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71 Cards in this Set
- Front
- Back
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Alteration in anatomical outline on radiograph |
-Fracture
-Luxation/subluxation -Proliferation -Lysis -Abnormal development |
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Alteration in density of an anatomically normal structure
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-Increased:
--sclerosis: increased density of existing bone --Proliferation: new bone formation --Dystrophic calcification: something is calcifying that should not be -Decreased --separation --lysis |
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Radiographic lesions of the Equine carpus
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-Chip fractures
-Slab fractures -Osteophytes -Enthesiophytes -Sclerosis |
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Ultrasound diagnoses for Neonates and young animals
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-Umbilical remnants
-Uroperitoneum -Meconium retention or impaction -Hernias -Rib fractures -Intussusceptions (small intestinal) -Enterocolitis -Congenital heart disease -Other misc. |
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Indications for Umbilical ultrasound in neonates
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-Fever of unknown origin
-Septic joint in otherwise healthy neonate -Chronic ill-thrift, poor-doer -Abnormal external umbilical remnant -A normal external remnant does NOT rule out abnormalities of internal remnants |
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Normal External anatomy of umbilicus
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-Equine and camelids:
--1 umbilical vein to liver --2 umbilical arteries to aorta --1 urachus to bladder -Bovine: --2 umbilical veins --umbilical arteries and urachus often retract into abdomen when umbilical cord breaks |
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Normal internal anatomy of Umbilicus
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-Equine and bovine are the same
-1 umbilical vein --becomes the round ligament of the liver -2 umbilical arteries --becomes the round ligaments of the bladder -1 urachus --becomes a “potential space,” median ligament of the blader |
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Technique for umbilical ultrasound
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-High frequency transducer
--6.0-10.0 MHz or higher -Clip 5cm of hair along ventral midline -Apply warmed coupling gel --foals hate cold gel, will kick! -Easiest to perform in standing neonate --also easier to be kicked, need to be careful |
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Normal umbilical veins in foal or calf on ultrasound
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-Foal: 1 umbilical vein
-Calf: can see 2 veins -Lumen varies in appearance based on maturity of blood clot -Want to assess size and appearance of the vessel |
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Normal urachus on ultrasound in neonate
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-Urachus is “potential space”
-Find 2 umbilical arteries, find space inbetween -Abnormal to have fluid in the urachal space |
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Normal bladder on ultrasound in neonate
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-Can be large or small
--large bladder is common with “mattress foals,” sick foals -Urine should be anechoic --may see Na CaCO3 crystals during first week of life or so |
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Omphalitis
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-Infection or inflammation of any portion of the external umbilical remnant
-Need to follow umbilicus into abdomen to determine specific structures affected -Main reason for ultrasound of umbilicus -Never do only an external scan of the umbilicus, should always do internal scan also! |
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Omphalophlebitis
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-Infection of the umbilical vein
-Vein is more than 1cm in diameter -Fluid filled-lumen of umbilical vein --fluid can be anechoic, hypoechoic, echogenic, or hyperechoic -Complication includes liver abscess --can clearly see on ultrasound -May have SQ swelling along ventral abdomen (cellulitis) -Will see enlarged, thick-walled vein filled with echoic fluid on ultrasound |
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Urachitis and Urachal abscess
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-Enlarged urachus
--combined measurement of urachus and umbilical arteries is more than 1.5*2.5cm -Thickened urachal wall -Fluid-filled urachus --fluid may be anechoic, hypoechoic, ecogenic, or hypoechoic --potential space is filled with thickened urachus and fluid -May see abscess, gas with anaerobic infection -May have SQ swelling around ventral abdomen -Urachitis is common in cows -May have polyuria as clinical sign --frequently postures to urinate |
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Urachitis and Cystitis
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-Normal neonatal foal should have anechoic urine
-Cystitis appears as echogenic particles in urine -may also have thickening of bladder wall -May see settling of particles ventrally |
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Patent urachus
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-Urachus should be “potential space”
-If patent, can appear as anechoic fluid-filled tubular connection between bladder and external remnant of the umbilicus -May also see urachal diverticulum --urachus is patent at bladder apex but not at external remnant --diverticulum heads towards umbilical remnant --diagnosed on ultrasound |
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Bladder hemorrhage in foals
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-Hematuria
-Stranguria -Anemia -Echogenic clot with swirling echogenic fluid indicates active hemorrhage |
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Uroperitoneum in neonate
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-Common problem
-Bladder is only source of urine in the abdomen, indicates ruptured bladder --bladder can also “seep” -Can be ruptured bladder, ruptured urachus, ruptured ureter, or necrotizing cystitis -Will see large anechoic peritoneal effusion --if hypoechoic to echoic, indicates chemical peritonitis -Can see GI viscera floating -May image defect in the urinary tract -May see retroperitoneal fluid accumulation if there is a urachal or ureteral defect -Free fluid in the abdomen with collapsed, folded bladder --can sometimes see defect and umbilical arteries next to the bladder |
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Neonatal patient preparation for abdominal ultrasound
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-Clip entire ventral abdomen
--xiphoid to pubis and lateral sides of abdomen from paralumbar fossa to elbow, ventral to lung -Use 5.0-10.0 MHz transducer --high frequency can be used to look for superficial abnormalities -Always scan from most ventral location to detect abnormal small intestine --abnormal intestine is usually heavy, sinks down |
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Meconium impaction on ultrasound
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-Hypoechoic meconium within hyperechoic intraluminal contents
--“snow globe effect” -Hyperechoic material within small colon dorsal to the bladder --scan through the bladder and look dorsal |
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Intussusception in neonates
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-Jejunojejunal: Will see “target” sign on ultrasound
--outer intussuscipiens and inner intussusceptum -Ileocecal: hard to see if cecum is filled with gas --if cecum is filled with fluid, will be able to see |
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Hernias in neonates
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-Umbilical hernia
-Inguinal hernia -Diaphragmatic hernia -Abdominal wall hernia -Need to determine: --size --contents --infection --adhesions |
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Enterocolitis and Abomasitis in Neonates
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-Fluid distention
-Thick walled -Irregular mucosal surface -Increased or decreased peristaltic activity -Gas in wall of GI indicates necrotizing --consider Clostridia |
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Abomasitis in neonates
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-will see gas bubbling through walls of abomasum
-Worry about clostridial infection |
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Foal Ascariasis
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-Echogenic tubular worms visible in small intestine
-Can see worms surrounding lumen |
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Rhodococcus Equi on ultrasound
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-Abscesses:
--multiple cavitated hypoechoic areas --lack normal pulmonary architecture -Abscesses are not pathognomonic for Rhodococcus equi, can also indicate strep --need to compare with clinical signs and history |
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Pulmonary edema and ARDS on ultrasound
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-Looks like multiple coalescing comet tails
--indicates pulmonary edema |
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Rib fractures on ultrasound
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-Discontinuation of normal smooth hyperechoic bony echo
-May see irregular bony proliferation or a callus -Sometimes easier to diagnose on ultrasound than on radiograph |
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Ultrasound of normal lung and pleura
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-Hyperechoic line of air moving with respirations
-Air is a bright line that blocks everything past it -Diaphragm can be imaged ventral to the ventral lung |
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Ultrasound of non-effusive pleuritis
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-Lung slides with rough movements across parietal pleura of chest wall and diaphragm
-Lung does not move well -Will see a lot of comet-tails |
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Ultrasound of pleural effusion and Pulmonary atelectasis
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-Anechoic fluid in pleural space
--fluid surrounds lung tissue -Lung tissue is collapsed and not filled with air -Pericardial diaphragmatic ligament floating in the fluid -Hypoechoic and compressed ventral lung tip is floating in fluid -Dorsal lung is aerated as normal |
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Ultrasound of fibrinous pleural effusion
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-Hypoechoic fibrinous loculations around atelectic ventral lung instead of clear fluid
--“spiderwebs” -May see hypoechoic fibrin on parietal and visceral pleura of lung |
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Ultrasound of fibrinous anaerobic pleuropneumonia
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-Anechoic fluid with hypoechoic fibrin between parietal and visceral pleura
-Hyperechoic free gas in pleural space, trapped in fibrin -Compressed hypoechoic ventral tip of the lung |
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Ultrasound of pneumothorax
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-Will see break in characteristic air reverberation artifact
-Soft-tissue density echo at interface indicates atelectic lung -“Curtain sign: |
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Ultrasound of Hydropneumothorax
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-Pneumothorax with pleural effusion
-Dorsal and ventral movement of gas-fluid interphase --“curtain sign” -Lung is floating deeper in fluid |
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Ultrasound of hemothroax
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-Hypoechoic-echoic fluid with swirling motion in pleural space
-Can see with diaphragmatic hernia |
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Pulmonary consolidation on Ultrasound
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-Right ventral lung is most commonly affected
-Will see comet-tail artifacts -Hypoechoic pulmonary parenchyma -Air bronchograms -Fluid bronchograms -Gelatinous parenchyma with loss of normal architecture |
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DDx for comet-tail artifacts
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-COPD
-Pulmonary edema -Pneumonia -Artifacts originate in the lung periphery or slightly deeper -Small, hypoechoic areas in lung periphery -Unspecific sign, can be caused by any pulmonary pathology |
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Ultrasound of Necrotizing pneumonia
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-Hypoechoic, swollen gelatinous lung parenchyma |
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Ultrasound of Pulmonary abscess
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-Focal cavitated lesion in pulmonary parenchyma with loss of internal architecture |
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Management and prognosis for horses with pleuropneumonia
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-Best prognosis if there is no pleural fluid, fibrin, loculations, free gas echoes, or parenchymal necrosis
-Treatment is increased with complications |
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Cranial mediastinal abscess on ultrasound
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-May see ventral thoracic edema and swelling in left front
-Hypoechoic fluid and fibrin fills cranial mediastinum -Want to look at the front of the lung |
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Cranial mediastinal lymphosarcoma in horses
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-Homogeneous or heterogenous mass
--usually occupies entire cranial mediastinum -Enlarged homogenously hypoechoic cranial mediastinal lymph node -Caudal cardiac displacement is caused by large mass -Usually lots of pleural effusion -Dorsal and cranial extension of mass towards thoracic inlet |
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Uses for abdominal ultrasound
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-Differentiate medical or surgical colic cases
--medical: enteritis, colitis, duodenitis, ileus, spasmodic colic, impaction --surgical: intussusception, strangulation, obstruction, enterolith, impaction -Identify and characterize abdominal masses -identify and characterize peritoneal fluid -Evaluate abdominal organs -Need t know anatomy and ultrasonographic anatomy -Evaluate the entire abdomen --especially ventral refion -Can be done transabdominally or rectally |
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Normal intestine on ultrasound
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-Less than 3mm wall thickness
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Normal stomach on ultrasound
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-May have some air and solid ingesta
-Not normal to have lots of fluid -Size will increase with fluid and gas distention in some pathological condtions -Always associated with spleen |
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Nephrosplenic entrapment on ultrasound
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-Spleen is displaced ventrally
-Cannot see left kidney and caudal border of the spleen -May see large colon echo in the way |
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Ultrasound of sand impaction
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-Lots of colonic sacculations
-Hyperechoic echoes with strong acoustic shadows |
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Ultrasound of colangiohepatitis
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-Hyperechoic structures with acoustic shadows
-Biliary distention -Hepatomegaly -Heterogenous liver parenchyma -Echoic areas throughout the hepatic parenchyma -Hepatomegaly -Round ventral liver margin |
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Ultrasound of fatty liver in cows
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-Marked hepatomegaly with rounded borders
-Loss of normal architecture -Increased echogenicity of parenchyma |
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Ultrasound of hepatic lymphosarcoma
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-Marked hepatomegaly
-Homogenous and echoic hepatic parenchyma -heterogenous parenchyma with discrete masses -Loss of vascular markings |
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Ultrasound of the Spleen
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-Transabdominally from left ventral abdominal region
-Hypoechoic homogenous appearance -Most echoic abdominal organ |
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Ultrasound of splenic lymphosarcoma
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-Marked splenomegaly
-Masses with heterogenous echogenicity are most common |
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Ultrasound of cows wit Traumatic Reticuloperitonitis/Hardware disease
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-Abscesses in cranioventral abdomen
--echogenic depositis or cavitated masses on reticulum --echogenic masses with hypoechoic cavities -Abdominal effusion -Displacement of the reticulum and impaired motility -Complements radiographs --cannot see metallic foreign bodies with ultrasound -Hypoechoic fluid and hyperechoic gas in cranioventral abdomen with adhesions |
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Ultrasound of hemoperitoneum
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-Echoic fluid with swirling movements in peritoneal cavity
-Large hyperechoic mass in spleen |
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Fractures of the Pelvis
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-Ilium
-Ischium -Tuber coxae (most common in young horses) -Acetabulum -Diagnose based on stance, rectal exam, ultrasound, scintigraphy, radiographs --radiographs are last option, requires anesthesia --scintigraphy is least invasive and can be done standing |
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Common problems wit coxo-femoral joint
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-DJD
-Fracture -Sepsis -Coxo-femoral luxation -Slipped capital epiphysis |
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Types of pelvic fractures
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-Type I: simple, non-acetabular
--fair prognosis -Type II: comminuted, non-acetabular --guarded prognosis --leads to secondary DJD -Type III: simple acetabular --guarded to poor prognosis --leads to DJD -Type IV: communited acetabular --poor prognosis |
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Radiographs of the pelvis
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-Not great
-Need almost no motion due to big Mas --anesthetize animal -Need a grid on the plate |
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Scintigraphy of the Pelvis
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-Most sensitive imaging modality
-Does not require general anesthesia -Fast -Accurate -Minimal risk to the patient |
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Radiographic anatomy of the Stifle
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-Patella
--6 ligaments hold patella between tibia and distal femur -Distal femur --Distal medial femoral condyle and femorotibial joint is most common location for injury -Femoral condyles --lateral condyle is more rounded than medial condyle, less weight-bearing -Medial trochlear ridge -Lateral trochlear ridge -Fibula is on lateral aspect -Tibial plateau -Median tibial eminence -Tibial crest -Proximal tibial growth plate |
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Joints associated with the Stifle
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-Femoropatellar
-Femorotibial-medial --communicates with femoropatellar joint -Femorotibial-lateral --does not communicate with any other joints |
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Soft tissue anatomy of the Stifle
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-Ligaments
-Menisci -Meniscal ligaments -Articular surfaces -Subchondral bone |
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Radiographic views of the stifle
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-Caudo-cranial
-Latero-medial -Caudolateral-cranialmedial oblique --safe angle -Skyline view of patella -Put limb of interest back and plate in the groin |
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Diagnosing stifle disease
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-Signalment
-Physical exam -Lameness exam -Nerve blocks -Radiographs --Always radiograph contralateral side for comparison! -Ultrasound -Scintigraphy -Arthroscopic evaluation |
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Stifle diseases
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-Lateral trochlear ridge
-Distal medial femur -DJD -Fractured patella -Fractured tibial tuberosity -Tumoral calcinosis -Soft tissue injury |
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Lateral trochlear ridge of the distal femur
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-Very common site of OCD
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Diagnosing cysts in stifle
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-Degree of lameness
-Nerve blocks -Radiology -Minimal effusion usually -Most cysts are medial, in the proximal tibia -Want to know location and size of the cyst, age of the animal, and use of the animal |
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Diseases of the Distal femur
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-Osseous cyst on medial femoral condyle
-OCD on lateral trochlear ridge of the femur |
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Treatment for fractured tibial tuberosity
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-Leave it alone
--heals with fibrous union --takes 4-6 months -Used to put in screws and wires |
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Tumor calcinosis in the Stifle
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-Calcification of soft tissue on proximal and lateral fibula is most common |
