Endoscopic Surgery in the Management of Contamination and Infection of Joints, Tendon Sheaths, and Bursae

McIlwraith, C. Wayne

doi:10.1016/b978-0-7234-3693-5.00014-x

Cited by 7 publications

(17 citation statements)

References 77 publications

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“…For example, it is possible that minor local pathology prior to synovial sepsis was managed routinely by stable staff and may not have been reported at presentation. Nonetheless, evidence of penetration or foreign material is relatively frequently recognised surgically in contaminated synovial structures following traumatic inoculation but was not identified in any case in the present series . A prospective multicentre study would minimise some of these limitations and allow further characterisation of the risk factors, pathophysiology and prognosis for synovial sepsis of unknown origin when a haematogenous route is suspected.…”

Section: Discussionmentioning

confidence: 66%

Synovial sepsis of unknown origin in the adult Thoroughbred racehorse

Byrne¹,

Lumsden²,

Lang³

et al. 2019

Equine Veterinary Journal

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Summary Background Synovial sepsis of unknown origin is a rare cause of lameness in the adult horse, and a haematogenous pathogenesis has been proposed in previous cases. Objectives To describe the features and outcome of synovial sepsis of unknown origin in adult Thoroughbred racehorses. Study design Retrospective case series. Methods Hospital records for admissions between 2005 and 2015 were reviewed to identify adult horses diagnosed with synovial sepsis of unknown origin. Presentation, clinicopathological, microbiological and diagnostic imaging findings were recorded. Treatment methods, surgical findings, complications and long‐term outcome were evaluated. Results Eleven cases were identified over the study period. Diagnosis was established from clinical examination and clinicopathologic findings, which were comparable to other aetiologies of synovial sepsis. Affected structures included synovial joints, tendon sheaths and bursae. Concurrent osteochondritis dissecans or articular cartilage lesions were evident during arthroscopic surgery in three cases. Significant intrasynovial haemorrhage was not identified. Microbial culture of synovial fluid or synovial biopsy was positive in 6/11 of cases, with all isolates being Gram‐positive cocci. Of the 6 positive microbial cultures, all isolates demonstrated in vitro sensitivity to a cephalosporin antimicrobial agent. A concurrent remote wound was present in a single case. No other potential origins of bacteraemia were identified. Treatment methods included endoscopic surgery, standing multineedle lavage, intravenous regional limb perfusion, intrasynovial medication and/or systemic antimicrobial administration. All horses survived to hospital discharge. For the 6/11 cases that raced following synovial sepsis, the median period for return to racing was 221 days. Main limitations A small study population, which was retrospectively reviewed. Conclusions Synovial sepsis of unknown origin is rare in the adult Thoroughbred racehorse and can affect a range of synovial structures. A concurrent potential source of bacteraemia is rarely identified. With appropriate management, the prognosis to return to racing is fair.

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Section: Discussionmentioning

confidence: 66%

Synovial sepsis of unknown origin in the adult Thoroughbred racehorse

Byrne¹,

Lumsden²,

Lang³

et al. 2019

Equine Veterinary Journal

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“…Local extension of a perisynovial infection may also result in infectious arthritis (McIlwraith et al . ).…”

Section: Introductionmentioning

confidence: 97%

“…In addition, a comprehensive tutorial article has been published (Bertone 1999). Further to this there is a recent review of the pathophysiology and management of infectious arthritis, which also provides an insight into the current literature available on infective arthritis in man (McIlwraith et al 2014).…”

Section: Introductionmentioning

confidence: 99%

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Idiopathic infectious arthritis of the coxofemoral joint in a mature horse

Woodford

Puzio

Parker

2016

Equine Veterinary Education

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Summary The authors are aware of only one previously described case of idiopathic infectious arthritis of the coxofemoral joint in a mature horse. The case described herein presented with clinical signs that localised pain to the proximal limb, subtle increased radiopharmaceutical uptake at the coxofemoral joint and an increase of the major acute phase protein, serum amyloid A in the horse's blood biochemistry. The latter finding led the authors to search initially for an infective process. Ultrasound guided aspiration of the coxofemoral joint yielded infected synovial fluid. Despite the duration of the condition, nonsurgical treatment allowed the horse to return to its previous, relatively modest, level of activity. This case is presented to supplement the single previously published case report of idiopathic adult coxofemoral infectious arthritis in the horse.

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“…If left unidentified, or if treatment is suboptimal or delayed, the destructive combination of bacteria and host immunity can permanently debilitate the synovial environment, in particular the articular cartilage, resulting in unresolvable lameness (McIlwraith et al . ).…”

Section: Introductionmentioning

confidence: 97%

Infraspinatus and intertubercular (bicipital) bursae sepsis

Barker

2015

Equine Veterinary Education

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The case report by O'Sullivan et al. in this month's issue of EVE describes an unusual case of synovial sepsis raising interesting points on synovial infection in general and more specifically the implication of haematogenous spread of bacteria from a remote site in the mature horse. The identification of synovial sepsis in this location is challenging due to the complex and unfamiliar anatomy in the shoulder region. This clinical commentary reviews the anatomy in this region and discusses the unusual presentation of synovial sepsis secondary to haematogenous spread.

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Endoscopic Surgery in the Management of Contamination and Infection of Joints, Tendon Sheaths, and Bursae

Cited by 7 publications

References 77 publications

Synovial sepsis of unknown origin in the adult Thoroughbred racehorse

Synovial sepsis of unknown origin in the adult Thoroughbred racehorse

Idiopathic infectious arthritis of the coxofemoral joint in a mature horse

Infraspinatus and intertubercular (bicipital) bursae sepsis

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