This week was all equine with some great cases to challenge the residents.
Case 1
15 year old Thoroughbred gelding lame in the right hind limb. Lameness resolves with an abaxial sesamoidean local anesthetic block. There was a crescent shaped, smoothly marginated defect in the dorsolateral margin of P3. There was a subtle defect in the sole of the hoof at this location. Differential diagnoses: keratoma, with possible abscessation. This horse had a keratoma and an associated abscess. There is debate as to whether the keratoma is the cause or result of inflammation in the foot.
Case 2
9 year old Thoroughbred jumper with chronic grade 2/5 lameness of the right front limb. Positive to fetlock flexion, partial block of the lameness with a PD. On radiographs of the fetlock and foot, there were osteophytes on dorsal P2 and the extensor process of P3. There was also an irregular lucent area parallel to the joint surface of lateral P3. There was sclerosis surrounding this area on the DP and the lateral projections. There appeared to be a lucency that provided communication between the cystic area and the coffin joint. Diagnosis: osseous cyst-like lesion of P3 with communication to the coffin joint. This was most likely a congenital lesion, though trauma could not be ruled out. Further diagnostics could include an arthrogram to prove joint communication.
Case 3
2 year old Thoroughbred colt in race training. 1/5 lame left front, positive to fetlock flexion. On fetlock radiographs, there was a subtle radiolucency of MC3 visible on the dorsolateral-palmaromedial oblique projection, and very faintly seen on the lateral projection. A flexed lateral projection was requested, which clearly showed a radiolucent lesion of the sagittal ridge of MC3. Diagnosis: Osteochondrosis.
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