Page 189 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

164 CHAPTER 1

VetBooks.ir 1.306 1.307

Fig. 1.306 Lateromedial radiograph of the carpus Fig. 1.307 Carpal sheath distension in the right
and distal radius deliberately underexposed to foreleg. Note the golf ball-sized swelling proximal and
highlight the relatively radiolucent caudal distal radial lateral to the carpus (arrow). (Photo courtesy Graham
osteochondroma. (Photo courtesy Graham Munroe) Munroe)

Diagnosis associated torn tendonous tissue. AL-SDFT des-
Diagnosis is made through careful clinical exami- mitis and tendonitis of the SDFT or DDFT can be
nation. Diagnostic intrasynovial analgesia may be managed conservatively. In cases of carpal canal syn-
required in some cases. Radiography and ultrasonog- drome caused by constriction, the carpal flexor reti-
raphy of the carpal/distal antebrachium (Fig. 1.308) naculum can be sectioned tenoscopically with care
and occasionally MRI can provide most of the diag- taken to avoid the radial artery and medial palmar
nostic information related to conditions of the car- vein. Idiopathic tenosynovitis may respond to rest
pal sheath, although tenoscopy of the sheath may and controlled exercise with intrathecal hyaluranon
be required for definitive diagnosis and treatment and/or corticosteroids.
(Fig. 1.309).
Prognosis
Management Prognosis following removal of osteochondroma
Removal of osteochondromas and radial physeal and radial physeal exostosis often depends on
exostoses, plus management of concurrent dam- the degree of damage to other structures (e.g.
age to the DDFT can be achieved tenoscopically. DDFT). Routine carpal sheath tenosocopy has
Involvement of the carpal sheath with accessory been recently associated with an increased risk of
bone fractures can also be treated through teno- postoperative sepsis compared with other elective
scopic debridement of the affected portion and procedures.