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Infectious tenosynovitis (viral arthritis): influence of maternal antibodies on the development of tenosynovitis lesions after experimental infection by day-old chickens with tenosynovitis virus.

When chicks with maternal antibodies against infectious tenosynovitis (viral arthritis) virus were inoculated orally at 1 day old with tenosynovitis virus, they were protected against developing active tenosynovitis lesions 3 weeks later. They were not protected against subcutaneous inoculation, however. Breeder vaccination against tenosynovitis resulted in immunity of the progeny against oral infection at 1 day old, whereas progeny from unvaccinated breeders were susceptible to such a challenge.

Animals↗

De Quervain's tenosynovitis. Stenosing tenosynovitis of the first dorsal compartment.

De Quervain's tenosynovitis is a disorder characterized by pain on the radial (thumb) side of the wrist, impairment of thumb function, and thickening of the ligamentous structure covering the tendons in the first dorsal compartment of the wrist. It is precisely defined as stenosing tenosynovitis of the first dorsal compartment. It is a relatively common, uncomplicated, and noncontroversial musculoskeletal disorder of the distal upper extremity. The purpose of this review is to summarize information from the medical literature on aspects of De Quervain's tenosynovitis likely to be of interest and relevant to occupational medicine practitioners. The topics covered include normal anatomy and kinesiology; history; clinical observations related to diagnosis; pathology; pathophysiology; clinical observations on etiology; descriptive epidemiology; epidemiological studies; and case management. Models for the pathogenesis of De Quervain's tenosynovitis are proposed and opportunities for future research presented.

Case Management↗

Antigen-induced tenosynovitis in hypersensitized rabbits: a model for rheumatoid tenosynovitis.

Rabbits were first immunized and later challenged with the same antigen (bovine serum albumin, or ferritin) by injection into the tibialis anterior tendon. Inflammatory changes of the tenosynovium and epitenon included infiltration by neutrophils (early) and mononuclear cells (later) over a 6-week course of tenosynovitis. A pattern of antigen entrapment in the tendon together with immunoglobulin was shown by use of radiolabelled antigen and immunochemical staining. Half-life of antigen in the tissues averaged 5 days over the 6-week period. Changes in the epitenon included cellular necrosis, appearance of phagocytic cells, and disruption of the collagen matrix. Tissues of control animals (challenged without prior immunization) showed minimal changes and significantly less retention of antigen (P greater than 0.005). The model is relevant to the mechanism of tendon damage associated with antigen-driven chronic inflammation, as may be the case in rheumatoid arthritis.

Animals↗

Severity of tenosynovitis in reovirus-infected chickens fed various dietary levels of choline, folic acid, manganese, biotin, or niacin.

Five experiments were conducted to determine the incidence and severity of tenosynovitis in tendons distal to the tarsal joint in 4-, 6-, and 8-week-old reovirus WVU 2937-infected chickens fed diets containing 20%, 100%, or 200% of the 1977 National Research Council nutrient requirements (NCR-77) of manganese, biotin, niacin, choline, or folic acid. Male chickens, but not female chickens, fed 20% or 100% or the NRC-77 level of folic acid had consistently higher lesion scores of tenosynovitis than male chickens fed the 200% NRC-77 level of folic acid. Increasing dietary manganese levels from 20% to 200% NRC-77 reduced the severity of tendon swelling in 6- and 8-week-old male chickens and appeared to increase the severity of tendon swelling in 8-week-old female chickens. Male chickens fed 20% of the NRC-77 required level of biotin had numerically more severe tenosynovitis at 6 weeks of age and significantly more severe tenosynovitis at 8 weeks of age than male chickens fed 100% and 200% of the NRC-77 level of biotin. Increasing dietary choline levels from 20% to 200% of the NCR-77 required level increased the severity of tenosynovitis numerically at 6 weeks of age and significantly at 8 weeks of age. When data were pooled across diet, male chickens had significantly more severe tenosynovitis than female chickens at 4, 6, and 8 weeks of age in the choline experiment and at 4 and 6 weeks of age in the folic acid experiment. Differences in the severity of tenosynovitis of individual treatment means (sex X diet X infection interaction means) occurred at only the 20% or 100% NRC-77 level of choline or folic acid. Male chickens also had more severe tenosynovitis than female chickens when fed 20% of the NRC-77 required level of manganese for 6 or 8 weeks.

Age Factors↗

Enhanced MR imaging of tenosynovitis of hand and wrist in inflammatory arthritis.

OBJECTIVE: The purpose of this study is to describe the appearance of tenosynovitis in various tendon groups in the wrist and hand and to compare MR enhanced and non-enhanced imaging evaluation of tenosynovitis of hand and wrist in inflammatory arthritis. DESIGN AND PATIENTS: We reviewed 72 MRI studies of hands and wrists, including coronal, axial and sagittal images in 30 consecutive patients with inflammatory arthritis and tenosynovitis. We compared the degree of synovitis on T2-weighted vs contrast-enhanced T1-weighted images, using a predetermined scale. We also measured the extent of tenosynovitis in three dimensions. The tendons were assigned to volar, dorsal, ulnar and radial groups in the wrist and to extensor, flexor and thumb groups in the hand. Degree of tenosynovitis (graded 0-3), cross-sectional area and volume of the inflamed synovium in various tendon groups were then compared by statistical analysis. RESULTS: Review of the medical records revealed the following diagnoses in our patient population: rheumatoid arthritis (n=16), unspecified inflammatory polyarthritis (n=9), psoriatic arthritis (n=2), CREST syndrome (n=1), systemic lupus erythematosus (n=1), paraneoplastic syndrome with arthritis (n=1). The average T2 brightness scores and post-gadolinium enhancement scores were 1.0 and 1.7, respectively (P<0.001) in the wrist studies. The average T2 brightness scores and post-gadolinium enhancement scores were 0.7 and 1.4, respectively (P<0.001) in the hand studies. The average sensitivity of T2-weighted imaging for detection of tenosynovitis was 40% in the hand and 67% in the wrist tendons, when contrast-enhanced images were used as a reference. Carpal tunnel flexor tendons were the most frequently affected tendons of the wrist. The most frequently affected tendons of the hand were second and third flexor tendons. The hand flexors demonstrated higher degrees of enhancement and larger volumes of the inflamed tenosynovium than did the hand extensors and tendons of the thumb. CONCLUSION: Enhanced MR imaging of the hand and wrist is a superior technique for detection of tenosynovitis. We observed carpal tunnel flexor tendons to be the most frequently affected tendons of the wrist. The flexor tendons of the second and third digits were the most frequently affected tendons of the hands. Higher contrast-enhancement scores and inflammation were noted in the hand flexor than in the extensor tendons.

Adult↗

Distal intersection tenosynovitis of the wrist: a lesser-known extensor tendinopathy with characteristic MR imaging features.

OBJECTIVE: To present the MRI imaging findings of extensor tenosynovitis at the distal intersection or crossover between the second (extensor carpi radialis longus (ECRL) and brevis (ECRB)) and third (extensor pollicis longus (EPL)) extensor compartment tendons, and the anatomical details that may play a role in the pathogenesis of this condition. DESIGN AND PATIENTS: The imaging studies and clinical records of five patients (three females and two males, with ages ranging between 22 and 78 years; mean age, 49 years) presenting with pain on the dorsal and radial aspect of the wrist were reviewed by two musculoskeletal radiologists in consensus. Three cases were identified serendipitously during routine clinical reading sessions; a follow-up computerized database search for additional cases reported in the prior two years yielded two additional cases. The overall number of cases screened was 1,031. The diagnosis of tendinopathy affecting the second and third compartment extensor tendons was made on the basis of MRI findings and clinical follow-up, or synovectomy. RESULTS: All patients showed signs of tenosynovitis: in four patients both the tendons of the second and third extensor compartments were affected; the fifth patient showed signs of tenosynovitis of the EPL tendon, and tendinosis of the extensor carpi radialis tendons. Three patients showed tenosynovitis proximal and distal to the point of intersection; and in two of them, a discrete point of constriction was appreciated at the crossover site in relation to the extensor retinaculum. Two patients showed tenosynovitis limited to the segment distal to the point of decussation. Tendinosis tended to follow the presence of tenosynovitis. In one of the patients, subtendinous reactive marrow edema in Lister's tubercle was noted. CONCLUSION: Distal intersection tenosynovitis may be related to the biomechanical pulley effect exerted by Lister's tubercle on the EPL tendon as it leaves the third compartment and crosses over the extensor carpi radialis tendons, as well as the constraining effect of the extensor retinaculum. These anatomical features determine the presence of characteristic MR imaging findings.

Adult↗

Magnetic resonance imaging findings in patients with peroneal tendinopathy and peroneal tenosynovitis.

OBJECTIVE: To compare the magnetic resonance (MR) imaging findings of a group of patients with clinically diagnosed peroneal tendonopathy and peroneal tenosynovitis with the MR imaging findings of a control group of patients with no clinical evidence of peroneal tendon disorder. SUBJECTS AND METHODS: The MR examinations of 24 patients with symptomatic peroneal tendinopathy or peroneal tenosynovitis and 70 patients with no clinical evidence of peroneal tendon disorder were retrospectively reviewed to determine the presence or absence of four MR imaging findings: 1) predominantly or uniform intermediate signal intensity within the peroneal tendons on one or more axial proton density-weighted images, 2) predominantly or uniform intermediate signal intensity within the peroneal tendons on three consecutive axial proton density-weighted images, 3) intermediate T2 signal intensity within the peroneal tendons, and 4) circumferential fluid within the common peroneal tendon sheath greater than 3 mm in maximal width. The sensitivity and specificity of these MR imaging findings for determining the presence or absence or symptomatic peroneal tendinopathy or peroneal tenosynovitis were calculated. RESULTS: The sensitivity of MR imaging findings 1, 2, 3, and 4 for determining the presence of peroneal tendinopathy or peroneal tenosynovitis were 92%, 92%, 50%, and 17% respectively. The specificity of MR imaging findings 1, 2, 3, and 4 for determining the absence of peroneal tendinopathy or peroneal tenosynovitis were 57%, 79%, 93%, and 100% respectively. CONCLUSION: The presence of predominantly or uniform intermediate signal intensity within the peroneal tendons on three consecutive axial proton density-weighted images is a highly sensitive and moderately specific indicator of symptomatic peroneal tendinopathy. The presence of intermediate T2 signal within the peroneal tendons, and the presence of circumferential fluid within the peroneal tendon sheath greater than 3 mm in maximal width, are highly specific indicators of peroneal tendinopathy and peroneal tenosynovitis respectively.

Adult↗

Heterophil function in healthy chickens and in chickens with experimentally induced staphylococcal tenosynovitis.

Heterophil function was evaluated in 16 healthy chickens and in 46 chickens with experimentally induced staphylococcal tenosynovitis. In paired blood samples, heterophils from chickens with tenosynovitis had a significant increase in adherence, chemotaxis, phagocytosis, and bacterial killing of Staphylococcus aureus compared to heterophils from healthy chickens. The percent adherence of heterophils to nylon fiber columns increased significantly from a 78.4% mean +/- 6.6% standard deviation to 87.6% +/- 3.2% after induction of staphylococcal tenosynovitis. Heterophil movement following in vitro exposure to saline or endotoxin was increased in chickens with tenosynovitis; 3 +/- 1 heterophils/0.25 mm2 to 10 +/- 6 heterophils/0.25 mm2 and 136 +/- 29 heterophils/0.25 mm2 to 340 +/- 74 heterophils/0.25 mm2, respectively. Endotoxin-activated serum was chemoattractive for heterophils from all chickens. Flow cytometry was used to define the heterophil population on light scatter histograms, evaluate individual cell phagocytosis of latex beads, and quantitate the number of beads phagocytosed per heterophil. When incubated with increased numbers of beads, only heterophils from chickens with tenosynovitis phagocytosed higher numbers of beads. At heterophil to bead ratios of 1:10, the percentage of heterophils that phagocytosed beads increased from baseline values of 37.8% +/- 9.0% to post-infection values of 67.3% +/- 7.5%. Using 1:20 heterophil to bead ratios, heterophil phagocytosis increased from 38.7% +/- 9.9% to post-infection values of 79.8% +/- 7.3%. Heterophils from all chickens were able to phagocytose and kill log phase staphylococcal bacteria. After phagocytosis, the heterophils from chickens with staphylococcal tenosynovitis rapidly decreased the number of viable bacterial colony forming-units per milliliter by approximately one log.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Simultaneous vaccination of one-day-old broiler chickens with tenosynovitis virus and turkey herpesvirus.

An attenuated tenosynovitis virus vaccine and turkey herpesvirus (HVT) vaccine mixed prior to vaccination were injected subcutaneously into one-day-old chicks. In laboratory and field trials there did not appear to be any interference, because chickens vaccinated with both vaccines were effectively immunized against challenge with virulent Marek's disease virus or tenosynovitis virus when compared with unvaccinated chickens or chickens vaccinated with either HVT or tenosynovitis virus. The combined tenosynovitis and HVT vaccine had essentially the same virus titers when compared to the titers of each vaccine prior to mixing. Also, the HVT viremia levels and the serum neutralization titers of chickens vaccinated with both vaccines were essentially the same as those in chickens vaccinated with a single vaccine. In field trials, chickens vaccinated with the combined vaccines had fewer condemnations for parts and septicemia-toxemia and total condemnations when compared to chickens not vaccinated with tenosynovitis virus. There was less mortality in the majority of the flocks vaccinated with tenosynovitis virus vaccine and HVT when compared to flocks receiving only HVT vaccine.

Animals↗

Tuberculous tenosynovitis: a cause of Carpal Tunnel Syndrome.

OBJECTIVE: To highlight the presentation of tuberculous tenosynovitis as Carpal Tunnel Syndrome (CTS). METHODS: A descriptive study conducted with purposive sampling on the patients presenting between April 2004 to January 2005 to the department of Plastic Surgery, CMH Rawalpindi, with the clinical picture of CTS. Symptoms and signs were recorded. The carpal tunnels were explored under nerve blocks. Where tenosynovitis was observed per-operatively, specimen of excised synovium were sent for histo-pathological examination, acid fast stains and bacterial cultures, to ascertain or rule out the presence of tuberculosis. RESULTS: A total of 53 patients predominantly males were included in the study. The median age was 43 years and average duration of symptoms was 9 months. Tenosynovitis was observed in three patients (6%) per-operatively, with histopathology suggestive of Tuberculous tenosynovitis. Point Prevalence of tuberculous tenosynovitis as a cause of CTS was 6%. These patients reported clinical improvement with anti-tuberculosis treatment. NCS/EMG co-related well with clinical relief. CONCLUSION: Tuberculous tenosynovitis is an uncommon cause of median nerve compression at the wrist. As symptoms are usually typical of CTS, diagnosis is frequently missed. Consideration of the possibility, examination of the opened canal at surgery and proper treatment can result in a successful outcome.

Adult↗

MR arthrographic findings in tenosynovitis of the long bicipital tendon of the shoulder.

PURPOSE: To assess the MR arthrographic findings of bicipital tenosynovitis in correlation with arthroscopy. DESIGN AND PATIENTS: The shoulder MR arthrographies of 500 consecutive patients were retrospectively analyzed for signs of bicipital tenosynovitis and associated pathologies. Forty patients (8%) had MR evidence of bicipital tenosynovitis, but only 17 (3%) with arthroscopic confirmation were included in the study. The MR findings in these patients were compared with those of 10 patients with rotator cuff lesions but arthroscopically normal long biceps tendons. MR arthrography was performed with 10-15 ml of a 250 mmol/l gadoterate meglumine (Gd-DOTA) solution injected under fluoroscopic guidance, and transaxial, oblique coronal and sagittal MR sequences were obtained. RESULTS: All 17 patients showed one or more abnormal findings: signal increase in the tendon with or without fusiform distension was seen in 12, surface irregularities in six, adhesions in 11 and noncommunicating effusions of the tendon sheath in six. Associated abnormalities of the rotator cuff were present in 16 while the seventeenth patient had glenohumeral synovitis without rotator cuff pathology. MR arthrograms correlated with arthroscopic findings in the joint but comparison was not possible in the intertubercular groove portion of the biceps tendon. None of the 10 patients with an arthroscopically normal biceps tendon showed any of the MR findings of bicipital tenosynovitis. CONCLUSION: Bicipital tenosynovitis is detectable by MR arthrography. In most cases it is an associated finding of rotator cuff abnormalities and likely to have a similar etiology. When lesions of the anterior rotator cuff are recognized, the biceps tendon should be scrutinized for inflammatory changes.

Adult↗

Distal stenosing tenosynovitis.

Three patients are described with distal stenosing tenosynovitis involving the flexor digitorum profundus and the A3 pulley. One patient had isolated distal stenosing tenosynovitis and two patients had combined distal and proximal stenosing tenosynovitis of the flexor digitorum superficialis and the A1 pulley. All three patients with four digits involved had improvement of their symptoms after release of the A3 pulley. When involved, the A1 pulley was released at the same time. Patients with proximal stenosing tenosynovitis may have an associated distal stenosing tenosynovitis that if overlooked may cause persistence of symptoms after surgical treatment.

Adult↗

Diagnostic quality and scoring of synovitis, tenosynovitis and erosions in low-field MRI of patients with rheumatoid arthritis: a comparison with conventional MRI.

OBJECTIVE: To compare dedicated low-field MRI (lfMRI) with conventional MRI (cMRI) in the detection and scoring of synovitis, tenosynovitis and erosions in patients with rheumatoid arthritis. PATIENTS AND METHODS: The wrist and finger joints of 17 patients with rheumatoid arthritis (median (range) disease duration 8 years (7-12); Disease Activity Score 3.3 (2.6-4.5)) were examined by 0.2 T lfMRI and 1.5 TcMRI. The protocols comprised coronal spin-echo and three-dimensional gradient-echo sequences before and after contrast medium administration. Synovitis of the metacarpophalangeal and proximal interphalangeal joints 2-5 and the wrist joints was scored according to Outcome Measures in Rheumatology recommendations. Tenosynovitis and erosions were scored using 4-point and 6-point scales, respectively. The results were analysed by calculating kappa values and performing McNemar's test intra-individually on a joint-by-joint basis. RESULTS: Agreement between the two MRI techniques was good to excellent for synovitis and erosions, and moderate for tenosynovitis. Of the 306 joints evaluated, 245 and 200 joints showed synovitis in lfMRI and cMRI, respectively. Scoring of synovitis of the finger joints yielded kappa values from 0.69 to 0.94. Of the 68 flexor tendons evaluated, tenosynovitis was diagnosed by lfMRI in 24 and by cMRI in 33 instances. Of the 391 bones evaluated, 154 and 139 showed erosions in lfMRI and cMRI, respectively. kappa values for erosion scores were between 0.65 and 1. CONCLUSION: Dedicated, lfMRI shows high agreement with cMRI in diagnosing and scoring synovitis, tenosynovitis and erosions in rheumatoid arthritis when using standardised scoring systems.

Adult↗

Incidence and causes of tenosynovitis of the wrist extensors in long distance paddle canoeists.

OBJECTIVES: To investigate the incidence and causes of acute tenosynovitis of the forearm of long distance canoeists. METHOD: A systematic sample of canoeists competing in four canoe marathons were interviewed. The interview included questions about the presence and severity of pain in the forearm and average training distances. Features of the paddles and canoes were determined. RESULTS: An average of 23% of the competitors in each race developed this condition. The incidence was significantly higher in the dominant than the nondominant hand but was unrelated to the type of canoe and the angle of the paddle blades. Canoeists who covered more than 100 km a week for eight weeks preceding the race had a significantly lower incidence of tenosynovitis than those who trained less. Environmental conditions during racing, including fast flowing water, high winds, and choppy waters, and the paddling techniques, especially hyperextension of the wrist during the pushing phase of the stroke, were both related to the incidence of tenosynovitis. CONCLUSION: Tenosynovitis is a common injury in long distance canoeists. The study suggests that development of tenosynovitis is not related to the equipment used, but is probably caused by difficult paddling conditions, in particular uneven surface conditions, which may cause an altered paddling style. However, a number of factors can affect canoeing style. Level of fitness and the ability to balance even a less stable canoe, thereby maintaining optimum paddling style without repeated eccentric loading of the forearm tendons to limit hyperextension of the wrist, would seem to be important.

Athletic Injuries↗

Tuberculous tenosynovitis and bursitis: imaging findings in 21 cases.

PURPOSE: To describe imaging features of tuberculous tenosynovitis and bursitis with various imaging methods. MATERIALS AND METHODS: Twenty-one patients with surgically and/or pathologically proved tuberculosis of the tendon sheaths or bursae were evaluated. Routine radiography, arthrography, computed tomography (CT), and magnetic resonance (MR) imaging were used in some or all of the patients. RESULTS: Twelve patients had tuberculous tenosynovitis, and nine had bursitis. Tuberculous tenosynovitis most commonly involved the tendon sheaths of the hand and wrist, whereas bursitis occurred most frequently about the hip, especially in the trochanteric bursa. All cases of tuberculous tenosynovitis or bursitis showed soft-tissue swelling on plain radiographs, with calcification demonstrated in three of nine (33%) cases. CT and MR imaging allowed evaluation of all forms of tuberculous tenosynovitis (hygromatous, serofibrinous, and fungoid forms), whereas tuberculous bursitis exhibited two patterns of involvement: either a distended bursa or multiple small abscesses. Contrast material-enhanced radiography (i.e., arthrography) helped delineate communication between the affected structures. CONCLUSION: All imaging methods can provide complementary information that is helpful for determination of therapy. MR imaging seems to be superior in evaluating the extent of the lesion, particularly in soft tissue.

Adolescent↗

Focal radial styloid abnormality as a manifestation of de Quervain tenosynovitis.

OBJECTIVE: de Quervain disease is a stenosing tenosynovitis of the first dorsal wrist compartment. The purpose of this study was to determine whether focal radial styloid abnormality (cortical erosion, sclerosis, or periosteal bone apposition) as shown by radiography can be an indicator of de Quervain tenosynovitis. MATERIALS AND METHODS: A retrospective review of 49 radiographs from 45 patients in whom the clinical diagnosis of de Quervain tenosynovitis was confirmed (positive findings on Finkelstein's test) and 64 radiographs from 62 asymptomatic patients was carried out independently by two musculoskeletal radiologists in a blinded fashion. Findings on radiographs were assessed for focal radial styloid abnormality and assigned a diagnostic grade (1, definitely normal; 2, probably normal; 3, equivocal; 4, probably abnormal; 5, definitely abnormal). Receiver operating characteristic curves were constructed and compared. Kappa statistics for interobserver and intraobserver variability were calculated. RESULTS: The presence of focal radial styloid abnormality correlated significantly with the presence of de Quervain tenosynovitis (p < 0.05). The areas under the receiver operating characteristic curves for each reviewer equaled 0.71 and 0.76. Kappa values for interobserver variability equaled 0.44 (moderate agreement), and intraobserver variability equaled 0.62 (substantial agreement). CONCLUSION: Focal radial styloid abnormality is an indicator of de Quervain stenosing tenosynovitis of the wrist.

Adult↗

Noninfected tenosynovitis of the digital flexor tendon sheath: a retrospective analysis of 76 cases.

REASONS FOR PERFORMING STUDY: Until recently, the pathogenesis of noninfected tenosynovitis of the digital flexor tendon sheath (DFTS) has been considered obscure. With the advent of tenoscopy some inciting causes have been described, but to date few cases with a precise diagnosis have been reported. HYPOTHESIS: Tenoscopic surgery enables accurate diagnosis and facilitates treatment of noninfected tenosynovitis of the DFTS. METHODS: The case records of all horses with noninfected tenosynovitis of the DFTS admitted to a referral clinic over a 7-year period were evaluated retrospectively. Follow-up information was obtained by telephone questionnaire. RESULTS: A total of 76 horses were referred; all were evaluated tenoscopically and 11 of these subsequently were explored by open surgical techniques. The most common diagnoses were marginal tears of the deep digital flexor tendon (DDFT) (n = 44) and tears of the manica flexoria (MF) (n = 23). Greater than 6 months' follow-up information was available for 61 animals, of which 68% were sound and 54% returned to preoperative levels of performance. Sheath distension was eliminated in 33% and improved in 69% of horses. Marginal tears of the DDFT, marked preoperative distension and open surgical repair of deep digital flexor lesions were associated with reduced levels of post operative performance: Marginal tears were associated with post operative lameness and long tears with a reduced performance level compared with short tears. Marginal tears of the deep digital flexor tendon, marked preoperative distension and increasing duration of clinical signs also were associated with lack of improvement in distension following surgery. CONCLUSION: Tenosynovitis of the DFTS may result from tears in the deep or superficial digital flexor tendons, manica flexoria or other structures with synovial communication. To date, these can be identified confidently only by tenoscopy, which also permits appropriate lesion management. POTENTIAL RELEVANCE: The diagnostic information obtained from and therapeutic options offered by tenoscopy justify its early use in cases of noninfected tenosynovitis of the DFTS.

Animals↗

What is the likelihood that a horse treated for septic digital tenosynovitis will return to its previous level of athletic function?

REASONS FOR PERFORMING STUDY: Septic digital tenosynovitis is a serious problem in the horse, with a poor prognosis being reported for recovery. HYPOTHESIS: The occurrence of septic digital tenosynovitis would significantly reduce the likelihood of a horse returning to its previous level of athletic function. METHODS: Medical records of 90 horses treated for septic digital tenosynovitis were reviewed. Data retrieved included age, sex, location of inciting cause of sepsis, time from onset of clinical signs to presentation for treatment, and whether the horse survived to be discharged. Long-term outcome was determined through telephone questionnaires. Univariate analyses of categorical variables were conducted for each outcome. RESULTS: Overall, 87.8% of horses (79/90) survived to be discharged from the hospital. Only one factor examined was shown to have a significant effect on outcome. A delay of 1-7 days between onset of clinical signs and presentation for treatment reduced significantly the likelihood of the horse surviving to be discharged from the hospital. Of the horses discharged from the hospital, long-term follow-up was available for 72 horses, with 54.2% (39/72) returning to their previous level of athletic function. CONCLUSIONS: Only approximately 50% of horses treated for septic digital tenosynovitis returned to their previous level of athletic function following resolution of synovial sepsis. POTENTIAL RELEVANCE: Accurate figures allowing a realistic assessment of the athletic future of a horse following treatment for septic digital tenosynovitis are of value to both the owner and treating veterinarian.

Animals↗