10-year-old gelding Thoroughbred
September 1, 2017
Right hind limb lameness, 40% improvement with high 4-point and 80% improvement with intra-articular
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- This case represents a traumatic comminuted biarticular fracture of the central tarsal bone with marked central tarsal bone sclerosis. Mild 3rdtarsal bone sclerosis is also appreciated. Minimal new bone formation is noted at the medial malleolus. Very mild increased soft tissue opacity was noted at the proximal and distal intertarsal joints.
- This case differentiated between candidates who were familiar with equine anatomy and appropriate pathology, and those who could not. Successful candidates earned almost all case points while unsuccessful candidates earned almost none. Case average is 79%.
- Standard four views of the tarsus were available and candidates were expected to be able to come appropriate diagnosis based on these.
- Fully successful candidates recognized two orthogonal fracture lines; one identified on the DP and the other on the DLPMO. Most candidates, while successful, failed to recognize this fundamental roentgenology and often synthesized the case as a single biarticular fracture rather than comminuted. They also recognized the central tarsal bone sclerosis.
- Partially successful candidates generally concluded on a slab fracture +/- sclerosis of the central tarsal bone.
- Unsuccessful candidates failed to recognize the fracture lucencies and/or central tarsal bone sclerosis. Numerous unsuccessful candidates described osteochondrosis lesions which were not present.
- Many candidates described osteophyte formation at either the distal interphalangeal or tarsometatarsal joints which was not present. A normal smooth variation in the articular margins of these joints is within normal limits particularly given the subtle obliquity often noted in projections.
- Many candidates described the 3rdtarsal bone sclerosis as severe as the central tarsal bone sclerosis and concluded on likely stress fractures of the 3rd tarsal bone. The 3rd tarsal bone was far more subtly sclerotic seen on all projections.