Page 196 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Musculoskeletal system: 1.4 The forelimb 171

VetBooks.ir caudal margin of the olecranon and proximal radius 1.327
is sufficient in most cases (Figs. 1.325, 1.326),
but an additional lateral plate can be used in com-
minuted/unstable fractures in adults.

Prognosis
Fixation with wires (with or without pins) or plate
fixation has a good outcome in most cases. Presence
of concurrent infection/sepsis will reduce prognosis.
Unstable fracture repairs will lead to contralateral
limb overuse problems.

ELBOW OSTEOARTHRITIS

Definition/overview
Degenerative joint disease of the cubital joint. Fig. 1.327 Mediolateral radiograph of the elbow
showing irregular new bone formation at the
Aetiology/pathophysiology proximocranial aspect of the radius consistent with
OA can develop secondary to joint trauma, collateral osteophytosis.
ligament injury, OCLL, intra-articular ulna frac-
ture or synovial sepsis. 1.328

Clinical presentation
OA is unusual in the elbow and horses present with
a variable, progressive lameness. Joint effusion, if
present, is usually not palpable.

Differential diagnosis
OCLL; collateral ligament injury.

Diagnosis
Intra-articular analgesia of the cubital joint usually
localises the lameness to the elbow. Radiography,
particularly a mediolateral projection, will show
radiographic changes consistent with OA, par- Fig. 1.328 Craniomedial/caudolateral oblique
ticularly osteophytosis involving the cranioproxi- radiograph of a horse presenting with a 3-week
mal margin of the radius (Fig. 1.327). Entheseous history of right forelimb lameness localised to the
new bone may also be evident (Fig. 1.328). elbow. This radiograph shows enthesous new bone
Ultrasonography may visualise periarticular osteo- on the proximolateral radius. Ultrasonography
phytes and demonstrate joint effusion. Increased revealed thickening and loss of normal fibre pattern
radiopharmaceutical uptake may be seen on nuclear in the lateral collateral ligament, with capsular
scintigraphy. thickening and entheseophyte formation at the
osseous margins.
Management
Intra-articular medication (hyaluranon/corticoste-
roids) and palliative treatment (NSAIDs) are indi- Prognosis
cated for elbow OA. Prognosis for soundness is guarded.