Fachbereich Veterinärmedizin


Service-Navigation

    Publikationsdatenbank

    Neue Behandlungsansätze für spezifische Erkrankungen des Hufgelenkes und des Strahlbeines beim Pferd, diagnostiziert mittels Magnetresonanztomographischer Untersuchung (2013)

    Art
    Hochschulschrift
    Autor
    Janssen, Imke (WE 17)
    Quelle
    Berlin: Mensch und Buch Verlag, 2013 — 70 Seiten
    ISBN: 978-3-86387-384-4
    Verweise
    URL (Volltext): http://www.diss.fu-berlin.de/diss/receive/FUDISS_thesis_000000096224
    Kontakt
    Klinik für Pferde, allgemeine Chirurgie und Radiologie

    Oertzenweg 19 b
    14163 Berlin
    Tel.+49 30 838 62299 Fax.+49 30 838 62529
    email:pferdeklinik@vetmed.fu-berlin.de

    Abstract / Zusammenfassung

    The syndrome “Palmar foot pain” often disguises the early stages of navicular disease. These
    early signs can be represented by an increased signal intensity in the navicular bone in fat
    suppressed images on Magnetic Resonance Imaging (MRI). Increased signal intensity in these
    fat suppressed images probably represents bone oedema and potentiates an increased risk of
    osteoarthritis.

    One potential treatment modality for this condition is the use of Calcium dobesilate. This has
    an effect on pressure dynamics and could potentially be used as a treatment for navicular disease
    in horses if administered during the early stages of the syndrome. The aim of this study was to
    monitor both the degree of lameness and the MRI changes seen in twelve horses treated with
    Calcium dobesilate and displaying increased signal intensity from fat suppressed images in the
    spongiosa region of the navicular bone. Twelve horses with a front foot lameness which had
    been present for between one month and two years were selected for the study. Inclusion criteria
    were: absence of radiographic findings on standard foot radiographs and an increased signal
    intensity in fat suppressed images of the navicular bone spongiosa region without concurrent
    lesions being detected elsewhere on MRI scans of the foot.

    Horses were treated with Calcium dobesilate and were then subjected to a controlled exercise
    regime. They were re-evaluated at two and four months after treatment. In the first follow-up
    examination 83% of the horses showed a reduced level of lameness whilst two months later this
    had increased to 91%. At the end of the trial eight of the twelve horses were found to be sound.
    During the pilot study fat suppressed images of the navicular bone showed a reduction in the
    intensity of the signal from the medullary cavity following treatment.

    Polyacrylamide Hydrogel is a potential new treatment for degenerative osteoarthritis of the
    Distal Interphalangeal Joint (DIP joint) when conventional medication fails. In this case one ml
    of Polyacrylamide Hydrogel was applied to the DIP joint of twelve affected horses. All horses
    were displaying a chronic recurrent lameness on one or both fore limbs which had been present
    for more than three months and which had been found to be due to osteoarthritis of the DIP
    joint. These horses had been previously treated on at least two occasions with intra-articular
    medication such as Hyaluronic acid, Glucocorticoides and/or autologous conditioned serum.

    These treatments had proved unsuccessful. The diagnosis of osteoarthritis was based on the
    abolition of lameness using both regional and intra-articular anaesthesia and by using
    radiological and MRI findings. These cases were re-examined one and six months following
    treatment. Six months after treatment eight of the treated horses were now sound whilst a further
    two horses showed some improvement. The other two horses were unchanged.

    This case report demonstrates the development of an osseous cyst-like lesion in the spongiosa
    of the navicular bone in a “high level” show jumping horse displaying chronic intermittent fore
    limb lameness. The first evidence of navicular bone pathology was an increased signal intensity
    on fat suppressed images in the medulla of the right navicular bone. This progressed to a cystic
    lucency which could be identified radiographically at twenty four months of age. The horse´s
    progress was monitored over a period of twenty six months; this monitoring included lameness
    investigations, treatment, diagnostic radiographs and six follow-up standing low field MRI
    sessions. At the last clinical recheck the horse no longer showed signs of lameness and
    continued to perform in international showjumping events.