Page 122 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Musculoskeletal system: 1.3 The foot 97

VetBooks.ir 1.167 1.168

Figs. 1.167, 1.168 Septic pedal osteitis. Dorsoproximal/palmarodistal oblique (1.167) and lateromedial (1.168)
radiographs indicating the presence of septic pedal osteitis and a sequestrum at the dorsal solar margin of the
distal phalanx.
1.169 infection to an adjacent structure, such as the navic-
ular bursa, DIP joint or DDFT, or concurrent lami-
nitis or pathological fracture of the distal phalanx
worsens the prognosis.

BONE CONTUSIONS OF THE DISTAL
AND MIDDLE PHALANGES

Definition/overview
Bone contusion or bruising is an MRI diagnosis
characterised by the presence of fluid-like signal
in bone. Bone contusions of the phalanges occur
mostly in the region of the palmar processes of the
distal phalanx and the dorsodistal aspect of the mid-
Fig. 1.169 T1-weighted MR image of a sequestrum of dle phalanx. The latter usually involves a well-cir-
the distal phalanx adjacent to the insertion of the deep cumscribed area of cancellous bone adjacent to the
digital flexor tendon (arrow) following a puncture wound dorsal half of the DIP joint and can be located axially
to the frog 2 weeks previously. There is marked and or abaxially in the middle phalanx.
generalised osseous fluid signal in the distal phalanx.
Aetiology/pathophysiology
The aetiology of bone bruising is uncertain but impact
broad-spectrum antibiotics until all exposed sur- trauma, either of a monotonic or chronic repetitive
faces are covered with granulation tissue. NSAIDs nature, is considered as the most likely cause. Bone
are administered as needed and tetanus prophylaxis contusions have been observed in the distal phalanx
provided. The wound heals by secondary intention. following kicking of a wall or a stall door.

Prognosis Clinical presentation
The prognosis for returning to work in most cases Lameness associated with bone bruising is gener-
of septic osteitis is good. However, extension of the ally acute in onset, but this may vary and insidious