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Development of an equine nuclear medicine facility for gamma camera imaging.

A nuclear medicine facility constructed specifically for the application of a gamma camera system to the radioisotope imaging of bone, pulmonary circulation and ventilation in the horse is described. The gamma camera was previously used for human nuclear medicine, and a support for the gamma camera head was specifically designed for this work. Imaging protocols are suggested and the necessary materials for bone and lung studies are described. Images of bone and lung are shown and computer analysis of the data indicated. Imaging times are approximately 1 to 2 mins and typical bone and lung studies can be completed in 20 to 30 mins.

Animals↗

The fabella sign: fabella displacement in synovial effusion and popliteal fossa masses. Normal and abnormal fabello-femoral and fabello-tibial distances.

Posterior displacement of the fabella is a reliable sign of synovial effusion or mass which may be applied even when inflammation or post-traumatic edema obscures the extrasynovial fat lines of the knee joint. The fabella normally moves posteriorly as the knee is flexed, but correlation of fabella position with degree of flexion defined ranges of normal and abnormal fabella position which are useful in diagnosis. If all lateral views are obtained with the knee flexed over a standard angle bolster, fabella position is standardized and fabella displacement readily detected without need for measurement. With experience, fabella displacement is readily apparent in non-standard positions as well. Normal fabella position does not rule out small effusion or effusion which is confined to the suprapatellar pouch because the knee is extended.

Adolescent↗

A technique for management of traumatic rupture of the equine suspensory apparatus.

Problems involving the management of acute traumatic rupture of the equine suspensory apparatus include loss of blood flow to the foot, proper immobilization, and pressure sores from casts. A technique utilizing a board splinting device attached to the affected limb at the toe and subsequent corrective shoe support provides immobilization, prevents dropping of the fetlock, can be applied to the standing animal, and allows frequent changing of the bandages, if necessary.

Animals↗

Morphometric study of the equine navicular bone: age-related changes and influence of exercise.

Navicular bones from the four limbs of 95 horses, classified in 9 categories, were studied. The effects of age on navicular bone morphometry and histomorphometry were estimated, after adjustment of the data to even out the effects of front and rear limbs, morphometrical type, sex, weight, and size. All the external measurements of the navicular bone decreased significantly with increasing age. From the histomorphometrical data, cortical bone volume decreased with age in most horses, whereas cancellous bone volume and, in particular, the marrow spaces increased. The increase in the cancellous bone volume could have resulted from tunnelling of the internal part of the cortex, which converted it progressively into a porous trabecular-like structure. Trabecular bone volume also decreased with age and the trabecular lattice changed dramatically to become disconnected in aged horses. These observations corresponded closely to those reported for ageing of the skeletal system in humans. However, in sporting horses, the navicular cortical bone volume increased with age and the cancellous bone volume decreased. Exercise appeared to have decreased bone resorption and increased bone formation at the endocortical junction. The cancellous bone architecture was also improved. in that the trabecular lattice and trabecular bone volume remained unchanged in aged sporting horses. Our findings confirmed that exercise may be good practice to prevent age-related bone loss.

Age Factors↗

Patella cubiti in dogs.

The occurrence of patella cubiti in dogs and man and its clinical signs, diagnosis, and treatment are described. The origin of the bone is discussed and it is concluded that the bone might be part of the normal anatomy. At present the prevalence of the bone in dogs is under investigation at Cornell University.

Animals↗

Management of foot pain associated with accessory bones of the foot: two clinical case reports.

STUDY DESIGN: Case study. OBJECTIVES: To discuss the differential diagnosis, the nonsurgical and postoperative management of common accessory bones of the foot. BACKGROUND: Accessory bones of the foot that are formed during abnormal ossification are commonly found in asymptomatic feet. Two of the most common accessory bones are the accessory navicular and the os peroneum. Their painful presence must be considered in the differential diagnosis of any acute or chronic foot pain. The optimal treatment for the conservative and postoperative management of painful os peroneum and accessory navicular bones remains undefined. METHODS AND MEASURES: Therapeutic management of the fractured os peroneum included bracing, taping, and foot orthotics to allow healing of involved tissues, and stretching. The focus of the postoperative management of the accessory navicular was joint mobilization and progressive strengthening. Dependent variables included level of pain with provocation and alleviation tests of joint and soft tissue; girth and sensory tests of the foot and ankle; goniometric measures of foot and ankle; strength of ankle and hip muscles; functional tests; and patient's self-reported pain status. RESULTS: The patient with the fractured os peroneum was treated in 13 visits for 10 weeks. At discharge from physical therapy, the patient had the following outcomes relative to the noninvolved side: 100% return of normal sensation tested by light touch and vibration; pain decreased from 6/10 to 1/10; 100% reduction of swelling with ankle girth to normal; 100% range of motion of ankle and subtalar joints. Strength in plantar flexion and eversion remained 20% impaired (80% return to normal) secondary to pain. Upon discharge, he still reported mild pain when walking but was able to return to previous leisure activities. The second patient with the accessory navicular was treated in 18 visits over 9 weeks. Relative to the uninvolved side, she was discharged with the following: 70% return of range of motion in the foot and ankle, 100% of strength in hip and ankle, and 100% return of balance. She could squat and jump without pain and she returned to full premorbid activity level. CONCLUSIONS: Rehabilitative management of both cases addressed specific impairments and was successful in improving the patients' activity limitation. Clinicians should be aware that these accessory bones are possible sources of disability, secondary to foot pain.

Adult↗

The painful foot.

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Arthritis, Rheumatoid↗

Hand-wrist and cervical vertebral maturation indicators: how can these events be used to time Class II treatments?

BACKGROUND: Ossification events in the hand and wrist and in the cervical vertebrae have been shown to occur at specific times before, during and after the adolescent growth spurt, but there is still debate about the applicability of these findings to the clinical management of Class II cases. The aim of this study was to relate, on an individual basis, cervical vertebral maturation stages and hand-wrist ossification events to the timing of peak statural and mandibular growth in a group of indigenous Australians. METHODS: Velocity curves for stature and mandibular growth were constructed for 47 boys and 27 girls, and maturation events were then plotted on the curves. RESULTS: For the majority of children, peak velocity in mandibular growth coincided with peak velocity in stature. Particular combinations of hand-wrist and cervical maturation events occurred consistently before, during or after the adolescent growth spurt. CONCLUSION: Our findings are consistent with those for North American children and we believe that assessment by orthodontists of a combination of hand-wrist and cervical vertebral maturation stages will enhance prediction of the adolescent growth spurt, thereby contributing to a positive, purposeful and more confident approach to the management of Class II cases.

Adolescent↗

Suspensory apparatus prosthesis in the horse. Part 2: In vivo evaluation in a suspensory apparatus disruption model.

The suspensory apparatus of one forelimb was surgically disrupted in six adult horses by transecting the distal sesamoidean ligaments. A double-braided prosthetic ligament made of aramid yarn was installed to support the flexor surface of the metacarpophalangeal joint. The prosthesis was routed through tunnels in the third metacarpal bone and proximal phalanx, and secured to bone with screws. Evaluation by radiography, synovial fluid analysis, cinematography, and dynamography was performed before surgery and at weeks 16 and 30. Supracondylar cortical lysis and periosteal proliferation were observed on postoperative radiographs. Synovitis and fragmentation of the prosthesis were apparent from synovial fluid evaluation. Weight bearing and metacarpophalangeal joint motion were decreased and loading was transferred in part to the opposite forelimb. Clinical lameness improved and weight bearing increased during the second half of the 30-week period. At necropsy, there was abrasion of the prosthesis and the articular surfaces in contact with the prosthesis. Diffuse granulomatous synovitis developed in response to aramid fiber fragments within the synovium.

Animals↗

Keller resection arthroplasty for treatment of hallux valgus deformity: increased correction with fibular sesamoidectomy.

Thirty-eight patients (50 feet) were treated with Keller resection arthroplasties combined with fibular sesamoidectomies. Thirty-six patients were females (48 feet) and two were males (two feet). Their ages ranged from 55 to 87 years and averaged 68.4 years. Preoperative metatarsophalangeal (MTP) angles averaged 34 degrees (range, 10 to 55 degrees) and intermetatarsal (IM) angles averaged 15 degrees (range, 8 to 27 degrees). All patients were evaluated at an average of three years after surgery. An average correction of 18 degrees in the MTP angle and 6 degrees in the IM angle were obtained. At follow-up, 76% of patients had no pain, 14% had mild pain, and 10% had moderate pain; 76% had no activity limitations, 22% had recreational limitations, and 2% had daily limitations. Ninety-five percent of patients were satisfied with the results of their surgery.

Aged↗

Navicular bone disease: a comparative histomorphometric study.

Twelve horses suffering from navicular bone disease were examined in a prospective, controlled histomorphometric study for six months. The objective was to compare the histology of navicular bones from untreated animals to those treated with the egg-bar shoeing technique. These data were compared to similar sections from three normal animals. The current investigation provided quantitative support to previous findings concerning clinical improvement. Detailed histology, changes in bone morphometry and pathophysiological reactions are discussed.

Animals↗

A case report of patella cubiti.

Report of a patella cubiti in a patient with juvenile rheumatoid arthritis. The genesis of this patella is unknown up to now. The following hypotheses are discussed: 1. Persistent separation of the non fused epiphyseal bone centre with consecutive independent development. 2. Avulsion of the epiphysis due to muscle tension. 3. Epiphysitis as cause of the new formed patella.

Adult↗

The arterial supply of the navicular bone in the normal horse.

An arteriographic and histological study of the arterial blood supply of 35 navicular bones, from 19 adult horses with no clinical or radiographical signs of navicular disease, is described. The arteries enter the navicular bone from four directions: distal, proximal, medial, and lateral. The navicular bone can be divided into areas which receive arteries from one, two, or three directions, whereas the distal supply covers the largest part of the navicular bone. The distal arteries enter the navicular bone through the nutrient foramen which contains loose connective tissue, nutrient vessels and myelinated nerves. At least 77 per cent of the nutrient foramina contains synovial membrane. Twelve per cent of the arteries in the navicular bone show histological changes. Thickening of the intima with or without splitting of the internal elastic membrane and hyalinization, fibrosis and hypertrophy of the media were observed.

Angiography↗

The effect of artificial occlusion of the Ramus navicularis and its branching arteries on the navicular bone in horses: an experimental study.

The clinical, radiographic, arteriographic, scintigraphic and histological effects of experimental occlusion of the Ramus navicularis (R. Navicularis) and its branching arteries are evaluated. Occlusion of the R. navicularis and its branching arteries creates changes, arteriographically and histologically, which resemble those of navicular disease. The increased bone remodelling, the shift in arterial pattern, the formation of collaterals and the increased connective tissue in the synovial membrane and nutrient foramina, as a reaction to the reduction of the distal arterial supply of the navicular bone, are also pathological features in the navicular bones of horses with navicular disease. The results of the present study support the theory that a reduced distal arterial supply of the navicular bone is important in the pathogenesis of navicular disease.

Angiography↗

Sensory innervation of the navicular bone and bursa in the foal.

The sensory innervation of the navicular bone (os sesamoideum distale) and its suspensory ligaments [ligamenta sesamoidea collateralia (CSL) and ligamentum sesamoideum distale impar or distal sesamoidean impar (DS-impar) ligament] and the navicular bursa (podotrochlearis) was examined in the neonatal foal using immunocytochemistry. With antisera raised to substance P (SP) and human calcitonin gene-related peptide (CGRP), immunoreactive nerves were demonstrated to innervate the CSL and navicular bursa. Within CSL, and SP- and CGRP-like nerves were present in the synovial lining of the navicular bursa, appearing to reach the surface lining. These nerves appeared to enter the CSL and navicular bursa via the abaxial regions of the foot. Both peptides were present in the deep digital flexor tendon (DDf) along the palmar border of the navicular bursa, as well as in the DS-impar ligament. More nerve fibres were present in the dorsal part of CSL bordering the distal interphalangeal joint than was observed palmarly in CSL along the navicular bursa. Both peptides were observed to innervate the cartilage canals within the navicular bone. In terms of relative densities of immunoreactive SP- and CGRP-like peptides, the CSL dorsally and the DS-impar ligament had the highest relative densities of nerve fibres followed by the navicular bone, the palmar aspect of CSL and the DDf tendon bordering the navicular bursa. These results are discussed in relationship to local anaesthetic injections into the navicular bursa.

Animals↗