Septic Physitis Research Articles

Clinical findings and outcome in goats with discospondylitis and vertebral osteomyelitis.

Vertebral infections, including vertebral osteomyelitis, septic physitis, and discospondylitis, are rarely reported in goats, and when reported, have been largely limited to necropsy case reports. Describe clinical findings and outcome in goats with vertebral infections evaluated by computed tomography (CT). Five goats with vertebral osteomyelitis, septic physitis, and discospondylitis evaluated by CT. Retrospective case series. The most common presenting complaints were progressive weakness, paresis and recumbency. Three goats were tetraparetic and 2 goats had pelvic limb paraparesis. Clinicopathologic findings included leukocytosis, mature neutrophilia, and hyperfibrinogenemia. The most common vertebrae affected were C7-T1. All 5 goats had discospondylitis with or without vertebral osteomyelitis and septic physitis. Computed tomographic evidence of spinal cord compression was present in 4/5 goats. Medical management (antimicrobials, physical therapy, analgesia, supportive care) was attempted in 4 goats, and 1 goat was euthanized at the time of diagnosis. All 4 goats that were treated regained ambulatory ability and survived to hospital discharge. Despite severity of CT imaging findings, goats with discospondylitis, septic physitis, and vertebral osteomyelitis can successfully return to ambulatory function. Additional studies are required to determine ideal treatment regimens.

Diagnosing and treating septic arthritis, physitis and osteomyelitis in foals

Background: Septic arthritis, physitis and/or osteomyelitis (SAPO) is a common presentation in foals, particularly those aged under seven months old. Due to its often rapid progression and the fact that prognosis is improved if treatment begins within 24 hours of the onset of clinical signs, it is important that affected patients are identified as early as possible and treatment initiated promptly.Aim of the article: This article guides practitioners on the clinical signs of SAPO cases and outlines the diagnostic and treatment options available.

Haematogenous septic arthritis, physitis and osteomyelitis in foals: A tutorial review on pathogenesis, diagnosis, treatment and prognosis. Part 2

SummaryHaematogenous septic arthritis, physitis and osteomyelitis are manifestations of a potentially debilitating or even life‐threatening disease entity encountered in all types of foals from neonates to approximately 7 months of age. Correct and complete diagnosis and successful treatment requires collaboration across specialties; medicine, anaesthesia, diagnostic imaging, surgery, and rehabilitation. However, in order to succeed it is important that all specialties have an overall knowledge of all aspects of the disease complex. Therefore, the aim of this review is to give an overview of aetiology, presenting complaints, clinical findings, diagnostic imaging, treatment, rehabilitation and prognosis.

Haematogenous septic arthritis, physitis and osteomyelitis in foals: A tutorial review on pathogenesis, diagnosis, treatment and prognosis. Part 1

SummaryHaematogenous septic arthritis, physitis and osteomyelitis (SAPO) is a potentially debilitating or even life‐threatening disease entity encountered in foals of all ages between birth and approximately 7 months old. Correct, and complete, diagnosis and successful treatment require collaboration between specialties including medicine, anaesthesia, diagnostic imaging, surgery and rehabilitation services. However, in order to succeed, it is important that all specialties have an overall knowledge of all aspects of the disease complex. Therefore, the aim of this review is to give an overview of aetiology, presenting complaints, clinical findings, diagnostic imaging, treatment, rehabilitation and prognosis. Part one deals with all aspects of aetiology and how to make a diagnosis. Part two deals with all aspects of treatment, rehabilitation and prognosis.

Multifocal haematogenous osteomyelitis and septic physitis in a dog

A 10-month-old male cane corso was evaluated for a four-day history of lethargy and anorexia associated with right thoracic limb lameness. Physical examination, diagnostic imaging and cytological findings were suggestive...

Clinical and Radiographic Findings of Septic Physitis in Foals

AbstractThe objective of this review is to detail the clinical and radiographic features of septic physitis in foals. Medical records were evaluated from 2008 to 2018 of cases that had septic physitis based on a combination of clinical and radiographic findings. Ten foals were diagnosed with septic physitis. In 8 of 10 foals, presence of a discrete, focal, irregular radiolucency centred on the physis and extending into the epiphysis and metaphysis was present. In the remaining two foals, subtle irregularity and diffuse radiolucency along the length of the physis was present. Three foals were able to later perform athletic function and two were sound but not in training (mean follow-up = 12 months). Overall, a distinguishing radiographic feature of septic physitis in foals is the presence of a focal radiolucency centred on the physis which is associated with the epiphysis and metaphysis consistent with osteolysis.

Septic epiphysitis and sequestrum formation in the glenoid of the scapula in a five-month-old foal diagnosed by computed tomography

A five-month-old Connemara foal presented for acute-onset, severe left forelimb lameness with fever, neutrophilia and an elevated serum amyloid A concentration. Radiographs were suspicious of septic physitis of the proximal...

Short-term outcome and risk factors for post-operative complications following umbilical resection in 82 foals (2004-2016).

Umbilical remnant infection and patent urachus are an important cause of morbidity for the equine neonate. Left untreated, fatal complications can develop. Identifying risk factors for post-operative complications after surgery are important for estimating prognosis. To identify risk factors associated with post-operative complications in foals undergoing umbilical remnant resection due to patent and/or infected umbilical remnants. Retrospective case series. Foals undergoing umbilical remnant resection due to patent urachus or infected remnants at the Marion duPont Scott Equine Medical Center from 2004 to 2016 were included in the study. Data were obtained from medical records and associations between outcomes and post-operative complications, and pre or intraoperative clinical variables were assessed using bivariable and multivariable analyses. Eighty-two foals underwent umbilical remnant resection of which 73 (89.0%) survived to discharge. The urachus was the most commonly affected structure being patent and/or infected in 84.1% of cases. Concurrent diseases were present in 60.6% of foals prior to surgery, with diarrhoea and septic arthritis being most common. The presence of preoperative septic arthritis and/or physitis were significantly associated with nonsurvival (OR 33; 95% confidence interval 1.1-985.2; P = 0.04). Longer anaesthesia time (OR 1.4; 95% confidence interval 1.1-1.7; P = 0.02) and failure of passive transfer of immunoglobulins (OR 5.9; 95% confidence interval 1.2-29.04; P = 0.03) were associated with increased odds for post-operative complications. It is not known if medical treatment alone would have been successful in foals that did not receive preoperative medical treatment. Overall survival is high after surgical excision of umbilical remnants. The presence of preoperative septic arthritis and/or physitis was associated with decreased survival and failure of passive transfer of immunoglobulins and longer anaesthesia times were associated with increased odds for post-operative complications.

Surgical treatment of septic physitis in 17 foals

To document the progression and outcome after surgical curettage of septic physes in foals. Case series of 17 foals, aged <9 weeks, with septic physitis. All foals were treated surgically with curettage of physeal lesions. Combinations of systemic antibiotics, intravenous regional perfusion of antibiotic and antibiotic-impregnated polymethylmethacrylate beads were used as adjunct medical treatments. Tissue removed from the physis of three foals during surgery was sent for pathological analysis. At follow-up, 15 of the 17 foals were alive. In the two foals with septic physitis of the distal tibia, the condition was bilateral. Eight foals had concurrent septic arthritis of the joint adjacent to the growth plate, but this did not affect outcome. Referring veterinarians of the foals were contacted at least 9 months post-surgery and all reported excellent functional, and good to excellent cosmetic, outcomes. Pathological examination of the septic physeal tissue showed that normal growth plate had been replaced by inflammatory tissue. Septic physitis in foals may be treated using surgical curettage in selected cases. Removal of septic material might be expected to expedite resolution of infection, especially important in immunologically challenged neonates, where septic tissue may act as a reservoir for seeding of infection to other sites.

Computed tomography in the diagnosis of septic physitis in two foals

Computed tomography in the diagnosis of septic physitis in two foals

From the editors

From the editors

Cancellous bone grafting in the treatment of bovine septic physitis

Summary Eleven young cattle (8-24 months of age) were treated for septic physitis of the metacarpal or metatarsal bones. Two new elements were added to the traditional treatment. Firstly, homologous cancellous bone grafts were used for their osteoinductive properties even in an infected surrounding. (Actinomyces pyogenes was recovered most commonly.) Secondly, a walking cast was applied for better immobilization of the lower limb with minimal discomfort to the animal. After surgery, the 11 bovine patients needed an average walking cast period of 4.5 weeks and 1 to 2 weeks' treatment with antibiotics. The new treatment regime expedites the healing process and shows a success rate of 100%. Follow-up after 6 months revealed that all animals were completely sound without recurrence of the physitis.