Abstract
SummaryThis report describes the diagnosis and management of repetitive stress-related injury (RSRI) of the proximal metacarpus in a seven-year old Thoroughbred racehorse. Intra-articular analgesia of the middle carpal joint (MCJ) as well as perineural analgesia of the lateral palmar nerve (LPN) abolished lameness and a diagnosis of RSRI of the proximopalmar metacarpus was made after nuclear scintigraphic examination. Given the response to intra-articular analgesia, the authors undertook a cadaver study in order to better describe the relationship between the medial and lateral palmar pouches of carpo-metacarpal joint (CMCJ), the LPN and the deep branch of the lateral palmar nerve (DBLPaN).
Highlights
A seven-year-old Thoroughbred gelding that was in full preparation for racing was presented for investigation of acute-onset, grade 3/5 [10] right forelimb lameness on two separate occasions following galloping approximately 2 months apart
As magnetic resonance imaging (MRI) and nuclear scintigraphy have enabled a far greater understanding of the relationship between diagnostic analgesia and the vast array of pathology that can result in equine lameness [3,4,9]
Using a standard metric ruler from the distal margin of the accessory carpal bone (ACB), the distance at which the deep branch of the lateral palmar nerve (DBLPaN) arose from the lateral palmar nerve (LPN) and the distance to the deep volar arch [15] were measured and recorded (Figure 3)
Summary
A seven-year-old Thoroughbred gelding that was in full preparation for racing was presented for investigation of acute-onset, grade 3/5 [10] right forelimb lameness on two separate occasions following galloping approximately 2 months apart. Detailed clinical examination failed to reveal any obvious site of lameness On both occasions, perineural analgesia of the lateral and medial palmar and palmar metacarpal nerves at the level of the distal second and fourth metacarpal bones (low 4-point nerve block) was performed using a total volume of 8 ml of mepivicaine hydrochloride 2% (Intra-epicaine). Adjunctive therapies instigated on the basis of a misdiagnosis can prove costly to owners and result in a poor outcome Advanced imaging modalities such as MRI and nuclear scintigraphy have enabled a far greater understanding of the relationship between diagnostic analgesia and the vast array of pathology that can result in equine lameness [3,4,9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
