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( Figure 2 ) . Considering the patient age, breed and multifocal clinical presentation, the primary differential diagnosis was infectious osteomyelitis (fungal Aspergillus spp were considered most likely due to the patient signalment) with suspicion of

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in Journal of the American Veterinary Medical Association

be seen and has a prominent gas-fluid interface (white arrows). The oval highlights multiple fragments (oval) are visible at the cranial angle of the scapula. The findings were considered to represent suppurative osteomyelitis of the scapula

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in Journal of the American Veterinary Medical Association

, suggesting ongoing mandibular osteomyelitis ( Figure 1 ). The MMA bead was no longer visible. Figure 1— Right lateral oblique radiographic image of the head of a 2-year-old female red-necked wallaby ( Macropus rufogriseus ; case 1) obtained 60 days

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine outcome of horses with osteomyelitis of the sustentaculum tali (ST), with or without associated tarsal sheath tenosynovitis, following surgical débridement and lavage.

Design—Retrospective study.

Animals—10 horses in which a diagnosis of osteomyelitis of the ST had been made on the basis of history, physical examination findings, and results of radiography.

Procedure—Information on results of diagnostic testing, surgical findings, postoperative treatment, and short-term outcome was obtained from the medical records. Long-term follow-up information was obtained through reevaluation of horses at the teaching hospital and telephone conversations with referring veterinarians, owners, and trainers.

Results—Treatment consisted of surgical débridement, intra- and postoperative lavage, and long-term antimicrobial and anti-inflammatory treatment. Eight horses had evidence of involvement of the tarsal sheath. One horse was euthanatized after surgery because of a lack of response to treatment; the other 9 were discharged from the hospital. Severity of lameness had improved, but all still had grade-1 or -2 lameness at the time of discharge. One horse was euthanatized after discharge because of contralateral hind limb laminitis, and another horse was lost to follow- up. Of the remaining 7 horses, 6 returned to their previous use, and 1 was sound but retired for breeding for unrelated reasons.

Conclusions and Clinical Relevance—Results suggest that horses with osteomyelitis of the ST, with or without concomitant tarsal sheath tenosynovitis, can have an excellent to good outcome and may return to their previous use after surgical débridement of affected tissues and lavage of the tarsal sheath. (J Am Vet Med Assoc 2001;219:341–345)

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine clinical, radiographic, and scintigraphic abnormalities in and treatment and outcome of horses with trauma-induced osteomyelitis of the proximal aspect of the radius.

Design—Retrospective study.

Animals—5 horses.

Procedure—Data collected from the medical records included signalment; history; horse use; degree of lameness; radiographic, ultrasonographic, and scintigraphic findings; treatment; and outcome.

Results—Duration of lameness prior to referral ranged from 14 to 60 days. Mean severity of lameness was grade 3 of 5, and all horses had a single limb affected. All horses had signs of pain during elbow joint manipulation and digital palpation over the lateral aspect of the proximal end of the radius. Radiographic lesions consisted of periosteal proliferation, osteolysis, and subchondral bone lysis. Scintigraphy in 3 horses revealed intense pharmaceutical uptake diffusely involving the proximal end of the radius. Two horses had sepsis of the elbow joint. All horses were treated with antimicrobials long-term; 1 horse was also treated by local perfusion of the radial medullary cavity through an indwelling cannulated screw. At follow-up, all horses had returned to their previous function.

Conclusions and Clinical Relevance—Results suggest that osteomyelitis of the proximal end of the radius can result from a traumatic injury to the antebrachium. Because lesions may be an extension of septic arthritis, a thorough examination of the wound area and elbow joint is recommended. Prolonged systemic antimicrobial treatment can result in a successful outcome. (J Am Vet Med Assoc 2003;223:486–491)

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate use of technetium Tc 99m disodium hydroxymethylene diphosphonate (99m-Tc- HDP) for assessing fracture healing and 99m-Tc-HDP and technetium Tc 99m ciprofloxacin (99m-Tc-CIPRO) for early diagnosis of osteomyelitis in rabbits.

Animals—32 skeletally mature New Zealand White rabbits.

Procedure—A femoral fracture defect stabilized with bone plates and cortical screws was used. Scintigraphy was performed 4, 8, 12, and 16 weeks after surgery. The 99m-Tc-CIPRO scan was performed 48 hours after the 99m-Tc-HDP scan. The uptake ratio of the experimental limb to the normal limb was calculated by use of multiple regions of interest. Results of radiography performed to determine external callus and lysis grade and percentage defect ossification at 16 weeks were compared with scintigraphy results.

Results—Infected fractures had a higher uptake ratio for 99m-Tc-HDP and 99m-Tc-CIPRO than noninfected fractures. Infected fractures could be differentiated from noninfected fractures late in healing by use of 99m-Tc-HDP. Although 99m-Tc-CIPRO was better than 99m-Tc-HDP for identifying infection, there was a high incidence of false positive and negative results with 99m-Tc-CIPRO. There was an association between 99m-Tc-HDP uptake ratio and callus formation and a good correlation between 99m-Tc-HDP uptake ratio and defect ossification after 4 weeks.

Conclusions and Clinical Relevance—99m-Tc-HDP and 99m-Tc-CIPRO may be useful for diagnosing osteomyelitis late in fracture healing; however, false positive and false negative results occur. Technetium Tc 99m disodium hydroxymethylene diphosphonate may be useful for evaluating fracture healing. ( Am J Vet Res 2003;64:736–745)

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in American Journal of Veterinary Research
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association