

Tenoscopic Anatomy of the Equine Carpal Flexor Synovial Sheath

Objective —To describe the tenoscopic anatomy of the carpal sheath of the flexor tendons (carpal sheath) viewed from a lateral approach.
Study Design —Tenoscopic observation of structures within the carpal sheath subsequently confirmed by dissection.
Animals or Sample Population—12 equine cadaveric forelimbs.
Methods —The limbs were positioned lateral side up with the carpus slightly flexed. After distention of the carpal sheath, a portal for the arthroscope was made approximately 3 cm proximal to the distal radial physis and 2.5 cm caudal to the radius between the tendons of the ulnaris lateralis and lateral digital extensor muscles.
Results —A lateral tenoscopic approach was adequate to identify all structures within the carpal sheath. From proximal to distal, structures identified using this approach were the radial head of the deep digital flexor muscle, accessory ligament of the tendon of the superficial digital flexor muscle, distal radial physis, tendons of the superficial and deep digital flexor muscles, accessory carpal bone, antebrachiocarpal and middle carpal joints, and vincula of the tendon of the deep digital flexor muscle.
Conclusions —A lateral tenoscopic approach offered an easy, repeatable entry into the carpal sheath and allowed good observation of all structures within the sheath except for the medial borders of the tendons of the deep and superficial digital flexor muscles.
Clinical Relevance —Applications of a lateral tenoscopic approach to the carpal sheath include diagnostic procedures, lavage and synovial resection for septic tenosynovitis, desmotomy of the accessory ligament of the tendon of the superficial digital flexor muscle for flexural deformity or tendinitis, and removal of osteochondromas from the distal radial metaphysis.     

Subchondral bone cysts with fractures of the extensor processes in a horse.

Probable cause of fracture in a Paint gelding was a congenital bone defect involving the extensor process area of the right and left forelimb distal phalanges. Radiographically and histologically, subchondral bone cysts at the fracture lines were suspected. These cysts were thought to have developed in association with abnormal ossification centers at the extensor process areas of the third phalanx. Partial avulsion of weak extensor processes would then occur from natural forces exerted on these weakened bony prominences via the common digital extensor tendon. Support for osteochondrosis as a cause of this bone cyst formation was seen in histologic examination of fragments removed. Within the bony trabeculae, a dysplastic focus of cartilage with mineralized plaques and osseous tissues was observed. Findings supported a diagnosis of osteochondrosis, to the extent that the disease is presently understood in horses. Surgical correction by fragment removal was performed to circumvent progression of degenerative joint disease, which was evident as partial cartilage erosion of the distal dorsal articular surface of the second phalanx and fracture fragments. Recovery from surgery was rapid, and several months after surgery, the horse was sound for pleasure riding.     

Surgical repair of synovial fistulae between a carpal hygroma,the tendon sheath of the extensor carpi radialis and the antebrachiocarpal joint in a horse

This paper reports the diagnosis and repair of synovial fistulae between a carpal hygroma and both the antebrachiocarpal (ABC) joint and the extensor carpi radialis (ECR) tendon sheath of the left carpus in a 7-year-old gelding. The communication was confirmed using contrast radiography. Arthroscopy visualised the synovial fistulae and aided in the surgical repair. The gelding made a full athletic and acceptable cosmetic recovery.     

PRESUMPTIVE TENOSYNOVIAL OSTEOCHONDROMATOSIS IN A HORSE

A 5 year old Arabian mare was evaluated for a non-painful swelling located dorsal to the right carpus which had been present for 2 years. Radiographically, multiple mineralized bodies were identified dorsal to the distal radius and carpus in the region of the tendon sheath of the extensor carpi radialis muscle. The radiographic appearance of the carpal bones was within normal limits. On ultrasound examination, multiple hyperechoic foci with posterior shadowing were seen adjacent to the extensor carpi radialis tendon. There was minimal distension of the tendon sheath and no abnormalities within the substance of the extensor carpi tendon were identified. Considering the radiographic and sonographic findings, a presumptive diagnosis of tenosynovial osteochondromatosis was made. Histological confirmation of this diagnosis was not obtained as the owner declined further diagnostic evaluation.     

A study of the anatomy and injection techniques of the ovine stifle by positive contrast arthrography, computed tomography arthrography and gross anatomical dissection

Although ovine stifle models are commonly used to study osteoarthritis, meniscal pathology and cruciate ligament injuries and repair, there is little information about the anatomy of the joint or techniques for synovial injections. The objectives of this study were to improve anatomical knowledge of the synovial cavities of the ovine knee and to compare intra-articular injection techniques. Synovial cavities of 24 cadaver hind limbs from 12 adult sheep were investigated by intra-articular resin, positive-contrast arthrography, computed tomography (CT) arthrography and gross anatomical dissection. Communication between femoro-patellar, medial femoro-tibial and lateral femoro-tibial compartments occurred in all cases. The knee joint should be considered as one synovial structure with three communicating compartments. Several unreported features were observed, including a communication between the medial femoro-tibial and lateral femoro-tibial compartments and a latero-caudal recess of the lateral femoro-tibial compartment. No intermeniscal ligament was identified. CT was able to define many anatomical features of the stifle, including the anatomy of the tendinous synovial recess on the lateral aspect of the proximal tibia under the combined tendon of the peroneus tertius, extensor longus digitorum and extensor digiti III proprius. An approach for intra-articular injection into this recess (the subtendinous technique) was assessed and compared with the retropatellar and paraligamentous techniques. All three injection procedures were equally successful, but the subtendinous technique appeared to be most appropriate for synoviocentesis and for injections in therapeutic research protocols with less risk of damaging the articular cartilage.     

Traumatic communication of the extensor carpi radialis tendon sheath and antebrachiocarpal joint in two horses

Two horses were examined due to lacerations at the level of the craniodistal antebrachii. Further evaluation of the lacerations revealed communication with the extensor carpi radialis tendon sheath and potentially the antebrachiocarpal joint. Positive contrast arthrography performed via the palmarolateral pouch of the antebrachiocarpal joint was used to diagnose communication with the extensor carpi radialis tendon sheath. Both the joints and tendon sheaths were treated aggressively with surgical debridement and lavage, followed by post operative medical management and rehabilitation. Both horses made a full recovery and are performing in their intended level of use with acceptable cosmetic results. Traumatic communication with the carpal joints should be considered when evaluating lacerations involving the forelimb extensor tendon sheaths.     

ULTRASONOGRAPHY OF THE DORSAL AND LATERAL ASPECTS OF THE EQUINE CARPUS: TECHNIQUE AND NORMAL APPEARANCE

The normal ultrasonographic appearance of the dorsal and lateral soft tissue structures and anatomic landmarks of the equine carpus useful in clinical imaging are described.
Both limbs of 5 cadavers and 5 clinically sound adult horses were imaged using a 7.5 MHz sector transducer. At the dorsal aspect of the carpus and distal radius, the extensor carpi radialis- and the common digital extensor tendon and their tendon sheaths were easily identified. These two tendons are the most prominent structures in this region. Smaller and more difficult to identify are the tendon and tendon sheath of the extensor carpi obliquus-, the lateral digital extensor- and the ulnaris lateralis muscle. The ultrasonographic appearance and course through the carpal region of the tendons and tendon sheaths mentioned are described. Other soft tissue structures examined include the lateral collateral ligament, the carpal joint capsule and the distal articular cartilage of the radius. Ultrasonographic findings correlated well with gross anatomy in the cadavers limbs.     

Avulsion of the origin of the tendon of the extensor digitalis longus muscle in a Dobermann pinscher

Avulsion of the tendon of the extensor digitalis longus muscle is a rare condition in young, large breed dogs or as a consequence of chronic lateral patellar luxation in adult dogs. Current technique of fixation consists into reattaching the fragment with a lag screw at its origin in the extensor fossa of the lateral femur condyle. If the fragment was considered too friable and reactive to be reattached, it was amputated and the tendon was sutured to the joint capsula. In this present case a adaptation screw with a washer was inserted distally to the sulcus extensorius through the tendon. The proximal part of the tendon was sutured to the joint capsula. The postoperative result was excellent, with recovery of full function of the Musculus extensor digitalis longus.     

Solitary osteochondroma of the radius in three horses

Osteochondroma of the distal portion of the radius was diagnosed in 3 horses with a history of lameness and distention of the common tendon sheath of the superficial and deep digital flexor tendons at the level of the carpal canal. In 2 horses, the exostosis was removed through an incision at the caudal border of the lateral digital extensor muscle above the carpal ligament.     

Reproducibility and Repeatability of Equine Muscle Thickness Measurements with Ultrasound

This study examined the reproducibility and repeatability of muscle thickness (MT) measurements with ultrasound for the following muscles: extensor carpi radialis, extensor digitorum longus (both flexed and extended), gluteus medius, longissimus lumborum, semitendinosus, and supraspinatus. Three examiners measured thickness of these muscles in five Thoroughbreds on 3 consecutive days. The day of measurement did not have any effect on the mean MT value of the muscles examined (P > .05). The left longissimus lumborum muscle was the only muscle for which the second measurement varied from the first and third (P < .05). The examiners had an effect on the mean coefficient of variation (CV) of the thickness of the flexed left extensor carpi radialis and flexed left extensor digitorum longus. The daily measurements varied more in the case of one of the examiners. Mean CVs higher or close to 10% were reported for both sides of the flexed extensor digitorum longus and for the supraspinatus muscles. The lowest CV was calculated for the longissimus lumborum and the extended semitendinosus (<5%). The largest disagreements between the examiners were observed for both sides of the flexed extensor digitorum longus and the supraspinatus (>10%–<20%). The best agreement was measured for the extended extensor carpi radialis and the longissimus lumborum (>3%–<7%). The results showed that for some muscles, it was difficult to locate the exact anatomical site for taking the MT measurements. To reduce CV, it was suggested that only one examiner should take all the measurements and the whole procedure must be such that it is as comfortable as possible for this particular examiner.     

Arthroscopic removal of a palmar radial osteochondroma causing carpal canal syndrome in a horse.

A 5-year-old Arabian stallion with moderate effusion in the right carpal canal and intermittent lameness in this limb was diagnosed to have an osteochondroma projecting from the distal portion of the radius into the carpal canal. oral phenylbutazone treatment over the next 3 years allowed the stallion to continue its show career. Right forelimb lameness returned at that time, and ultrasonography revealed the osteochondroma impinging on the dorsal surface of the deep digital flexor tendon. The owner elected to have the osteochondroma surgically removed. The horse was anesthetized, and the carpal sheath was distended with balanced polyionic solution. A 4-mm arthroscope was inserted into the carpal sheath, and the osteochondroma projecting into the sheath was identified. The osteochondroma was removed by use of a Ferris-Smith bone rongeur, which was inserted into the carpal sheath through a stab incision over the osteochondroma. The effusion in the carpal sheath and the lameness resolved by 2 months, and the horse was returned to training 4 months after surgery.     

Macroscopic study of the functional significance of the forearm muscles in the giant panda

The extensor and flexor group muscles and their related muscles were functional-morphologically observed in the dead body of the giant panda to clarify the action of the forearm and the palm in the manipulation of the species. The Musculus flexor carpi ulnaris had two developed heads, however, we can conclude that the contraction of this muscle slightly changes the angle of the accessory carpal bone to the ulna. The data pointed out that the accessory carpal bone acts as a supporting post, when the giant panda seizes the object. The M. abductor digiti I longus possessed the well-developed origin in both ulna and radius. These findings suggest that this muscle may function as a supinator of the forearm. We also suggest that the well-developed M. pronator quadratus and M. pronator teres, and the proximal part of the M. abductor digiti I longus and the M. supinator may efficiently contribute to the pronator-spinator action of the forearm, when the giant panda brings the food to its mouth using the manipulation system equipped in the palm region.     

Motor Neuron Organization and Corticospinal Fibers in the Cervical Intumescence of the Raccoon (Procyon lotor) Spinal Cord

Experiments were performed on 19 raccoons to determine the organization of the spinal alpha motoneurons innervating the muscles of the thoracic limb. Chromatolysis of motoneurons was provoked by resecting major nerves or removing individual muscles or muscle groups. Proximal intrinsic limb muscle motoneurons were located cranially in the cervical spinal intumescence and distal muscle motoneurons more caudally. Flexor motoneurons were generally dorsal and more laterally located within the lateral motoneuronal cell group than were the cell bodies innervating their extensor antagonists. The distribution of motor cortex projections to motoneurons was studied in five raccoons by selective silver impregnation of degenerating fibers after unilateral motor cortex ablation. Degenerating cortical projections within the motoneuronal cell group (Rexed's lamina IX) were seen only in the more dorsal and the lateral portions in the seventh and eighth cervical and the first thoracic spinal cord segments. Motor cortex preterminal and terminal fibers were in close apposition to the proximal dendrites and the somata of alpha motoneurons innervating primarily the more distal limb musculature and particularly the intrinsic muscles of the manus.     

Ultrasonographic examination of the carpal canal in dogs

The aim of this study was to determine the course of the median nerve and its adjacent structures in the carpal canals of 8 healthy dogs by using high-frequency transducers. Before performing ultrasonography, the transverse and posteroanterior diameters as well as the perimeter of the carpus were measured at just proximal to the side of the carpal pad. The anatomical structures were then determined at two levels of the carpal canal, which were named the proximal and distal levels, on the transverse sonograms. The cross-sectional areas, perimeters and the transverse and posteroanterior diameters of the median nerve were measured at these levels. Although all the measurements were larger at the proximal level, significant differences between the proximal and distal levels were determined for the cross-sectional area, the perimeter and the transverse diameter of the median nerve. On the transverse sonogram, the deep digital flexor tendon was seen in almost the center of the carpal canal like a comma shape and also it had a small concavity on the caudal side. The superficial digital flexor tendon was seen as an ovoid shape on the transverse sonograms and it was located nearly at the posterior side of the carpal canal. Both tendons were seen as intermediate-grade echogenic structures. The median artery was located inside of the concavity of the deep digital flexor tendon. Also, the median nerve was seen at the posteromedial side of the median artery. As a result of this study, the cross-sectional areas of the median nerve ranged between 1.01-2.68 mm² at the proximal level and between 0.93-1.91 mm² at the distal level.     

Muscles and fascial elements of the antebrachium and manus of the African elephant (Loxodonta africana,Blumenbach 1797): starring comparative and functional considerations

The structure of the limbs of elephants is unusual among mammals. In African elephants (Loxodonta africana, Blumenbach 1797), the front limbs serve to support the greatest part of the body mass of the largest land animal. In this study, we present new and detailed anatomical data regarding muscular and specific fascial structures of the lower front limb which were examined by means of standard anatomical and histological techniques. The muscles and tendons of the forearm (antebrachium) and hand (manus) are tightly surrounded by thick, highly elastic fascial layers which fuse with the lacertus (lac.) fibrosus and the so‐called ligamentum (lig.) humeroulnare. A well‐developed musculus (m.) brachioradialis occupies the proximolateral aspect of the forearm and its tendon inserts together with the lac. fibrosus on the os carpi intermedium. The lac. fibrosus, the lig. humeroulnare and the m. flexor carpi radialis reveal a large proportion of elastic fibres. These three structures may play an important role in storing strain energy thus promoting energy‐saving locomotion. On the palmar aspect of the carpus, metacarpus and digits, short flexor, abductor, adductor, lumbricales and interossei muscles are present, whereas supinator muscles are absent in all specimens. The short muscles of the hand together with specific dorsal tendons enable precise movements of specific toes.