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.
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)
Objective—To examine the effect of various clinical tracks within the veterinary medical clinical curriculum at Texas A&M University on clinical diagnostic proficiency as determined by pre- and post-training assessment. We expected that the clinical track chosen by the student would impact their measured outcome with bias toward higher scores in their chosen field.
Design—Prospective cohort study.
Study Population—32 students from the College of Veterinary Medicine and Biomedical Sciences at Texas A&M University.
Procedures—By use of standardized, written case scenarios, clinical reasoning was assessed twice: once prior to the clinical (fourth) year of the curriculum and again at completion of the clinical year. Students demonstrated their abilities to collect and organize appropriate clinical data (history, physical examination, and laboratory findings), determine clinical diagnoses, and formulate and implement acceptable treatment modalities. Data from clinical assessments were compared for a given cohort and correlated with other measures (eg, grades, standardized test scores, and species-specific curricular track).
Results—Differences were detected in clinical diagnostic proficiency among students in different clinical tracks and for different species groups in the case scenarios. Tracking by species group in the clinical veterinary curriculum appeared to affect development of clinical reasoning and resulted in differential proficiency among cases for differing species groups.
Conclusions and Clinical Relevance—Differences in clinical experiences between small animal tracks and all other track opportunities (large animal, mixed animal, and alternative) influenced the development of clinical proficiency in fourth-year veterinary students during their clinical training period.