Transcript Tendonitis - LearnGroup


Directed by

Professor Dr/ Mohammed
Adel
prepared by / Fatma. A. shaban
&
Zeinab. A. Abd-Elazeem 

Def 
The tendon is the extension of muscle for
attachment to bone .
Consist of: Fibrils
Long bundles of
collagen filaments
Primary
(1ry) fibre bundle
(2nd)
fibre bundle
tertiary fibre
bundle
Tendon .
*Collagen fibrils arranged in “Crimp” or “Zigzag” (allows extensive intermolecular crosslinking to increase tensile strength .
It allows gliding of tendon in areas
of abrupt directional change or
flexion.
Paratenon
elastic ,loosely arranged areolar
tissue surrounding the tendon . It
allows gliding function where
sheaths are not present
Superficial flexor tendon .
B. Deep flexor tendon
C. Suspensory ligament
D. Common digital
extensor tendon
A.
Def :inflammation involving tendons surrounded
by paratenon not synovial sheath .
 N.B :
*tendonitis in superficial digital flexor tendon
(SDFT) is common injury in racing equine
especially in forelimb .
* SDFT of hindlimb is uncommon in all breads
of horses.
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A.
B.
C.
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A.
B.
Position of tendonitis
High bow
just distal to the carpus .
Middle bow
in the middle 3rd of the
meta carpus .
Low bow
in the distal 3rd of the meta
carpus .
Severity of tendonitis:
Acute tendonitis
Chronic tendonitis .
Primary
A.
B.
C.

A.
B.
1.
2.
cause
Tendon trauma
Over extension (overlaoding)
Over use of tendon
Secondary cause
Inadequate training and excessive muscle fatigue
Abnormal congenital:
abnormal angulation of fetlock
Upright pastren(excessive pastren slope)
C) Improper shoeing and too long toes
D)Inocordination between body weight and
tendon strength
 Acute
tendonitis
A.
B.
C.
D.
E.
F.
G.
Diffuse swelling over the affected (SDFT)
Circumscribed swelling distal to carpus in case
of tendenitis of the DDFT
Swelling in case of inflammation of suspensory
ligament above level fetlock
Marked heat and tendon pain
The limb is held in fixed position
Variable degree of lamness according severity of
injury
Dropping of the fetlock joint due to distruption of
tendon
A.
B.
C.
D.
Fibrosis and hard swelling on the
palmer/planter aspect
The animal may be sound with mild work
and became lame with hardwork
Annular ligament constriction
In advanced severe case
knuckling over
the fetlock joint .
Clinical syptoms and physical examination
 Diagnostic ultrasonography (appear as black
line at site of tendonitis)
 X ray or radiological examination
1. Increase the size area of tendon
2. Normally appear radioopaque but in this
case appear radiolucent but in suppuration
appear white due to presence of the pus

Dealing
with tendonitis in equine
is one of extremely frustrating
musculoskeletal problems for the
equine trainer .
 only 20% of race horses starts to
or more times after injury
Graded prognosis
Acute tendonitis:
A. Application of hydrotherapy as ice or cold water
therapy every 4 to 6 hours during the initial 4872 hours
B.
Administration of non steroidal-non
inflammatory agents as phenyl butazone
through interruption of prostaglandin

C.
Pressure bandage
E) Tendon splitting of the core lesion
 This technique which uses tentome (thin
bladded scalpel ) to create vertical incision in
the tendon.
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


Pressure bandage
Tendon splitting
Tendon transplantation : transplantation of a
portion of the lateral digital extensor tendon
into SDF tendon. The graft act as organized
scaffold for healing replacement to induce
scar growth
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Superior check ligament desmotomy
Annular ligament desmotomy
Carbon fiber implantation : carbon suture
coated with polyglycolic acid induces
fibroblastic response.
Tendon Sheathing
neuroectomy
Corrective shoeing by using shoes with
calcins
Too long toes of shoe
 Def
:
means inflammation
involving tendon surrounded by a
synovial sheath
Or
inflammation of both tendon
and sheath
1.
2.
3.
4.
5.
Strained tendon in synovial sheath .(Acute
tenosynovitis).
Damaged mesotendon with loss of blood
supply.
Constriction of annular ligament , secondary
to “low bow” occurs in palmer or plantar
fetlock area.
Infection .
Direct trauma.
1.
2.
3.
Excessive synovial production
called wind puffs
Lameness heat , fluid distention
of involved sheath (Acute
tenosynovitis).
Constriction of tendon in annular
ligament with associated
lameness
1.
2.
3.
4.
5.
6.
7.
Hydrotherapy of the tendon similar to
treatment of a bowed tendon
Drainage of sheath to relieve pressure
Injection of steroid or sodium hyaluronate to
relieve inflammation and reduce secretion
within the sheath ( #if the tendon has continued
damage)
Application of bandage
Tendon splitting through the sheath
Annular ligament desmotomy.
In septic tendon sheath deal as septic arthritis