ULTRASONOGRAPHIC FINDINGS IN 38 HORSES WITH SEPTIC ARTHRITIS/TENOSYNOVITIS

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.     

Tenoscopic examination and proximal annular ligament desmotomy for treatment of equine "complex" digital sheath tenosynovitis

OBJECTIVE: To determine the outcome of horses with "complex" digital tenosynovitis treated by tenoscopic proximal annular ligament desmotomy and resection of synovial masses or adhesions, or both, within the digital sheath. STUDY DESIGN: Retrospective evaluation. ANIMALS OR SAMPLE POPULATION: Twenty-five horses with a clinical and ultrasonographic diagnosis of palmar or plantar proximal annular ligament constriction and ultrasonographic evidence of synovial masses or adhesions within the digital tendon sheath. METHODS: Each horse had tenoscopic surgery for annular ligament desmotomy combined with adhesiolysis and/or synovial mass resection. Mean follow-up time was 3.4 years. Spearman's rank correlation was used to assess the relationship between functional outcome or cosmetic results and preoperative variables including duration of clinical signs, digital sheath synovial fluid total protein concentration and nucleated cell count, thickness of the palmar or plantar proximal annular ligament (PAL), severity of adhesions, severity of synovial masses, degree of synovial distention, or limb affected. RESULTS: A total of 18 (72%) horses returned to athletic soundness, 4 were improved but not sound, and 3 were not improved. Cosmetic outcome was normal in 10 horses, improved but not normal in 12, and not improved in 3 horses. Cosmetic and functional outcome were significantly adversely affected by the duration of clinical signs and the severity of synovial masses. CONCLUSIONS: With appropriate tenoscopic surgical attention, horses with complex tenosynovitis syndrome characterized by synovial masses, adhesions, or both adhesions and masses, and PAL constriction, have a good prognosis for return to athletic soundness. CLINICAL RELEVANCE: Horses with PAL constriction and additional digital tendon sheath pathology such as adhesions and synovial masses have a 72% chance of returning to sound athletic performance, however 60% of horses retain some degree of cosmetic blemish in the affected limb. There is an inverse relationship between the duration of clinical signs and outcome, and therefore, prompt surgical attention is advised.     

Evaluation of a balloon constant rate infusion system for treatment of septic arthritis, septic tenosynovitis, and contaminated synovial wounds: 23 cases (2002-2005)

OBJECTIVE-To determine clinical findings and outcome in horses treated by means of a balloon constant rate infusion system. DESIGN-Retrospective case series. ANIMALS-23 horses. PROCEDURES-Medical records of horses examined at The Ohio State University veterinary teaching hospital from 2002 to 2005 that had septic arthritis, septic tenosynovitis, or penetration of a synovial structure and in which treatment involved a balloon constant rate infusion system were searched. Information pertaining to signalment, history, physical examination findings, clinicopathologic data, treatment, and duration of hospitalization was recorded. RESULTS-Mean+/- SD duration of hospitalization was 11.5+/-5.26 days. No correlation between duration of clinical signs and duration of hospitalization or duration of infusion pump use was detected, but correlations between WBC count and duration of hospitalization and WBC and duration of infusion-pump use were observed. All horses survived to discharge. Follow-up information was obtained on 17 horses, 16 of which were alive at the time of follow-up. Twelve of 13 horses for which followup information was available for at least 5 months were alive 5 months or longer after discharge. Thirteen of the 16 horses alive at follow-up were reported by owners as not lame, whereas the remaining 3 were mildly lame or intermittently moderately lame or had developed angular limb deformity in the contralateral limb. CONCLUSIONS AND CLINICAL RELEVANCE-Balloon constant rate infusion systems may be used effectively in treatment of septic arthritis, septic tenosynovitis, and contaminated synovial wounds. Clinical response and long-term outcome appeared to be comparable to results obtained with other techniques.     

Traumatic Septic Tenosynovitis of the Tarsal Sheath with Fragmentation of the Sustentaculum Tali: Surgical Treatment and Outcome in 3 Horses

This case report describes surgical treatment of 3 cases of septic chronic tenosynovitis of the tarsal sheath with fragmentation of the sustentaculum tali in 3 horses. Diagnosis was based on clinical signs, radiographic and ultrasonographic findings, synovial fluid cytology, and bacteriology. In each case, treatment consisted of tenovaginoscopy of the tarsal sheath performed with the horse under general anesthesia and regional intravenous perfusion of antibiotics. Follow-up data obtained between 12 and 46 months after surgery reported a good outcome, with a good cosmetic appearance in all cases described. Two horses returned to their intended use at 44 and 46 months, and 1 horse reportedly showed a remarkable functional improvement after 12 months. Despite the poor prognosis associated with the chronicity of the lesions, the presence of adhesions and the degree of involvement of the lateral digital flexor tendon, tenovaginoscopy of the tarsal sheath and regional antimicrobial therapy were successful therapeutic options for treating septic tenosynovitis of the tarsal sheath with fragmentation of the sustentaculum tali.     

What is the likelihood that a horse treated for septic digital tenosynovitis will return to its previous level of athletic function?

REASONS FOR PERFORMING STUDY: Septic digital tenosynovitis is a serious problem in the horse, with a poor prognosis being reported for recovery. HYPOTHESIS: The occurrence of septic digital tenosynovitis would significantly reduce the likelihood of a horse returning to its previous level of athletic function. METHODS: Medical records of 90 horses treated for septic digital tenosynovitis were reviewed. Data retrieved included age, sex, location of inciting cause of sepsis, time from onset of clinical signs to presentation for treatment, and whether the horse survived to be discharged. Long-term outcome was determined through telephone questionnaires. Univariate analyses of categorical variables were conducted for each outcome. RESULTS: Overall, 87.8% of horses (79/90) survived to be discharged from the hospital. Only one factor examined was shown to have a significant effect on outcome. A delay of 1-7 days between onset of clinical signs and presentation for treatment reduced significantly the likelihood of the horse surviving to be discharged from the hospital. Of the horses discharged from the hospital, long-term follow-up was available for 72 horses, with 54.2% (39/72) returning to their previous level of athletic function. CONCLUSIONS: Only approximately 50% of horses treated for septic digital tenosynovitis returned to their previous level of athletic function following resolution of synovial sepsis. POTENTIAL RELEVANCE: Accurate figures allowing a realistic assessment of the athletic future of a horse following treatment for septic digital tenosynovitis are of value to both the owner and treating veterinarian.     

Exostoses of the caudal perimeter of the radial physis as a cause of carpal synovial sheath tenosynovitis and lameness in horses: 10 cases (1999-2003)

OBJECTIVE: To determine the clinical, radiographic, ultrasonographic, and arthroscopic findings associated with tenosynovitis of the carpal synovial sheath induced by exostoses that originate from the caudal surface of the physeal scar of the distal radius and determine the results of surgical removal of those exostoses in horses. DESIGN: Retrospective study. ANIMALS: 10 horses. PROCEDURE: Medical records of horses with effusion in the carpal synovial sheath and lameness evaluated from 1999 to 2003 were examined. RESULTS: All horses had a history of intermittent mild to moderate effusion of the carpal synovial sheath and lameness of 1 forelimb. Results of regional perineural and intrathecal anesthesia of the carpal synovial sheath confirmed that the lameness originated in the carpal synovial sheath. Radiography revealed exostoses originating from the caudal cortex of the distal radius at the level of the closed physis. Arthroscopy was performed for confirmation and removal of exostoses that penetrated the carpal synovial sheath and impinged on the deep digital flexor tendon. All horses returned to previous athletic activity. One horse had a recurrence of clinical signs 12 months after surgery, which resolved with medical treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Tenosynovitis of the carpal synovial sheath and lameness were caused by impingement of exostoses of the caudal radius on the lining and contents of the carpal synovial sheath. Although the clinical signs and surgical treatment were similar to that caused by osteochondromas, these exostoses developed at the level of the closed physis of the distal radius and were not radiographically or histologically similar to osteochondromas.     

Bacterial culture of septic synovial structures of horses: Does a positive bacterial culture influence prognosis?

Reasons for performing study: The influence of synovial fluid culture on short‐ and long‐term prognosis of cases with septic synovitis requires study. Hypotheses: Horses with a positive bacterial culture from septic synovial fluid are less likely to survive or return to successful athletic function than those with a negative bacterial culture from septic synovial fluid. Methods: Records of mature horses presented to 2 equine referral hospitals for investigation of suspected septic synovitis were examined. Horses (n = 206) were included in the study if synovial fluid was submitted for full laboratory examination, including bacterial culture. A diagnosis of septic synovitis was based on a nucleated cell count >30 × 10⁹ cells/l or >90% neutrophils and other clinical, cytological and bacteriological parameters. Long‐term follow‐up was obtained by telephone questionnaire. Univariate analysis, using the Fisher's exact test, was used for all outcomes. Results: Fourteen (20.9%) of 67 horses with a positive bacterial culture from synovial fluid were subjected to euthanasia because of persistent synovial sepsis compared to 2 (1.44%) of 139 with negative bacterial cultures (P<0.001). Overall survival and successful long‐term return to function in horses with a positive bacterial culture was 50% (24/48 horses) compared to 70.5% (74/105) in culture negative horses (P = 0.01). In horses that survived to be discharged, successful long‐term return to function was not significantly different between culture positive and culture negative groups. Growth of Staphylococcus aureus from synovial fluid did not affect short‐term survival to discharge from the hospital compared to other positive bacterial culture; however, successful long‐term return to function was only 30.4% (4/13) in horses from which S. aureus was cultured compared to 73.9% (17/23) of horses in which other bacteria were cultured (P = 0.015). Conclusions and potential clinical relevance: Horses with a positive bacterial culture from a septic synovitis have a poorer prognosis for survival to discharge from hospital and overall long‐term return to function than horses that yielded no bacterial growth. When S. aureus was cultured, the long‐term prognosis was poorer.     

Open drainage, intra-articular and systemic antibiotics in the treatment of septic arthritis/tenosynovitis in horses.

Open drainage was used to treat 26 horses with persistent or severe septic arthritis/tenosynovitis. Infected synovial structures were drained through a small (3 cm) arthrotomy incision that was left open and protected by a sterile bandage. Joint lavage was performed in all 26 horses. In addition to systemic antibiotics, 23 of these horses were also treated with intra-articular antibiotics; amikacin (17 horses), gentamycin (2 horses), cefazolin (2 horses), and 2 horses were injected at different times with gentamycin and amikacin. The infection was eliminated from the involved synovial structures in 25 of 26 horses; 24 survived and were released from the hospital. The arthrotomy incisions healed by granulation in 16 horses; in 9 horses the arthrotomy incision was sutured closed once the infection was eliminated. Seventeen horses returned to soundness and resumed athletic function. Open drainage was an effective method of achieving chronic drainage from a joint or tendon sheath. It is indicated in horses that have established intra-synovial infections or in horses that do not respond to joint lavage through needles.     

Increased cartilage oligomeric matrix protein concentrations in equine digital flexor tendon sheath synovial fluid predicts intrathecal tendon damage

Objectives: To evaluate digital flexor tendon sheath (DFTS) synovial fluid cartilage oligomeric matrix protein (COMP) concentrations as a molecular marker for intrathecal pathology. Study Design: Case control study. Animals: Horses (n=46) with DFTS tenosynovitis; 23 fresh cadaver horses. Methods: DFTS synovial fluid samples were collected from clinical cases with noninfected DFTS tenosynovitis and from control DFTS. Clinical and surgical findings were recorded, and dissection of control limbs was performed to confirm the DFTS to be grossly normal. Synovial fluid COMP was quantified using a homologous competitive inhibition ELISA. Results: Abnormalities were identified tenoscopically: intrathecal tendon/ligament tearing was identified in 37 cases and 9 had other lesions. In control horses, synovial fluid COMP was higher in younger horses. Clinical cases with intrathecal tendon/ligament tearing had higher synovial fluid COMP than either clinical cases with other lesions, or controls. In horses ≥5 years old, the sensitivity and specificity of the assay was high for diagnosing intrathecal tendon/ligament tearing. Conclusions: COMP concentrations in DFTS synovial fluid were significantly greater than those in normal horses with noninfected tenosynovitis caused by intrathecal tendon/ligament tearing, but not by other lesions.     

MAGNETIC RESONANCE IMAGING FINDINGS IN HORSES WITH SEPTIC ARTHRITIS

Fourteen horses with septic arthritis underwent high‐field (1.5 T) magnetic resonance imaging (MRI). Septic arthritis was diagnosed based on results from historical and clinical findings, synovial fluid analyses and culture, and radiographic, ultrasonographic, arthroscopic, and histopathologic findings. MR findings included diffuse hyperintensity within bone and extracapsular tissue on fat‐suppressed images in 14/14 horses (100%), joint effusion, synovial proliferation, and capsular thickening in 13/14 horses (93%), bone sclerosis in 11/14 horses (79%), and evidence of cartilage and subchondral bone damage in 8/14 horses (57%). Intravenous gadolinium was administered to five of the 14 horses and fibrin deposition was noted in all horses. Other findings after gadolinium administration included synovial enhancement in 4/5 (80%) horses, and bone enhancement in 1/5 (20%) horses. The MR findings of septic arthritis in horses were consistent with those reported in people. MRI may allow earlier and more accurate diagnosis of septic arthritis in horses as compared with other imaging modalities, especially when the clinical diagnosis is challenging. It also provides additional information not afforded by other methods that may influence and enhance treatment.     

Treatment with continuous intrasynovial antimicrobial infusion for septic synovitis in horses: 31 cases (2000-2003)

OBJECTIVE-To determine clinical findings, complications, and outcome of septic synovitis in which continuous intrasynovial antimicrobial infusion (CIAI) was used for local antimicrobial delivery in horses. DESIGN-Retrospective case series. Animals-22 adult horses and 9 foals (horses<1 year of age). PROCEDURES-Records of horses with septic synovitis that had CIAI during treatment were reviewed. The association between clinical variables and whether horses performed their intended use following treatment was determined. RESULTS-42 synovial cavities were treated via CIAI. Twenty-nine cases were chronic (>7 days) in nature, 15 had been refractory to standard treatments, and 13 synovial infections had associated osteomyelitis. Mean duration from infection to initiation of CIAI was 19.7 days, and mean duration of CIAI was 6.1 days. Temporary discharge from the catheter site at the time of removal was evident in 8 horses. Dysfunction of the infusion system occurred in 2 horses and was corrected during the course of treatment. No long-term complications were reported. Thirty-nine (93%) synovial infections in 29 (94%) horses were resolved. Twenty adult horses and 8 foals were discharged from the hospital, and 19 of 24 horses with long-term follow-up performed their intended use. CONCLUSIONS AND CLINICAL RELEVANCE-CIAI was a useful adjunctive treatment for septic synovitis and allowed intrasynovial antimicrobial delivery into a variety of synovial cavities.     

Tenoscopy in 33 horses with septic and nonseptic digital tenosynovitis (1997–2001)

Tenoscopy is the use of an arthroscope to access tendon sheaths. This article reports clinical findings, treatments, and outcomes of 33 horses with either septic or nonseptic digital tenosynovitis submitted to 36 tenoscopies during 34 occasions at the Marion duPont Scott Equine Medical Center (1997–2001). Two of the 16 horses with septic tenosynovitis were euthanized at the hospital. From the 32 horses discharged from the hospital, outcome was obtained in 31 cases: 12 horses (6 septic) could work at the same level. No difference was detected between the outcome groups regarding clinical and laboratory variables. In nonseptic cases, lameness grade, circulating white blood cells, and plasma fibrinogen before surgery were lower, while the period between the onset of clinical signs and surgery was longer and duration of phenylbutazone treatment and hospitalization was shorter. No difference in the outcome was detected when septic and nonseptic cases were compared. Tenoscopy was useful for diagnosis and treatment of nonseptic and septic digital tenosynovitis. The small number of cases and the lack of accurate information due to the retrospective nature of the study may have prevented detection of a difference between the outcomes of horses with septic versus nonseptic tenosynovitis.     

Tenovaginoscopic approach to the common digital flexor tendon sheath of adult cattle: technique, normal findings and preliminary results in four clinical cases

The aim of this study was to describe the tenovaginoscopic approach to the bovine common digital flexor tendon sheath (CDFTS). A comparative anatomical, ultrasonographic and endoscopic study was undertaken using 26 healthy cadaver feet from adult dairy cows. Tenovaginoscopy was performed using a rigid, 30° arthroscope (length 18 cm; outer diameter 4mm) enabling a direct view of the synovial cavity and the following structures: digital flexor tendons, digital annular ligaments, lateral and medial pouches, three mesotendons, the vinculum of the superficial digital flexor tendon, and a slot-shaped opening in the manicaflexoria of the hind feet. Additionally, four clinical cases of septic tenosynovitis treated with lavage under tenovaginoscopic control were examined. Tenovaginoscopy represents a feasible, minimally invasive method for the diagnosis and treatment of septic tenosynovitis of the CDFTS, which allows the degree of alterations of the normal structures to be evaluated.     

Hematogenous (suspected-)septic inflammation of the synovial fossa in the adult horse: rare but deceptive (3 case reports)

Septic inflammation of the synovial fossa in the horse is a severe disorder that can lead to permanent invalidity. The synovitis can occur as a result of a perforating trauma, or via the blood (haematogenous). The latter route is rare in the adult horse. Three cases of suspected haematogenous septic synovitis are described in adult horses (older than 1 year). In two horses, timely and adequate treatment resulted in recovery, but this was followed by fatal recurrence. In one of these horses a persistent primary infection was found as cause; the other horse was not available for autopsy. The third horse was euthanized without treatment because the primary process was difficult to treat. It can be concluded that, in horses with suspected haematogenous septic inflammation of the synovial fossa, attention should be paid to the primary process--it is not enough to treat the synovitis alone.     

Factors associated with outcome following treatment of horses with septic tenosynovitis: 51 cases (1986-2003)

OBJECTIVE: To identify factors associated with outcome (ie, survival and return to function) following treatment of horses with septic tenosynovitis. DESIGN: Retrospective case series. ANIMALS: 51 horses with septic tenosynovitis. PROCEDURES: Information was obtained from medical records and through follow-up conversations with owners. Factors analyzed for an association with outcome included affected limb, etiology, duration of clinical signs prior to examination, presence of complications, primary treatment, secondary treatments, number of surgical procedures, and hospitalization time. RESULTS: Concurrent complications were identified in 41 (80%) horses. The primary treatment consisted of through-and-through lavage in 26 (51%) horses, tenoscopy in 20 (39%), and tenosynoviotomy combined with lavage in 5 (10%). Forty (78%) horses were discharged, and 37 (73%) survived at least 1 year after surgery; 21 of the 37 (57%) returned to their previous or a higher level of performance. Percentages of horses that survived 1 year after discharge and percentages that returned to their intended use did not vary significantly among treatments. Horses with tendon rupture or sepsis of an adjacent joint were significantly less likely to survive. Horses with tendon injury or pannus were significantly less likely to return to their intended use. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that various factors were associated with outcome in horses with septic tenosynovitis. However, surgical technique was not found to be associated with survival rate or rate of return to intended use.     

Evaluation of a broad range real-time polymerase chain reaction (RT-PCR) assay for the diagnosis of septic synovitis in horses

Septic synovitis is a potentially debilitating and life-threatening disorder in horses. We hypothesized that a universal bacterial real-time PCR (RT-PCR) assay would have improved sensitivity and decreased turn-around time for detection of bacteria in synovial fluid (SF) samples. Forty-eight SF samples were collected from 36 horses that presented to two referral institutions with suspected septic synovitis. Universal RT-PCR, bacterial culture and SF analysis were performed on all samples, and an interpretation on the sample being septic or not was derived by three board certified specialists from the history, clinical assessment and SF characteristics. RT-PCR results were compared to a composite standard comprised of positive culture and interpretation by all three specialists of samples as “septic”. For 41 of 48 samples (85%), culture and RT-PCR results were concordant. Compared to the composite standard, 83% of samples were correctly classified by RT-PCR (turn-around time of approximately 4 hours). Relative sensitivity and specificity of RT-PCR were 87% and 72% respectively, and 56% and 86% for culture. Hence, universal RT-PCR was a rapid and highly sensitive test, which may accelerate diagnosis and improve outcome for horses with septic synovitis.     

A retrospective study of 192 horses affected with septic arthritis/tenosynovitis.

The medical records of 192 horses with septic arthritis/tenosynovitis 1979-1989 were reviewed. Forty-three horses developed infection after an intra-articular injection, 46 following a penetrating wound, 25 following surgery, 66 were foals less than 6 months old, and 12 were adult horses without a known aetiology. Haematogenous infection of a joint occurs in adult horses and should be considered as a differential diagnosis in horses with an acute onset of severe lameness. The aetiology of the infection had a significant effect on the type of bacteria identified by culture. Staphylococcus was cultured from most of the horses that developed infection following a joint injection or surgery, 69% of the horses from which an organism was identified. Horses that developed infection secondary to a penetrating wound frequently provided cultures of more than one organism; Enterobacteriaceae and anaerobes were more frequently isolated in this group. The most common organisms isolated from foals were Enterobacteriaceae; E. coli was identified in more than 27% of the foals. The hock was the most frequently involved joint. Multiple treatments were used over the 10-year period of study. Survival rates were lowest in foals; only 45% survived to be released from the hospital. Survival was greater in adult horses; 85% of the horses that were treated were released from the hospital. Survival was significantly greater in horses with septic tenosynovitis; all 14 of the horses that were treated survived. Survival was not significantly affected by the joint involved or by the type of bacteria cultured from the synovial fluid.(ABSTRACT TRUNCATED AT 250 WORDS)     

CLINICAL AND ULTRASONOGRAPHIC CHARACTERISTICS OF SALIVARY MUCOCELES IN 13 DOGS

Salivary mucocele is one of the causes of submandibular swelling in dogs and is due to a collection of mucoid saliva that has leaked from a damaged salivary gland. The purpose of this case series report was to describe the clinical and ultrasonographic characteristics of confirmed salivary mucoceles in 13 dogs admitted to the Faculty of Veterinary Medicine at Cairo University. The final diagnosis of salivary mucocele was based on aspirate cytology for all dogs and additional surgical excision for seven dogs. For dogs admitted from 2 weeks to 1 month from the onset of clinical signs, the cervical mucocele appeared as a round echogenic structure with a large volume of central anechoic content. The wall was a clearly identified hyperechoic structure surrounding the gland. For dogs admitted between 1 to 2 months from the onset of clinical signs, the volume of anechoic material appeared less than that seen in the acute cases. The overall appearance of the salivary mucocele was heterogenous. For dogs admitted after 2 months from the onset of clinical signs, the salivary mucocele appeared grainy or mottled, with a heterogenous appearance and a further decrease in anechoic content. For one dog that presented after 3 months from the onset of clinical signs, the salivary mucocele was hard on palpation and appeared hyperechoic with distal acoustic shadowing. Findings from this study indicated that ultrasonographic characteristics of salivary mucoceles in dogs vary depending on the chronological stage of the disease.     

Dynamic flexion/extension and non‐weight bearing ultrasonography is helpful for identifying manica flexoria tears in horses

Lesions of the manica flexoria are a tenoscopic finding in horses with digital flexor tendon sheath tenosynovitis. This retrospective case series study describes the ultrasonographic findings in seven horses admitted for digital flexor tendon sheath swelling associated with lameness and tenoscopic confirmation of a manica flexoria tear. Six horses had a partial manica flexoria tear, one a complete rupture. The ultrasonographic examination included a static examination on the weight and non‐weight bearing limb and a dynamic limb assessment during flexion and extension. The main ultrasonographic finding at the static weight bearing examination in horses with a partial tear was an asymmetrical appearance of the manica flexoria at the level of the junction with the lateral border of the superficial digital flexor tendon, or an incomplete visualization of the manica flexoria in case of complete rupture. The split edges of the completed ruptured manica flexoria were seen floating in the synovial fluid at the examination in flexion. In six of seven cases, the superficial digital flexor tendon slid abnormally relative to the deep digital flexor tendon, during flexion/extension movements, with medial displacement of the superficial digital flexor tendon, appearance of an anechoic gap between the flexor tendons or reduced superficial digital flexor tendon sliding. Because ultrasonographic diagnosis of the manica flexoria tear is considered challenging, detection of these ultrasonographic features is helpful to increase the likelihood of identifying manica flexoria tears prior to tenoscopy. Authors recommend static ultrasonographic examination of the manica flexoria using a flexed limb position and dynamic ultrasonographic examination using flexion and extension positioning for horses with suspected digital sheath injury.     

Ultrasonographic findings of disorders of the tarsal region in 97 cattle--arthritis, bursitis, tenosynovitis, periarticular abscess and vein thrombosis

The clinical, radiographic, ultrasonographic and centesis findings of 97 cattle with disorders of the tarsal region (arthritis, bursitis, tenosynovitis, abscess, vein thrombosis) were reviewed (1994-2006), and the typical ultrasonographic findings of different tarsal disorders in cattle are presented. The following criteria were assessed: echogenicity, echopattern, size, shape, appearance of the borders of synovial or other cavities. Ultrasonographic findings were compared with the clinical, radiographic and arthrocentesis results and with intraoperative and/or necropsy findings. 50 cattle suffered from one tarsal disease only, in 47 cattle--up to three different--concurrent disorders in one tarsal region were identified. The afflicted synovial cavities and abscesses were definitely differentiated ultrasonographically in all cattle suffering from tarsal disorders a comprehensive diagnosis could be achieved due to the easy and rapid ultrasonographic differentiation of the incriminated soft tissues.