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PubMed1994

Adjuvant-induced inflammation of rat paw is associated with altered calcitonin gene-related peptide immunoreactivity within cell bodies and peripheral endings of primary afferent neurons.

Local inflammation is associated with profound changes in the biochemistry and physiology of primary afferent nerve fibers and the central neurons responding to their signals. In some tissues, the neural changes accompanying inflammation include sprouting and cytochemical changes that are delayed several days after the initial injury. In the present study, we have analyzed the effect of complete Freund's adjuvant (CFA)-induced inflammation in the rat paw on calcitonin gene-related peptide (CGRP) immunoreactivity (IR) in dorsal root ganglia and within tissue of the inflamed paw. We quantified the CGRP-IR within the L1, L4, and L6 ganglia, and in ankle, midpaw, joint and toe tissues. Analysis of the processed tissue revealed a significant increase in the percentage of CGRP-positive cells within L4 dorsal root ganglia ipsilateral to an inflamed hindpaw six days after administration of CFA. There was a parallel increase in the number and staining density of detectable CGRP-immunoreactive fibers in periarticular and perivascular tissues of the inflamed digits and inflamed ankle. The other tissues of the paw, including epidermis and the regions surrounding the abcesses, did not have detectable changes in CGRP-immunoreactive fibers, despite tissue swelling and dystrophic changes in the foot that included loss of mast cell staining. These data demonstrate that local inflammation of the rat paw has delayed influences on the peripheral nervous system, in addition to a number of previously characterized acute effects. The alterations of CGRP-IR were focused around specific tissue types, such as joints and subdermal blood vessels, and absent from others, such as epidermis or in the areas surrounding abscesses. This suggests production of local factors within reactive tissues that selectively interact with nerve fibers to induce changes in CGRP-IR within the fibers.

Animals↗

PubMed2004

Collateral desmitis of the distal interphalangeal joint in 18 horses (2001-2002).

REASONS FOR PERFORMING STUDY: There have been no previously published case series of horses examined using either scintigraphy or MRI to diagnose collateral ligament injuries not detectable using ultrasonography or radiography, nor have other concurrent soft tissue lesions been described. OBJECTIVES: To describe the clinical features of horses with desmitis of the collateral ligaments of the distal interphalangeal (DIP) joint and to evaluate the results of radiographic, ultrasonographic, scintigraphic and magnetic resonance imaging (MRI) examinations. METHODS: Horses were examined between January 2001 and January 2003 and were selected for inclusion in the study if there was unequivocal evidence of collateral desmitis of the DIP joint based on ultrasonography or MRI. Subject details, case history, results of clinical examination and responses to local analgesic techniques were reviewed. The results of radiographic, ultrasonographic, scintigraphic and MRI examinations were assessed. RESULTS: Eighteen horses were identified with desmitis of a collateral ligament of the DIP joint, 3 horses (Group 1) based on ultrasonography alone, 7 (Group II) with positive ultrasonographic and magnetic resonance images and 8 (Group III) with no lesion detectable using ultrasonography, but lesions identified using MRI. Seventeen horses had forelimb injuries and one a hindlimb injury. The medial collateral ligament was injured most frequently (13 horses). In the majority of horses, no localising clinical signs were seen. Lameness was invariably worse in circles compared with straight lines. Lameness was improved by palmar digital analgesia in 16 horses (87%), but only 6 were nonlame. Intra-articular analgesia of the DIP joint produced improvement in lameness in 6/15 horses (40%). In 16 horses, no radiographic abnormality related to the DIP joint or collateral ligament attachments was identified. Eight of 14 horses (57%) had focal, moderately or intensely increased radiopharmaceutical uptake (IRU) at the site of insertion of the injured collateral ligament on the distal phalanx. Alteration in size and signal in the injured collateral ligament was identified using MRI. In addition, 5 horses had abnormal mineralisation and fluid in the distal phalanx at the insertion of the ligament. Eleven horses had concurrent soft tissue injuries involving the deep digital flexor tendon, distal sesamoidean impar ligament, navicular bursa or collateral ligament of the navicular bone. CONCLUSIONS AND POTENTIAL RELEVANCE: Collateral desmitis of the DIP joint should be considered as a cause of foot lameness. Although some injuries are detectable ultrasonographically, false negative results occur. Focal IRU at the ligament insertion on the distal phalanx may be indicative of injury in some horses. MRI is useful for both characterisation of the injury and identification of any concurrent injuries. Further follow-up information is required to determine factors influencing prognosis.

Animals↗

PubMed1979

The transverse head of adductor hallucis.

91 human cadaver feet were dissected to reveal the transverse head of adductor hallucis and measurements of the weights, angles of pull, width of origin and insertions were recorded. The origins and insertions of this muscle were found to differ from standard textbook descriptions. The origin usually includes the deep transverse metatarsal ligaments of the foot, the plantar ligaments of the lateral metatarsophalangeal joints, the intermuscular septa of the third and fourth muscle layers and the fibular syndesmosis of HENKEL (1913). The insertion was found to be usually by fleshy attachment to the lateral border of the oblique head of adductor hallucia. The angle of pull and the adjusted weights (% of intrinsic muscle mass) were found to be highly variable. In addition the transverse head was absent in 6% of the specimens. The function of this muscle is in question and it is likely that it is of little importance in normal foot functions.

Female↗

PubMedDate not supplied

A case of macrocephaly-cutis marmorata telangiectatica congenita and review of neuroradiologic features.

Macrocephaly-cutis marmorata telangiectatica congenita (M-CMTC) is characterized by macrocephaly, cutis marmorata, capillary malformations, toe syndactily, joint laxity and pre-natal overgrowth. Cerebral abnormalities might also be seen. We reported cerebral magnetic resonance imaging (MRI) findings of a case with M-CMTC, who had giant atrial septal aneurysm and atrial septal defect. Cerebral alterations determined by MRI were bilateral prominent lateral ventricles, bilateral cortical dysplasia, cavum septi pellucidum cyst and calvarial hemangioma. At 17th day of his life he suddenly developed cardiorespiratory arrest and died.

Abnormalities, Multiple↗

PubMed1994

Effects of surgical technique on bone. A preliminary study.

The authors compared the use of the power saw with bone-cutting forceps for excision of bone. A total of 44 digits were studied in 12 patients. The study was performed on patients requiring bilateral digital arthroplasties of the proximal and distal interphalangeal joints. The authors examined the differences in healing: pain, inflammation, and fibrosis. Digits on which the power cuts were made showed a slight advantage with regard to inflammation and pain, until 1 week after surgery. By week 12, neither technique demonstrated superiority. Overall results demonstrated no significant digit (p > 0.2) or treatment effect (p = 0.11). The authors believe that the study showed that the technique used for bone excision may have little effect on inflammation and healing in the long-term management of a surgical patient.

Adult↗

PubMed2003

Lameness in 46 horses associated with deep digital flexor tendonitis in the digit: diagnosis confirmed with magnetic resonance imaging.

REASONS FOR PERFORMING STUDY: The differential diagnosis of foot pain has long proved difficult and the use of magnetic resonance imaging (MRI) offers the opportunity to further the clinical understanding of the subject. OBJECTIVES: To determine the incidence of deep digital flexor tendon (DDFT) injuries in a series of 75 horses with lameness associated with pain localised to the digit, with no significant detectable radiographic or ultrasonographic abnormalities, using MRI; and to describe a variety of lesion types and relate DDF tendonitis with anamnesis, clinical features, response to local analgesic techniques and nuclear scintigraphic and ultrasonographic findings. METHODS: All horses undergoing MRI of the front feet between January 2001 and October 2002 were reviewed and those with DDFT injuries categorised according to lesion type; horses with primary tendonitis (Group I) and those with concurrent abnormalities of the navicular bone considered to be an important component of the lameness (Group II). The response to perineural analgesia of the palmar digital nerves and palmar (abaxial sesamoid) nerves, intra-articular analgesia of the distal interphalangeal (DIP) joint and analgesia of the navicular bursa were reviewed. The result of ultrasonography of the pastern and foot was recorded. Lateral, dorsal and solar pool and bone phase nuclear scintigraphic images were assessed subjectively and objectively using region of interest (ROI) analysis. RESULTS: Forty-six (61%) of 75 horses examined using MRI had lesions of the DDFT considered to be a major contributor to lameness. Thirty-two horses (43%) had primary DDFT injuries and 14 (19%) a combination of DDF tendonitis and navicular bone pathology. Lesions involved the insertional region of the tendon alone (n = 3), were proximal to the navicular bone (n = 23) or were at a combination of sites (n = 20). Lesion types included core lesions, focal and diffuse dorsal border lesions, sagittal plane splits, insertional injuries and lesions combined with other soft tissue injuries. Many horses had a combination of lesion types. Lameness was abolished by palmar digital analgesia in only 11 of 46 horses (24%). Twenty-one of 31 horses (68%) in Group I showed > 50% improvement in lameness after intra-articular analgesia of the DIP joint, whereas 11 of 12 horses (92%) in Group II had a positive response. Twelve of 18 horses (67%) in Group I had a positive response to analgesia of the navicular bursa. Nineteen horses had lesions of the DDFT extending proximal to the proximal interphalangeal joint seen using MRI, but these were identified ultrasonographically in only 2 horses. Scintigraphic abnormalities suggestive of DDFT injury were seen in 16 of 41 horses (41%), 8 in pool phase images and 8 in bone phase images. CONCLUSIONS AND POTENTIAL RELEVANCE: DDFT injuries are an important cause of lameness associated with pain arising from the digit in horses without detectable radiographic abnormalities. Lameness is not reliably improved by palmar digital analgesia, but may be improved by intra-articular analgesia of the DIP joint in at least 68% of horses. Ultrasonography is not sensitive in detecting lesions of the DDFT in the distal pastern region, but a combination of pool and bone phase scintigraphic images of the digit is helpful in some horses. Further follow-up information is required to determine the prognosis for horses with lesions of the DDFT in the digit and to establish whether this is related to lesion severity and/or location.

Analgesia↗

PubMed1998

Hallux valgus in young patients: comparison of soft-tissue realignment and metatarsal osteotomy.

Two procedures of hallux valgus correction in young patients were compared by long-term results: soft-tissue realignment (McBride) and Mitchell osteotomy. From 1970 to 1990, 33 hallux valgus deformities of 17 patients were corrected with one of these procedures at the Orthopaedic Department of the University of Mainz. Patients' age at operation ranged from 9 to 20 years and average follow-up was 16 years later. Reevaluation consisted of subjective criteria, such as pain, shoe-fitting, functional disability and cosmetics and objective parameters (hallux-valgus and intermetatarsal angle, osteoarthrotic changes and range of motion of the metatarsophalangeal joint). They were assessed by report, interview, radiograph and physical examination and determined the overall outcome. McBride procedure showed 59% good, 12% satisfying and 29% dissatisfying long-term results, whereas outcome after Mitchell osteotomy was graded as good in 69%, satisfying in 12% and dissatisfying in 19% of the cases. Critical analysis emerged, that each procedure has its own bounds of indication. Successful hallux valgus correction can be achieved by an individual approach consisting of careful study of the indications, well-performed surgery and appropriate postoperative care.

Adolescent↗

PubMed1975

The form and function of retractile claws in the Felidae and other representative carnivorans.

Recent behavioral studies have shown the primary organ of prehension used in capturing prey to be the claw equipped forelimbs. In light of its functional importance, the claw retractile mechanism for 15 felid species is described and its function studied . The anatomy of the claw retractile mechanism for felids is then compared to that of other carnivorans. For felids,claw retraction is mechanically possible due to the unique shape of the middle and distal phalanges. Claw retraction, however, is a function of the dorsal elastic ligaments and not of the forearm extensor muscles. The resistance provided by these ligaments allows for flexion of the wrist and digital joints without claw protrusion. Moreover, co-contraction of both forearm flexor and extensor muscles is necessary to produce claw protrusion. The functional anatomy of claw retraction for felids differs considerably from that of most other carnivorans. However, the claw retractile mechanism for some advanced viverrids is structurally similar to that of the felids. For these viverrids prey seizing, as in the felids, has become a function of the forelimbs. For the other families of carnivorans, the jaws and not the forelimbs are used as the primary organ of prehension and the anatomy of the claw retractile mechanism reflects functional demands placed on it other than grasping and holding prey.

Animals↗

PubMed2003

Retrospective evaluation of equine prepurchase examinations performed 1991-2000.

REASONS FOR PERFORMING STUDY: Prepurchase examinations of horses are used increasingly as a means of evaluating future soundness. Data is lacking in the literature of the radiographic findings and results of the lameness examination of comprehensive prepurchase examinations. OBJECTIVE: To summarise the clinical and radiographic findings of prepurchase examinations and determine if radiographic findings correlated with the lameness examination and sale outcome. METHODS: Records of 510 cases were reviewed, radiographs evaluated and grades assigned the navicular bone, distal phalanx, and tarsus. Follow-up information on the horse status was obtained by telephone interviews for 173 horses. RESULTS: Thoroughbred geldings represented the most common breed and sex, mean age 8 years, mean asking price 12,439.40 dollars, and 52.8% were lame. Radiography was the most common diagnostic procedure performed (61.6%), with views of the front feet requested most often (86.6%) followed by the tarsi (68.1%). Grade 1 was most common for the navicular bone while Grade 2 predominated for the distal phalanx. The number of sound horses decreased as grades became more severe. For the tarsi, Grades 0 and 1 were most common for the proximal intertarsal and distal intertarsal/metatarsal joints, respectively. Horses with significant tarsal changes were still able to compete at their expected level. With respect to the radiographic examination, the mean +/- s.d. grade of the horses which were not lame at follow-up was 1.2 +/- 0.9 for the navicular bone and 15 +/- 0.8 for the third phalanx. The mean +/- s.d. grade of sound horses for the distal intertarsal joint was 0.7 +/- 0.6 and 1.14 +/- 0.8 for the tarsometatarsal joint. Horses for which owner follow-up was available and which had a Grade 3 score were also evaluated. For the navicular bone, 17/31 with a Grade 3 remained in active use at follow-up and for the distal phalanx 21/27 were in active use. For the distal intertarsal and tarsometatarsal joints, 20/21 with a Grade 3 were still in active use. CONCLUSIONS: Prepurchase examinations can have a significant effect on the outcome of the sale. For the navicular bone and distal phalanx, higher grades were associated with lameness. In contrast, higher grades in the tarsus were less likely to be associated with lameness. Warmbloods tended to have more extensive changes in the navicular bone and distal phalanx relative to Thoroughbreds but were not as lame. POTENTIAL RELEVANCE: Radiographic changes detected in the navicular bone, distal phalanx and tarsus should be interpreted with consideration to the clinical examination.

Age Factors↗

PubMed2004

Development of a 3D model of the equine distal forelimb and of a GRF shoe for noninvasive determination of in vivo tendon and ligament loads and strains.

REASONS FOR PERFORMING STUDY: As critical locomotion events (e.g. high-speed and impacts during racing, jump landing) may contribute to tendinopathies, in vivo recording of gaits kinematic and dynamic parameters is essential for 3D reconstruction and analysis. OBJECTIVE: To propose a 3D model of the forelimb and a ground reaction force recording shoe (GRF-S) for noninvasively quantifying tendon and ligament loads and strains. METHODS: Bony segments trajectories of forelimbs placed under a power press were recorded using triads of ultrasonic kinematic markers linked to the bones. Compression cycles (from 500-6000 N) were applied for different hoof orientations. Locations of tendon and ligament insertions were recorded with regard to the triads. The GRF-S recorded GRF over the hoof wall and used four 3-axis force sensors sandwiched between a support shoe and the shoe to be tested. RESULTS: Validation of the model by comparing calculated and measured superficial digital flexor tendon strains, and evaluation of the role of proximal interphalangeal joint in straight sesamoidean ligament and oblique sesamoidean ligament strains, were successfully achieved. Objective comparisons of the 3 components of GRF over the hoof for soft and hard grounds could be recorded, where the s.d. of GRF norm was more important on hard ground at walk and trot. CONCLUSIONS: Soft grounds (sand and rubber) dissipate energy by lowering GRF amplitude and diminish bounces and vibrations at impact. At comparable speed, stance phase was longer on soft sand ground. POTENTIAL RELEVANCE: The conjugate use of the GRF-S and the numerical model would help to quantify and analyse ground/shoe combination on comfort, propulsion efficiency or lameness recovery.

Animals↗

PubMed1996

[Clinical and experimental study of RA mixture in treatment of rheumatoid arthritis].

The RA mixture is composed of Tripterygium Wilfordii (TW) and other Chinese medicinal herbs with effect of expelling Wind, activiting blood circulation, invigorating the Kidney and Qi. The authors treated rheumatoid arthritis (RA) patients with RA mixture and compared it with D-penicillamine as control. The two group's therapeutical effect is similar (P > 0.05), but the side effect occuring ratio in treatment group was obviously lower than that of control group (P < 0.01). After treatment with RA mixture, the patient's human lymphocytic antigen-degenerative reaction (HLA-DR+) cell, CD4/CD8 ratio reduced and auto-mixed lymphocytic reaction (AMLR) level enhanced (P < 0.05). The results of animal experiment showed that swelling of RA model mouse's joint could be reduced by both RA mixture and TW. Comparing with TW, RA mixture had stronger effect in controlling the inflammation of synovial cell and fibroid degeneration of fibrocytes. At the same time, RA mixture had stronger effect in protecting the immune organ from atrophy and protecting functions of cellular immunity. All above suggest that RA mixture reduce the syndroms of RA by improving distribution of T lymphocyte subsets and the functions of cellular immunity. The other Chinese medicinal herbs in the RA mixture could enhance TW's therapeutical effect and reduce it's side effect.

Adult↗

PubMed1991

Determination of biomechanical characteristics of restrictive adhesions and of functional impairment after flexor tendon surgery: a methodological study of rabbits.

Formation of restrictive adhesions is one of the main obstacles in rehabilitation following hand surgery. Most experimental work, however, involves only a macroscopic and/or histologic evaluation of the amount of adhesions, and their functional characteristics are poorly described. The aim of this study was to develop an experimental technique for characterization of the biomechanical properties of the finger-tendon unit. An instrument was developed for continuous and simultaneous recording of tensile load, tendon excursion and angular rotation in the distal interphalangeal joint of rabbit digits. Utilizing this instrument, it was revealed that the first 50 degrees of flexion required virtually no tensile load either in unoperated digits or immediately after tenorrhaphy. Thereafter, the load required to obtain further flexion was progressively increased. The strength of adhesions, determined 2 weeks after tenorrhaphy, was best expressed as the maximum tensile load recorded before 50 degrees of flexion was reached. This measurement could also be used to register the strength of the tendon repair and to detect partial tendon rupture during the measurement. The technique allows both adequate measurements of the strength of the adhesions and of the tendon gliding ability after flexor tendon surgery.

Animals↗

PubMed2006

Hoof growth between two shoeing sessions leads to a substantial increase of the moment about the distal, but not the proximal, interphalangeal joint.

REASONS FOR PERFORMING STUDY: There is little insight into the effects of routine farriery on the internal structures of the distal limb in sound horses. OBJECTIVES: To measure the effect of change in hoof conformation during a shoeing interval on the moments about the proximal and distal interphalangeal joints (PIPJ, DIPJ) and to determine whether and how the horse compensates for this change in hoof conformation. METHODS: Both front feet of 9 sound Warmblood horses were measured while standing on a pressure-force measuring system and radiographed in a lateromedial direction shortly after shoeing and 8 weeks later. From these data, ground reaction forces (GRF) and lever arms were measured in order to calculate joint moments. RESULTS: After 8 weeks, the moment about the PIPJ did not increase significantly, but the moment about the DIPJ did so, indicating a compensatory mechanism for a change in hoof conformation in the DIPJ. CONCLUSIONS: Standing horses compensate for hoof conformation change during an 8-week shoeing interval, which leads to increased DIPJ extension and consequently an increased loading of the deep digital flexor tendon. POTENTIAL RELEVANCE: This study quantifies the effect of a shoeing interval on the internal structures of the foot and helps to determine an appropriate shoeing interval for individual horses in which the hoof with the lowest hoof angle is the best indicator. The exact determination of an optimal individual shoeing interval requires further study.

Animals↗

PubMed1998

Shaping of the cat paw for food taking and object manipulation: an X-ray analysis.

The kinematics of the cat distal forelimb during food-taking were analysed to obtain information on the movement processes within the paw before and during object taking in a species without monosynaptic corticomotoneuronal projections. The behaviour was investigated with two tests: either the table test (TT, food offered on a table located at ground level in a reaching distance of 22 and 28 cm) or the horizontal test (HT, food offered in a small container located at shoulder level, height 18-25 cm, reaching distance 6-12 cm). In five animals, the changes in configuration and the conjoint actions of the wrist, the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints were assessed with three-dimensional X-ray cinematography (time resolution 20 ms, spatial resolution 1 mm) and video analysis. While approaching the target, the digits were first extended and subsequently abducted. This 'preshaping' consisted of combined angular changes in the MCP and PIP joints, thereby attaining an adequate grip aperture. Each cat used a stable strategy, but different cats used different strategies. In the TT, preshaping involved an MCP extension and a PIP flexion. In the HT, predominant extension of the MCP, predominant extension of the PIP, or a combination of both were used, followed by MCP flexion and PIP flexion. The grip aperture started to decrease before object contact, earlier in the TT, later in the HT. Grasping was achieved by flexion of first the PIP and later the MCP. The X-ray analysis gave evidence for individuated digit movements. Correlation analysis of the angular position of the joints between the different phalanges showed that digits 3 and 4 acted in concert, as did digits 2 and 5, but with clear independence between the different pairs. Furthermore, the different phalanges served different purposes during the grasp. Digits 3, 4 established object contact, digits 2, 5 were mainly used to stabilize the paw onto the surface. The cat distal forelimb displays a refined movement repertoire during the preshaping and grasping phase of food-taking. During the preshaping phase, the kinematics resembled in some aspects the situation in humans. The results demonstrate the ability of the polysynaptic projections from the cortico-motoneuronal system to organize differentiated distal limb movements, including individuated movements of the digits.

Animals↗

PubMed1994

Survivorship analysis of implant arthroplasty for the first metatarsophalangeal joint.

During a 21-year period at the authors' institution, 93 primary implants of the first metatarsophalangeal joint were performed on 79 patients (12 men and 67 women). Their mean age was 56 years (range, 19 to 75 years). The average duration of follow-up evaluation in 75 patients who were alive and without reoperation was 12 years (range, two to 17 years). With the proportional hazards general linear model, young age was identified as a significant risk factor for poor survival: at ten years, implant survival was 82% in patients 57 years of age or younger, and 90% in patients older than 57 years. The overall probability that an implant would not have been removed was 86% at ten years after arthroplasty and 82% at 15 years.

Adult↗

PubMed2005

Lameness associated with foot pain: results of magnetic resonance imaging in 199 horses (January 2001--December 2003) and response to treatment.

REASONS FOR PERFORMING STUDY: The diagnosis of foot-related lameness often remains elusive and it can be difficult to offer rational treatment, or to predict outcome. OBJECTIVES: To describe the spectrum of injuries of the foot identified using magnetic resonance imaging (MRI), to determine their relative prevalence among MRI diagnoses and to establish the long-term results of treatment. METHODS: The MR images of horses examined from January 2001--December 2003 were reviewed. Horses were selected for MRI if the pain causing lameness was localised to the foot using perineural analgesia but any clinical, radiological or ultrasonographic abnormalities were insufficient to explain the degree of lameness. The clinical significance of lesions identified using MRI was determined with reference to the results of local analgesia, radiography, ultrasonography and nuclear scintigraphy. Follow-up information was obtained in January 2004 for horses which had been examined 6-36 months previously and the outcome classified as excellent (horse returned to full athletic function without recurrent lameness), moderate (sound, but only in light work), or poor (persistent or recurrent lameness). RESULTS: One hundred and ninety-nine horses underwent MRI examinations. Deep digital flexor (DDF) tendonitis was the most common injury (59%) with primary injury in 65 horses (33%) and a further 27 horses (14%) having lesions of the DDF tendon and navicular bone. Seventeen percent of horses had injuries to multiple structures, including 24 with DDF tendonitis. Desmitis of a collateral ligament (CL) of the distal interphalangeal (DIP) joint was the second most common injury (62 horses, 31%), with primary injuries in 30 horses (15%) and a further 32 horses (16%) that had CL desmitis in conjunction with other injuries. Prognosis was best for horses with traumatic injuries of the middle or distal phalanges, with 5 of 7 horses (71%) having an excellent outcome. Horses with primary lesions of the DDF tendon or CL of the DIP joint had excellent results in only 13 of 47 (28%) and 5 of 17 horses (29%), respectively. Horses with combined injuries of the DDF tendon and navicular bone, or primary navicular bone abnormalities, had a poor outcome, with the majority of horses suffering persistent lameness. CONCLUSIONS: A wide variety of lesions associated with foot pain were identified using MRI, a high proportion of which were primary soft tissue injuries with a guarded prognosis for return to full athletic function. POTENTIAL RELEVANCE: It is now possible to propose more rational treatment strategies for the variety of foot injuries identified using MRI than had previously been possible; however, further information concerning aetiopathogenesis of these injuries is needed to improve their management.

Animals↗

PubMed1998

The effects of proximal load on the excursion of autogenous flexor tendon grafts.

To determine the relationship between the intrinsic properties of tendon and tendon excursion in 2 types of autogenous tendon grafts, hindpaw intrasynovial and extrasynovial tendons were transferred to the lateral and medial forepaws of adult mongrel dogs (16 experimental and 16 control tendons). After each digit was marked with radiopaque markers, it was placed in a specialized jig, and weights of 25 g, 100 g, or 200 g were applied to the flexor tendons. Specialized radiographs were obtained with the digit in flexion and extension. Tendon excursion and joint rotation were calculated. There were no statistically significant differences between experimental groups for tendon excursion or for joint angular rotation (p > .05). For intrasynovial tendon grafts, the angular rotation per millimeter tendon excursion was 10.9 degrees +/- 2.4 degrees/mm, 9.4 degrees +/- 1.2 degrees/mm, and 9.0 degrees +/- 1.4 degrees/mm with 25-g, 100-g, and 200-g loads, respectively. Comparisons between experimental groups revealed that a statistically significant difference could not be determined (p > .05). With varying proximal loads, both intrasynovial and extrasynovial grafts showed similar amounts of tendon excursion. Variations in proximal load did not significantly influence the amount of excursion within the range of loads tested. Based on these data, it appears that the difference in repair potential for these 2 types of tendon grafts is not related to a differential in the amount of tendon graft excursion following transfer to the synovial space.

Animals↗

PubMed2005

Differential diagnosis of pedal osteomyelitis and diabetic neuroarthropathy: MR Imaging.

Almost all diabetic foot infections originate from a foot ulcer. Decreased pain perception and structural deformities such as previous partial foot amputation, Charcot joints, and toe deformity in combination with chronic ischemia lead to a propensity for skin breakdown and subsequent infection. Magnetic resonance (MR) imaging is increasingly performed to evaluate for potential bone infection, but diagnosis of osteomyelitis can be complicated because signal changes from acute Charcot arthropathy, fractures, and postoperative residues may be mistaken for infection. Signal alterations of bone infection may be atypical in sclerosing osteomyelitis and gangrene. Differentiation between osteomyelitis and acute or subacute neuroarthropathy requires careful analysis of the location of bone signal alterations, their distribution, and pattern because qualitative changes are often identical. Presence of secondary signs such as adjacent ulcer, cellulitis, and sinus tract is indicative of osteomyelitis. Differentiation of noninfected neuroarthropathy from infected neuroarthropathy based on MR examinations is difficult. Presence of a sinus tract, disappearance of subchondral cysts, diffuse bone marrow abnormality, and bone erosions are in favor of infection.

Diabetes Complications↗