LAS > Tendonitis > Flashcards

Tendonitis Flashcards

(47 cards)

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1
Q

Toe region

A

area on a tendon stress graph where a tendon’s crimp pattern absorbs 1-3% of strain

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2
Q

when are SDFT and SL most prone to injury

A

landing phase

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3
Q

treatment options for tendonitis (9)

A

MUST include rest + controlled exercise/rehab (while monitoring with serial US)

  • cold hydrotherapy > ice packs (do for 20 mins)
  • compression and coaptation to decrease edema and inflammation (severe may need splint/cast)
  • phenylbutazone
  • intralesional injections under US guidance (PRP, stem cells)
  • shock wave therapy (to increase vascularization and GF -> more organized scar tissue and decreased recovery times; great at decreasing pain)
  • US laser therapy
  • surgery
    • suturing tendon post percutaneous injury
    • annular ligament desmotomy if edema building up
    • superior check desmotomy
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4
Q

where to harvest stem cells from horse BM

A

tuber coxae or sternum

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5
Q

stress on tendon at a walk

A

3-8%

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6
Q

tendon units from inside out

A
  • collagen fibers
  • fibril
  • fascicule (surrounded by endotenon, which supplies blood, nerves, GFs, and elasticity)
  • tendon (surround by epitenon)

paratenon surrounds tendons that are NOT in a sheath (decreases friction, supplies blood and repair elements)

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7
Q

what causes tears in synovial cavity and where are they most common?

A

cause unknown

most common in DDFT of forelimb and Flexor Manica of hindlimb

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8
Q

how can you measure tendonitis using US?

A
  • Using US zones for metacarpal and pastern regions

- use measuring tape to measure distance between accessory carpal bone/calcaneous and transducer

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9
Q

when is the DDFT most prone to injury?

A

during push off phase

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10
Q

surgical options to treat tendonitis

A
  • suturing tendon post percutaneous injury
  • annular ligament desmotomy (if edema building up within tendon sheath)
  • superior check desmotomy
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11
Q

gold standard diagnostic for tendonitis

A

US ***do it 1 week AFTET injury because takes time to declare itself due to inflammatory cytokines

use 7.5-12 MHz transducer
always take both linear and transverse views
ALWAYS do both limbs (often bilateral if overuse injury)

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12
Q

_____ and _____ are most prone to injury during landing phase

A

SDFT and SL

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13
Q

There are US zones for which regions when measuring tendonitis?

A

metacarpal and pastern regions

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14
Q

which is better for tendonitis: cold hydrotherapy or ice packs?

A

cold hydrotherapy (no longer than 20 mins)

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15
Q

predisposing factors to tendonitis (6)

A
  • poor/deep ground
  • inadequate training
  • muscle fatigue
  • poor conformation: long sloping pasterns
  • poor hoof care (long toes; underrun heels)
  • improper bandaging/boots
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16
Q

signs you might see with tendonitis (3)

A
  • bowing of tendons
  • < change in limb in severe cases
  • severe lameness initially (but lameness will rapidly resolve once inflammatory phase has passed (1-2 weeks post injury)
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17
Q

_____ can restrict swelling if tendonitis occurs beneath it

A

annular ligament

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18
Q

tendons have a _____ pattern to impart elasticity

A

crimp/wave (decreases with age)

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19
Q

NSAID used for tendonitis

Study These Flashcards
A

phenylbutazone

20
Q

stress on tendon at a gallop

21
Q

intralesional injection options for tendonitis

Study These Flashcards
A
  • PRP: growth factors + scaffold for mesenchymal stem cells

- stem cells (decrease fibrosis and inflammation): autologous (bone marrow > adipose) vs. allogenic

22
Q

Insertion of SDF

Study These Flashcards
A

divides at P1 and then inserts on P2

23
Q

US is the gold standard diagnostic tool for tendonitis. what must you always remember? (3)

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A
  • image 1 week AFTER injury (takes time to declare itself due to inflammatory cytokines)
  • ALWAYS take both linear and transverse views
  • ALWAYS do both limbs (often bilateral if overuse injury)
24
Q

endotenon

Study These Flashcards
A

surrounds tendon fascicules and supplies blood, nerves, GFs, and elasticity

25
signs of chronic tendonitis on US
- variable enlargement - MIXED echogenicity - fibrosis/irregular striations
26
paratenon
surrounds tendons that are NOT in a sheath (decreases friction, supplies blood and repair elements)
27
options of stem cells to treat tendonitis
autologous: bone marrow better but takes 3 weeks to get back; adipose only takes 90 mins-48 hours (sites for BM include sternum or tuber coxae) allogenic
28
what do the extensor branches of the suspensory ligament join with?
common digital extensor; they branch away at the level of the fetlock/proximal sesamoids (where the suspensory ligament attaches)
29
stress on tendon at a trot
7-10%
30
epitenon
surrounds tendon and is contiguous with endotenon
31
tendon repair capabilities
limited type 1 -> type 3 (aka it scars over) tendons in a sheath heal WORSE
32
PE components when evaluating for tendonitis
- look for bowing of tendons - look for signs of inflammation - may present with severe lameness initially but will rapidly resolve once inflammatory phase has passed (1-2 weeks post injury) - look for < change in limb in severe cases - lameness exam (always palpate both when weight bearing and not) +/- nerve block
33
origin and insertion of suspensory ligament
origin: proximal MC/MTIII (reminder: this area is blocked by lateral palmar nerve block) insertion: proximal sesamoids; has extensor branches that join with common digital extensor
34
what surrounds tendon fascicules
endotenon (supplies blood, nerves, GFs, and elasticity)
35
level of stress needed to rupture a tendon
12-20%
36
most important component of tendonitis treatment
rest + controlled exercise (with serial US)
37
what imaging tools can be used for tendonitis?
- US (G.S.) - MRI - nuclear scintigraphy (for when you can't isolate lameness or find lesion)
38
goals of treatment for tendonitis (4)
- decrease inflammation - decrease risk of reinjury - speed up healing - increase tensile strength
39
insertion of DDF
dives between SDF (which divides at P1) and inserts on P3
40
Appearance of acute tendonitis on US
- enlarged but not thickened - hypoechogenicity - reduced striations - shape, margin, or position changes
41
what surrounds tendon
epitenon (and paratenon if NOT in a sheath)
42
which area of a tendon heals worst?
areas in a sheath
43
causes of tendonitis
- most commonly repetitive microtrauma (molecular inflammation progressively weakens tendon) - percutaneous (palmar/plantar more severe) - acute injury - EDx of tears in synovial cavity unknown
44
______ join to form a tendon
collagen fibers
45
true or false: never treat tendonitis with blistering, counter irritation, or pin firing
true
46
shock wave therapy for treatment of tendonitis
increases vascularization + GFs -> more organized scar tissue + decreased recovery time also GREAT at decreasing pain (beware risk of reinjury!!)
47
this is GREAT at decreasing pain from tendonitis (beware reinjury!!)
shock wave therapy
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