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Almohamad Z. Ultrasonography of the normal donkey tarsus (equus asinus). Sci Rep 2024; 14:10425. [PMID: 38714804 PMCID: PMC11076484 DOI: 10.1038/s41598-024-61066-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 04/30/2024] [Indexed: 05/10/2024] Open
Abstract
Tarsal joint illness is a frequent source of hind limb lameness due to the complex anatomy of the region and the presence of numerous bony and soft tissue structures. Proper lameness diagnosis aims to discover the structure provoking lameness. Ultrasonography documents valuable information of soft tissues and characterizes soft tissue injuries that have heretofore been difficult to obtain either noninvasively or via radiography. The objectives of the current study were to develop and describe a standardized ultrasonographic protocol for investigation of the tarsal region in donkeys. The donkey tarsal anatomy was investigated in 5 cadavers and the tarsi of 11 healthy lameness free adult donkeys were echographically investigated. The dorsal, plantar, lateral and medial aspects of the tarsal region were substantially evaluated at four anatomical landmarks in both the longitudinal and horizontal planes using a multi-frequency 5-12 MHz linear transducer. Sonoanatomy of the extensor and flexor tarsal tendons, collateral and plantar ligaments, and synovial pouches was delineated and described. Systematic echography of the tarsal region allowed accurate localization and thorough exploration of various soft tissues of clinical interest in the donkey tarsus. Sonograms provided in this study should serve as a reference database for tarsal ultrasonography in clinical circumstances.
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Affiliation(s)
- Zakriya Almohamad
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, PO Box 400, Al-Ahasa, 31982, Kingdom of Saudi Arabia.
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Van Cauter R, Serteyn D, Lejeune JP, Rousset A, Caudron I. Evaluation of the appearance of osteochondrosis lesions by two radiographic examinations in sport horses aged from 12 to 36 months. PLoS One 2023; 18:e0286213. [PMID: 37220101 DOI: 10.1371/journal.pone.0286213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/10/2023] [Indexed: 05/25/2023] Open
Abstract
Osteochondrosis is a developmental orthopedic disease characterized by a defect of enchondral ossification. This pathological condition develops and evolves during growth and is influenced by various factors, in particular genetic and environmental. However, little research has been conducted on the dynamic of this condition in horses after the age of 12 months. The retrospective study presented here investigates changes in osteochondrosis lesions through two standardized radiographic examinations carried out on young Walloon sport horses after one year of age (mean age at first and second examination was 407 (±41) and 680 (±117) days respectively). Each examination, analyzed independently by three veterinarians, included latero-medial views of the fetlocks, hocks, stifles, plantarolateral-dorsomedial hocks view and additional radiograph if the operator deemed it necessary. Each joint site was graded as healthy, osteochondrosis (OC) or osteochondrosis dissecans (OCD) affected. A group of 58 horses was studied, among them 20 presented one or more osteochondrosis lesions for a total of 36 lesions present during at least one examination. In this population, 4 animals (6.9%) presented osteochondrosis during only one examination (2 at the first examination and 2 at the second one). Moreover, it was possible to demonstrate the appearance, disappearance and more generally the evolution of 9/36 lesions (25%) within the different joints. The results of the study suggest that, although substantial main limitations, osteochondrosis lesions can evolve after the age of 12 months in sport horses. Knowing this is useful in helping to decide the appropriate radiographic diagnosis timing and management.
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Affiliation(s)
- Raphaël Van Cauter
- Centre Européen du Cheval, Mont-le-Soie, Vielsalm, Belgium
- Département des Sciences Cliniques des Équidés, Chirurgie et Orthopédie, FARAH, Université de Liège, Liège, Belgium
| | - Didier Serteyn
- Centre Européen du Cheval, Mont-le-Soie, Vielsalm, Belgium
- Département des Sciences Cliniques des Équidés, Chirurgie et Orthopédie, FARAH, Université de Liège, Liège, Belgium
| | - Jean-Philippe Lejeune
- Centre Européen du Cheval, Mont-le-Soie, Vielsalm, Belgium
- Département des Sciences Cliniques des Équidés, Chirurgie et Orthopédie, FARAH, Université de Liège, Liège, Belgium
| | - Alycia Rousset
- Centre Européen du Cheval, Mont-le-Soie, Vielsalm, Belgium
| | - Isabelle Caudron
- Centre Européen du Cheval, Mont-le-Soie, Vielsalm, Belgium
- Département des Sciences Cliniques des Équidés, Chirurgie et Orthopédie, FARAH, Université de Liège, Liège, Belgium
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Nocera I, Puccinelli C, Sgorbini M, Bagnoli E, Citi S. Ultrasonography of the Metacarpal/Tarsal-Phalangeal Joints in Healthy Racehorses: Normal Appearance, Breed-Related and Age-Related Features. Animals (Basel) 2022; 12:ani12192657. [PMID: 36230398 PMCID: PMC9558986 DOI: 10.3390/ani12192657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/24/2022] [Accepted: 09/29/2022] [Indexed: 11/23/2022] Open
Abstract
In adult horses, specific ultrasound (US) features and reference values have been reported for the appearance of the joint cartilage and thickness according to the type of joint, such as femoropatellar and tarsocrural. The US appearance of the fetlock has been described in several diseases. The present research evaluates the US features of the metacarpal/tarsal-phalangeal joints in healthy racehorses according to age and breed, since no information is available in the literature. Seventy-one fetlocks in 28 healthy horses (15/28 thoroughbreds and 13/28 standardbreds) were assessed. The horses were grouped as follows: group A < 5 years old vs. group B ≥ 5. A portable ultrasound machine and a linear transducer (5−7.5 MHz) were used. Dorsal metacarpal/tarsal-phalangeal joints were scanned. The US images were reviewed offline in terms of articular cartilage appearance, thickness, and subchondral bone appearance by an experienced observer. Data were reported as the median, minimum, and maximum for cartilage thickness values, and differences between groups were evaluated. Cartilage thickness values were statistically lower in group A than B in the standardbreds, except for the lateral thickness in longitudinal view. No differences were detected in the thoroughbreds within age groups. All of the young standardbreds showed a normal cartilage and subchondral appearance. No statistical differences were found between breeds. Our results highlight the characteristics of the US appearance of metacarpal/tarsal-phalangeal joints specifically in racehorses, with some variations according to age. Since the cartilage can change according to joint growth, age and training activity, the present findings suggest the use of specific references for US features, which are key to correctly evaluating the health of the fetlock.
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Affiliation(s)
- Irene Nocera
- Institute of Life Sciences, Sant’Anna School of Advanced Studies, Via Santa Cecilia 3, 56127 Pisa, Italy
- Correspondence:
| | - Caterina Puccinelli
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy
| | - Micaela Sgorbini
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy
| | - Emma Bagnoli
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy
| | - Simonetta Citi
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy
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Hoey S, O'Sullivan J, Byrne J, Devine S, Toomey W, McAllister H, Skelly C. Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings. Ir Vet J 2022; 75:8. [PMID: 35477486 PMCID: PMC9044857 DOI: 10.1186/s13620-022-00216-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background Osteochondrosis is a common condition of young horses where there is a failure of endochondral ossification, usually at predisposed sites. The estimated prevalence of osteochondrosis is 33–44%, with radiographic screening of yearlings being used to identify lesions. Radiography has two major limitations: poor sensitivity in detecting cartilaginous lesions and secondly, the exposure of the horse and personnel to ionising radiation. Ultrasonography allows imaging of the articular cartilage and subchondral bone margins and has been shown to be more sensitive in identifying osteochondrosis lesions. However, the ultrasonographic technique for examining joints is operator dependant, resulting in highly variable examinations, thus affecting its reliability and reproducibility as a screening test. Results A prospective observational clinical population study was undertaken involving twenty-two clinically normal weanling thoroughbred horses on-farm, describing a detailed protocol of the ultrasonographic examination technique for on-farm screening of common sites of osteochondral disease in the young horse, namely the carpal, metacarpophalangeal, stifle, tarsal and metatarsophalangeal joints. Conclusion Two veterinary practitioners used the technique to illustrate the repeatability of the protocol. The step-by-step protocol provides a valuable, reliable, repeatable technique for veterinary professionals performing screening ultrasound in the field. Supplementary Information The online version contains supplementary material available at 10.1186/s13620-022-00216-7.
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Affiliation(s)
- Seamus Hoey
- Equine Clinical Studies, Diagnostic Imaging and Anaesthesia, School of Veterinary Medicine, University College Dublin, Dublin, Ireland.
| | | | - Jennifer Byrne
- Equine Clinical Studies, Diagnostic Imaging and Anaesthesia, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Sinead Devine
- Equine Clinical Studies, Diagnostic Imaging and Anaesthesia, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - William Toomey
- Clinic na gCapall, Farranacurragh, Oldleighin, Co. Carlow, Ireland
| | - Hester McAllister
- Equine Clinical Studies, Diagnostic Imaging and Anaesthesia, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Cliona Skelly
- Equine Clinical Studies, Diagnostic Imaging and Anaesthesia, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
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Hoey S, Stokes D, McAllister H, Puggioni A, Skelly C. A systematic review evaluating the use of ultrasound in the identification of osteochondrosis in horses. Vet J 2022; 282:105825. [DOI: 10.1016/j.tvjl.2022.105825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 03/05/2022] [Accepted: 03/24/2022] [Indexed: 11/16/2022]
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Kadic DTN, Bonilla AG. Diagnostic needle arthroscopy of the tarsocrural joint in standing sedated horses. Vet Surg 2020; 49:445-454. [PMID: 31943288 DOI: 10.1111/vsu.13375] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/20/2019] [Accepted: 12/07/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To develop and assess a needle arthroscopic technique to diagnose conditions of the tarsocrural joint (TCj) in standing sedated horses. STUDY DESIGN Experimental study. SAMPLE POPULATION Six cadaveric hind limbs (phase 1) and six healthy horses (Phase 2). METHODS In phase 1, each TCj was examined with a 1.2-mm-needle arthroscope. Suitability of the needle arthroscope and degree of joint visualization with traditional arthroscopic approaches were assessed. In phase 2, the feasibility of the procedure was assessed in six standing healthy horses. A custom-made splint and base were developed to maintain joint flexion during the procedure. RESULTS Thorough evaluation of the dorsal intra-articular structures of the TCj via dorsomedial and dorsolateral approaches was possible in both phases. The procedure was feasible, quickly performed, and well tolerated by all horses. Complications consisted of moderate movement (2/6 horses) and hemarthrosis (3/6 horses). CONCLUSION Diagnostic standing needle arthroscopy of the TCj allowed thorough evaluation of the dorsal aspect of the joint while avoiding the cost and risks associated with general anesthesia. Inadvertent puncture of the dorsomedial vasculature with the cannula and obturator led to significant hemarthrosis. CLINICAL IMPACT Needle arthroscopy of the TCj offers an alternative diagnostic tool when traditional imaging techniques (radiography and ultrasonography) are unrewarding or nondiagnostic. The technique is conceived mainly for diagnostic purposes, but its use during short interventions warrants investigation.
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Affiliation(s)
- Dimitri T N Kadic
- Department of Clinical Sciences, College of Veterinary Medecine, University of Montreal, Saint Hyacinthe, Quebec, Canada
| | - Alvaro G Bonilla
- Department of Clinical Sciences, College of Veterinary Medecine, University of Montreal, Saint Hyacinthe, Quebec, Canada
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Hagag U, Tawfiek M. Ultrasonography, computed tomography and magnetic resonance imaging of the bovine metacarpo/metatarsophalangeal joint. Vet J 2018; 233:66-75. [DOI: 10.1016/j.tvjl.2018.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 01/01/2018] [Accepted: 01/03/2018] [Indexed: 11/26/2022]
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James O, Payne R, Bathe A, Greet T, Wylie C. Arthroscopy of the Dorsal and Plantar Pouches of the Tarsocrural Joint for the Treatment of Osteochondritis Dissecans in the Horse: Clinical Features and Follow-Up. Vet Surg 2016; 45:1049-1055. [DOI: 10.1111/vsu.12560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 06/28/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Oliver James
- Royal (Dick) School of Veterinary Studies; The University of Edinburgh, Dick Vet Equine; Edinburgh United Kingdom
- Rossdales Equine Hospital; Newmarket, Suffolk United Kingdom
| | - Richard Payne
- Rossdales Equine Hospital; Newmarket, Suffolk United Kingdom
| | - Andrew Bathe
- Rossdales Equine Hospital; Newmarket, Suffolk United Kingdom
| | - Tim Greet
- Rossdales Equine Hospital; Newmarket, Suffolk United Kingdom
| | - Claire Wylie
- Rossdales Equine Hospital; Newmarket, Suffolk United Kingdom
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Prevalence and characteristics of osteochondrosis in 309 Spanish Purebred horses. Vet J 2016; 207:112-117. [DOI: 10.1016/j.tvjl.2015.09.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 09/25/2015] [Accepted: 09/26/2015] [Indexed: 11/21/2022]
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10
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Nichols S, Lardé H. Noninfectious Joint Disease in Cattle. Vet Clin North Am Food Anim Pract 2014; 30:205-23, vii. [DOI: 10.1016/j.cvfa.2013.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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McCoy AM, Toth F, Dolvik NI, Ekman S, Ellermann J, Olstad K, Ytrehus B, Carlson CS. Articular osteochondrosis: a comparison of naturally-occurring human and animal disease. Osteoarthritis Cartilage 2013; 21:1638-47. [PMID: 23954774 PMCID: PMC3815567 DOI: 10.1016/j.joca.2013.08.011] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 07/30/2013] [Accepted: 08/03/2013] [Indexed: 02/02/2023]
Abstract
BACKGROUND Osteochondrosis (OC) is a common developmental orthopedic disease affecting both humans and animals. Despite increasing recognition of this disease among children and adolescents, its pathogenesis is incompletely understood because clinical signs are often not apparent until lesions have progressed to end-stage, and examination of cadaveric early lesions is not feasible. In contrast, both naturally-occurring and surgically-induced animal models of disease have been extensively studied, most notably in horses and swine, species in which OC is recognized to have profound health and economic implications. The potential for a translational model of human OC has not been recognized in the existing human literature. OBJECTIVE The purpose of this review is to highlight the similarities in signalment, predilection sites and clinical presentation of naturally-occurring OC in humans and animals and to propose a common pathogenesis for this condition across species. STUDY DESIGN Review. METHODS The published human and veterinary literature for the various manifestations of OC was reviewed. Peer-reviewed original scientific articles and species-specific review articles accessible in PubMed (US National Library of Medicine) were eligible for inclusion. RESULTS A broad range of similarities exists between OC affecting humans and animals, including predilection sites, clinical presentation, radiographic/MRI changes, and histological appearance of the end-stage lesion, suggesting a shared pathogenesis across species. CONCLUSION This proposed shared pathogenesis for OC between species implies that naturally-occurring and surgically-induced models of OC in animals may be useful in determining risk factors and for testing new diagnostic and therapeutic interventions that can be used in humans.
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Affiliation(s)
- Annette M McCoy
- Diplomate American College of Veterinary Surgeons; Postdoctoral Fellow, Veterinary Population Medicine Department, University of Minnesota, St. Paul, MN 55108, USA;
| | - Ferenc Toth
- Diplomate American College of Veterinary Surgeons; Postdoctoral Fellow, Veterinary Population Medicine Department, University of Minnesota, St. Paul, MN, USA;
| | - Nils I Dolvik
- Department of Companion Animal Clinical Sciences, Equine Section, Norwegian School of Veterinary Science, Oslo, Norway;
| | - Stina Ekman
- Department of Biomedicine and Veterinary Public Health, Division of Pathology, Swedish University of Agricultural Sciences, Uppsala, Sweden;
| | - Jutta Ellermann
- Department of Radiology, The Center for Magnetic Resonance Imaging Research, University of Minnesota, Minneapolis, MN, USA;
| | - Kristin Olstad
- Department of Companion Animal Clinical Sciences, Equine Section, Norwegian School of Veterinary Science, Oslo, Norway;
| | - Bjornar Ytrehus
- Section for Wildlife Diseases, Division of Pathology, National Veterinary Institute, Oslo, Norway;
| | - Cathy S Carlson
- Diplomate American College of Veterinary Pathologists; Professor, Veterinary Population Medicine Department, University of Minnesota, St. Paul, MN, USA;
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Fontaine P, Blond L, Alexander K, Beauchamp G, Richard H, Laverty S. Computed tomography and magnetic resonance imaging in the study of joint development in the equine pelvic limb. Vet J 2013; 197:103-11. [DOI: 10.1016/j.tvjl.2013.03.049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Beccati F, Chalmers HJ, Dante S, Lotto E, Pepe M. DIAGNOSTIC SENSITIVITY AND INTEROBSERVER AGREEMENT OF RADIOGRAPHY AND ULTRASONOGRAPHY FOR DETECTING TROCHLEAR RIDGE OSTEOCHONDROSIS LESIONS IN THE EQUINE STIFLE. Vet Radiol Ultrasound 2012; 54:176-84. [DOI: 10.1111/vru.12004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 11/12/2012] [Indexed: 11/27/2022] Open
Affiliation(s)
- Francesca Beccati
- Centro di Studi del Cavallo Sportive; Dipartimento di Patologia, Diagnostica e Clinica Veterinaria; Università degli Studi di Perugia; Perugia; Italy
| | | | - Sara Dante
- Centro di Studi del Cavallo Sportive; Dipartimento di Patologia, Diagnostica e Clinica Veterinaria; Università degli Studi di Perugia; Perugia; Italy
| | - Eleonora Lotto
- Centro di Studi del Cavallo Sportive; Dipartimento di Patologia, Diagnostica e Clinica Veterinaria; Università degli Studi di Perugia; Perugia; Italy
| | - Marco Pepe
- Centro di Studi del Cavallo Sportive; Dipartimento di Patologia, Diagnostica e Clinica Veterinaria; Università degli Studi di Perugia; Perugia; Italy
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Vanderperren K, Gielen I, Van Caelenberg A, Van der Vekens E, Raes E, Hauspie S, van Bree H, Saunders J. Ultrasonographic appearance of bony abnormalities at the dorsal aspect of the fetlock joint in geriatric cadaver horses. Vet J 2012; 193:129-34. [DOI: 10.1016/j.tvjl.2011.09.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2011] [Revised: 09/22/2011] [Accepted: 09/24/2011] [Indexed: 10/15/2022]
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Weaver MP, Wilant L. Owner survey of tarsocrural effusion (bog spavin) in Clydesdale horses. Vet Rec 2012; 170:286. [PMID: 22262698 DOI: 10.1136/vr.100225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A postal survey of the owners of Clydesdale horses in the UK and USA was conducted to obtain information on tarsocrural effusion ('bog spavin') as an indicator of osteochondrosis from 935 horses. Additional information requested included details of how this condition was investigated and treated. The reported tarsocrural effusion incidence was 10 per cent. The majority of respondents believed the condition to be of concern to Clydesdale owners, but only a minority were aware of the implications of tarsocrural effusion, suggesting that owner education would be of benefit.
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Affiliation(s)
- M P Weaver
- Department of Veterinary Clinical Sciences, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Large Animal Hospital, Easter Bush Veterinary Centre, Easter Bush, Roslin, Midlothian EH25 9RG, UK.
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Hinz A, Fischer AT. Comparison of the Accuracy of Radiography and Ultrasonography for Detection of Articular Lesions in Horses. Vet Surg 2011; 40:881-5. [DOI: 10.1111/j.1532-950x.2011.00873.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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LYKKJEN S, ROED KH, DOLVIK NI. Osteochondrosis and osteochondral fragments in Standardbred trotters: Prevalence and relationships. Equine Vet J 2011; 44:332-8. [DOI: 10.1111/j.2042-3306.2011.00434.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Raes EV, Vanderperren K, Pille F, Saunders JH. Ultrasonographic findings in 100 horses with tarsal region disorders. Vet J 2010; 186:201-9. [DOI: 10.1016/j.tvjl.2009.07.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Revised: 07/16/2009] [Accepted: 07/27/2009] [Indexed: 10/20/2022]
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