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Discussion on Chip/Fracture of distal lip of radius
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Member:
kamibroo
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Posted on Friday, May 18, 2007 - 12:05 am:
I had a 4yo racing TB x-rayed yesterday and an old (probably untreated) chip at the distal surface of the radius was found. The injury is thought to be old due to the amount of calcification that has built up. (The horse had 8 starts last year and 2 starts this year) The horse is lame and the vet has said that w/o surgery, he will not be able to be w/o pain. W/surgery, he might be essentially pasture sound (baring wrong steps, etc).
I'm now trying to figure the right way to locate and request a second opinion/analysis from a specialist. I'm located between Ohio State University and Penn State University. Today I left a message with the main office of OSU. From Penn State's web site, it seems like I'd have to get a formal referral from my vet? I have 4 views in digital DICOM / IDEXX Laboratories that can be exported to JPEG. My vet has said its okay to forward these to others.
I am trying to (a) verify what sort treatment routes and prognosis this injury can have and (b) the costs that would be associated with them.
I've attached two views for you to look at, if that helps.
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Member:
kamibroo
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Posted on Friday, May 18, 2007 - 12:27 am:
General comments for readers.
This horse's trainer for the last 5 starts knew he had a problem with the knee and thought he had a wind problem (stopping in races). The horse would be sore after a race, but then appear sound in between works. The horse's lungs were scoped seven times (all negative) and his knee was treated with pain meds and many other race track approaches, but never x-rayed.
That trainer spent easily five times the $$ treating the wrong problem that I spent to find out the real root of the problem. My vet said that had the problem been diagnosed earlier, the horse's prognosis might be better (not necesarily that he'd be a race horse, but have a better chance of good outcome).
In the future, if I have any horse with joint problems that are not dead simple, I personally will get x-rays. They are well worth it for the money spent, if nothing else but to rule out serious problems like this.
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Moderator:
DrO
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Posted on Friday, May 18, 2007 - 7:16 am:
Hello USHO,
Unless there are other signs of DJD in the other radiograhs, I disagree with the prognosis. In my limited experience of dealing with the presurgical evaluation (but have seen many ex-race horses that have had chips, some left in and some removed) I say arthroscopically remove the chips and I think there is a fair to good chance this horse could be used on trail and guarded to fair for possible hunter show ring. For that better second opinion from a orthopod you should have your vet call the university of your choice to make the arrangements.
DrO
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Member:
kamibroo
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Posted on Friday, May 18, 2007 - 7:41 am:
Thanks for the quick response. If you can see on your monitor that the calcification in the flexed view is going to the top of the image (very narrow at the top), then you are seeing all of the DJD. The rest of his joint is clean.
I did leave message for my vet asking for OSU contact. I guess I'll call again today and clarify that I'm asking for referral.
In the mean time, the horse will be on stall rest/hand walking. Would it make any sense to try 90 days stall rest first? Would the chip healing back to the bone be a good or bad thing?
Thanks again for the response and this site! Your article made it sound like he might have a slightly better chance than the vet let on. I guess I will wait to get connected to OSU and see what they recommend as a course of action. For now, I will continue with hope that he can be returned to some reasonable level of soundness.
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