Synovial and Osseous Infection

Richardson, Dean W.; Stewart, Suzanne

doi:10.1016/b978-0-323-48420-6.00086-7

Cited by 20 publications

(54 citation statements)

References 96 publications

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“…The current recommended tourniquet application time for standing horses in regional limb perfusion is 30 minutes in clinical settings and in experimental studies. 1,28 Several studies have investigated the ideal tourniquet application time for IVRLP by comparing synovial fluid concentrations at different time points post-infusion. Previously it has been suggested that the time to peak concentration (T max ) occurs 15 minutes post-infusion after IVRLP with 1.25 g of amikacin sulphate in the lateral/medial palmar/plantar vein of horses under general anaesthesia.…”

Section: Introductionmentioning

confidence: 99%

Time to Peak Concentration of Amikacin in the Antebrachiocarpal Joint Following Cephalic Intravenous Regional Limb Perfusion in Standing Horses

Gustafsson

Tatz

Dahan

et al. 2020

Vet Comp Orthop Traumatol

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Objective The aim of this study was to determine the time (Tmax) to the maximum concentration (Cmax) of amikacin sulphate in synovial fluid of the radiocarpal joint (RCJ) following cephalic intravenous regional limb perfusion (IVRLP) using 2 g of amikacin sulphate. Methods Cephalic IVRLP was performed with 2 g of amikacin sulphate diluted in 0.9% NaCl to a total volume of 100 mL in six healthy adult mixed breed mares. An Esmarch's rubber tourniquet was applied for 30 minutes and the antibiotic solution was infused through a 23-gauge butterfly catheter. Synovial fluid was collected from the RCJ prior to the infusion and at 5, 10, 15, 20, 25 and 30 minutes after completion of IVRLP. The tourniquet was removed after the last arthrocentesis. Synovial fluid amikacin sulphate concentrations were determined by liquid chromatography/tandem mass spectrometry. Results The calculated mean Tmax occurred at 15 minutes (range: 10–20 minutes) post-perfusion. The highest synovial fluid amikacin sulphate concentration was noted at 10 minutes in 2 horses, 15 minutes in 2 horses and 20 minutes in 2 horses. The highest mean concentration was 1023 µg/mL and was noted at 20 minutes. Synovial mean concentrations were significantly different between 15 and 30 minutes. Clinical Significance In this study no Tmax occurred after 20 minutes; thus, 30 minutes of tourniquet application time appear to be excessive. The 20 minutes duration of tourniquet application appears sufficient for the treatment of the RCJ in cephalic IVRLP using 2 g amikacin sulphate in a total volume of 100 mL.

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Section: Introductionmentioning

confidence: 99%

Time to Peak Concentration of Amikacin in the Antebrachiocarpal Joint Following Cephalic Intravenous Regional Limb Perfusion in Standing Horses

Gustafsson

Tatz

Dahan

et al. 2020

Vet Comp Orthop Traumatol

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“…There was no history of injury or synoviocentesis of the affected joint within 3 months prior to initial presentation. While septic arthritis in horses is most commonly a result of penetrating traumatic injuries or iatrogenic following intrasynovial injections, idiopathic synovial sepsis typically also involving one joint has recently been described 13 18 19. In a case series involving 11 horses, the diagnosis of synovial sepsis was based on an elevated nucleated cell count, total protein and a neutrophil differential percentage of ≥80%, whereas the culture of a causative organism was successful in only 6 patients 19.…”

Section: Discussionmentioning

confidence: 99%

“…Arthrocentesis of both joints was performed and cytology of the left tarsocrural joint revealed a total cell count of 8.1×10 9 cells/L (reference range <1.5×10 9 cells/L) of which 92% were neutrophils and a total protein of 22 g/L (reference range <25 g/L). Although the nucleated cell count was only mildly elevated, the presumptive diagnosis of a chronic septic arthritis of the left tarsocrural joint was made based on the presence of more than 90% neutrophils 13. Simultaneously to arthrocentesis, 5 mL of 2% mepivacaine (Mepinaest, Gebro Pharma GmbH, Fieberbrunn, Austria) was administered to the left tarsocrural joint and resulted in a 90% improvement of the left hind lameness.…”

Section: Investigationsmentioning

confidence: 99%

Arthritis, panuveitis and hyperaesthesia associated with Borrelia afzelii infection in a warmblood gelding

Sommerauer

Blohm

Spergser

et al. 2019

Vet Record Case Reports

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A 13-year-old warmblood gelding presented with a history of lameness, muscle atrophy and weight loss of 3 months. The horse demonstrated extensive hyperaesthesia over the left dorsal trunk, marked effusion of several joints, laryngitis and a dampened mental attitude. Synovial fluid analysis revealed arthritis of the left tarsocrural joint, being PCR-positive for Borreliaafzelii DNA. Subsequently, mild anterior uveitis of the right and severe panuveitis of the left eye with B. afzelii PCR-positive aqueous and vitreous humour, respectively, were diagnosed. Treatment included arthroscopy of the left tarsocrural joint, oral doxycycline administration for 6 weeks, ophthalmic and systemic anti-inflammatory therapy and left intravitreal preservative-free gentamicin (4 mg) injection. After initial improvement, the gelding’s clinical signs deteriorated resulting in peracute recumbency and sudden death 12 months later. Lyme borreliosis should be considered as differential diagnosis in complex cases of equine lameness, particularly when accompanied by hyperaesthesia and bilateral uveitis.

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“…Septic arthritis of haematogenous aetiology can occur in foals from immediately after birth and up to at least 7 months of age, but it is more common in neonatal foals secondary to sepsis (Platt 1977;Vos and Ducharme, 2008;Hepworth-Warren et al 2015;Wright et al 2017;. It is characterised by a severe inflammatory reaction, which can eventually lead to cartilage destruction, hypertrophy of the joint capsule, reduced range of motion and lameness (Fig 1) (Platt 1977;Firth 1983;Vos and Ducharme, 2008;Wright et al 2017;Richardson and Stewart 2019). If treatment is delayed, insufficient and/or ineffective, damage can become chronic in the form of osteoarthritis (OA), and the foal may be unable to pursue an athletic career (Martens et al 1986;Richardson and Stewart 2019).…”

Section: Introductionmentioning

confidence: 99%

“…It is characterised by a severe inflammatory reaction, which can eventually lead to cartilage destruction, hypertrophy of the joint capsule, reduced range of motion and lameness (Fig 1) (Platt 1977;Firth 1983;Vos and Ducharme, 2008;Wright et al 2017;Richardson and Stewart 2019). If treatment is delayed, insufficient and/or ineffective, damage can become chronic in the form of osteoarthritis (OA), and the foal may be unable to pursue an athletic career (Martens et al 1986;Richardson and Stewart 2019). In a worst-case scenario, the foal may even need to be subjected to euthanasia for humane reasons or die because of inability to stand and nurse or due to development of sepsis from the initiating bacteraemia (Cohen 1994).…”

Section: Introductionmentioning

confidence: 99%

Haematogenous septic arthritis, physitis and osteomyelitis in foals: A tutorial review on pathogenesis, diagnosis, treatment and prognosis. Part 1

Lindegaard

Galen

Aarsvold

et al. 2020

Equine Veterinary Education

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Haematogenous septic arthritis, physitis and osteomyelitis (SAPO) is a potentially debilitating or even life-threatening disease entity encountered in foals of all ages between birth and approximately 7 months old. Correct, and complete, diagnosis and successful treatment require collaboration between specialties including medicine, anaesthesia, diagnostic imaging, surgery and rehabilitation services. However, in order to succeed, it is important that all specialties have an overall knowledge of all aspects of the disease complex. Therefore, the aim of this review is to give an overview of aetiology, presenting complaints, clinical findings, diagnostic imaging, treatment, rehabilitation and prognosis. Part one deals with all aspects of aetiology and how to make a diagnosis. Part two deals with all aspects of treatment, rehabilitation and prognosis. MethodsSince this is considered a tutorial review, the authors aim to provide a selected review of the most relevant literature combined with the authors' experiences on the subject. Consequently, it should not be seen as a systematic review, and the reference list may not be exhaustive. Classification, aetiology and pathogenesisSAPO represents slightly different presentations of infection in the joint or the surrounding bone occurring as sequelae to bacteraemia or even sepsis in neonatal or young foals. Despite the differences, they share similarities in presentation that can make discrimination challenging (Firth et al. 1980;Firth 1983). Haematogenously disseminated bacteria originate

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Synovial and Osseous Infection

Cited by 20 publications

References 96 publications

Time to Peak Concentration of Amikacin in the Antebrachiocarpal Joint Following Cephalic Intravenous Regional Limb Perfusion in Standing Horses

Time to Peak Concentration of Amikacin in the Antebrachiocarpal Joint Following Cephalic Intravenous Regional Limb Perfusion in Standing Horses

Arthritis, panuveitis and hyperaesthesia associated with Borrelia afzelii infection in a warmblood gelding

Haematogenous septic arthritis, physitis and osteomyelitis in foals: A tutorial review on pathogenesis, diagnosis, treatment and prognosis. Part 1

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