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马桡骨生长板尾侧边缘外生骨疣作为腕滑膜鞘腱鞘炎和跛行病因:10例(1999 - 2003年)

Exostoses of the caudal perimeter of the radial physis as a cause of carpal synovial sheath tenosynovitis and lameness in horses: 10 cases (1999-2003).

作者信息

Nixon Alan J, Schachter Ben L, Pool Roy R

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.

出版信息

J Am Vet Med Assoc. 2004 Jan 15;224(2):264-70. doi: 10.2460/javma.2004.224.264.

Abstract

OBJECTIVE

To determine the clinical, radiographic, ultrasonographic, and arthroscopic findings associated with tenosynovitis of the carpal synovial sheath induced by exostoses that originate from the caudal surface of the physeal scar of the distal radius and determine the results of surgical removal of those exostoses in horses.

DESIGN

Retrospective study.

ANIMALS

10 horses.

PROCEDURE

Medical records of horses with effusion in the carpal synovial sheath and lameness evaluated from 1999 to 2003 were examined.

RESULTS

All horses had a history of intermittent mild to moderate effusion of the carpal synovial sheath and lameness of 1 forelimb. Results of regional perineural and intrathecal anesthesia of the carpal synovial sheath confirmed that the lameness originated in the carpal synovial sheath. Radiography revealed exostoses originating from the caudal cortex of the distal radius at the level of the closed physis. Arthroscopy was performed for confirmation and removal of exostoses that penetrated the carpal synovial sheath and impinged on the deep digital flexor tendon. All horses returned to previous athletic activity. One horse had a recurrence of clinical signs 12 months after surgery, which resolved with medical treatment.

CONCLUSIONS AND CLINICAL RELEVANCE

Tenosynovitis of the carpal synovial sheath and lameness were caused by impingement of exostoses of the caudal radius on the lining and contents of the carpal synovial sheath. Although the clinical signs and surgical treatment were similar to that caused by osteochondromas, these exostoses developed at the level of the closed physis of the distal radius and were not radiographically or histologically similar to osteochondromas.

摘要

目的

确定与源自桡骨远端骨骺瘢痕尾侧表面的外生骨疣所致腕滑膜鞘腱鞘炎相关的临床、放射学、超声学和关节镜检查结果,并确定马切除这些外生骨疣的手术效果。

设计

回顾性研究。

动物

10匹马。

方法

检查1999年至2003年评估的腕滑膜鞘积液和跛行马匹的病历。

结果

所有马匹均有腕滑膜鞘间歇性轻度至中度积液和1个前肢跛行的病史。腕滑膜鞘区域神经周围和鞘内麻醉结果证实跛行起源于腕滑膜鞘。放射学检查显示在闭合骨骺水平处有源自桡骨远端尾侧皮质的外生骨疣。进行关节镜检查以确认并切除穿透腕滑膜鞘并压迫指深屈肌腱的外生骨疣。所有马匹均恢复到以前的运动活动水平。1匹马在术后12个月出现临床症状复发,经药物治疗后缓解。

结论及临床意义

腕滑膜鞘腱鞘炎和跛行是由桡骨尾侧的外生骨疣压迫腕滑膜鞘的内衬和内容物所致。尽管临床症状和手术治疗与骨软骨瘤引起的相似,但这些外生骨疣在桡骨远端闭合骨骺水平处形成,在放射学或组织学上与骨软骨瘤不同。

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