Huber M J, Grisel G R
Department of Large Animal Clinical Services, College of Veterinary Medicine, Oregon State University, Corvallis 97331-4803, USA.
J Am Vet Med Assoc. 1997 Dec 15;211(12):1558-61.
An 18-month-old 450-kg [990-lb] sexually intact male Holsteiner was evaluated for lameness of the left forelimb of 3-months' duration. We were unable to localize the site of lameness, using intra-articular and perineural anesthesia, and radiography of the shoulder and cubital joint (elbow) did not reveal radiographic abnormalities. Nuclear scintigraphy was performed. An increase in radio-isotope uptake was evident at the lateral epicondyle of the left humerus. Radiographs of the region 3 weeks later revealed a 1.5-cm focal lucency surrounded by a 1.0-cm rim of necrotic bone. The lesion was consistent with an encapsulated osteomyelitis or bone abscess. Surgical correction was performed, using general anesthesia, and involved a lateral approach to the epicondyle of he humerus. Cyst contents were removed with curettage, and the cavity was packed with cancellous bone harvested from the tuber coxae. A coagulase-negative Staphylococcus organism was cultured from the abscess. The horse was sound 3 weeks after surgery, and radiography 10 months later revealed complete ossification and adjacent sclerosis at the surgical site. Solitary cystic lesions of long bones may represent bone abscesses capable of causing lameness in horses. Nuclear scintigraphy can provide early diagnostic capability. Curettage and cancellous bone grafting are indicated for treatment of bone abscesses.
对一匹18月龄、体重450千克（990磅）、未去势的雄性荷斯坦奶牛进行评估，其左前肢跛行已持续3个月。我们通过关节内和神经周围麻醉无法确定跛行部位，肩部和肘关节的X线摄影未显示出X线异常。于是进行了核闪烁扫描。左肱骨外侧髁处放射性同位素摄取增加明显。3周后该区域的X线片显示有一个1.5厘米的局灶性透亮区，周围有1.0厘米的坏死骨边缘。该病变符合包裹性骨髓炎或骨脓肿。采用全身麻醉进行手术矫正，采用肱骨外侧髁外侧入路。用刮匙清除囊肿内容物，并用从髋结节采集的松质骨填充腔隙。从脓肿中培养出一种凝固酶阴性葡萄球菌。术后3周马恢复正常，10个月后的X线摄影显示手术部位完全骨化且有相邻硬化。长骨的孤立性囊性病变可能代表能够导致马跛行的骨脓肿。核闪烁扫描可提供早期诊断能力。刮除术和松质骨移植适用于骨脓肿的治疗。
