ISSN 2398-2977      

Carpal joint: disease - overview

pequis

Introduction

  • Incidence: the carpus is a common site for both congenital and acquired conditions associated with lameness.
  • Cause: many potential causes - primary and secondary. Trauma is the most common secondary cause.
  • Signs: variable. Some conditions, eg hygroma, cause deformity without lameness.
  • Diagnosis: clinical examination and range of ancillary aids including joint anesthesia and radiography.
  • Treatment: depends on cause.
  • Prognosis: depends on cause.

Pathogenesis

Etiology

Trauma

Infectious

Multifactorial

Congenital and perinatal conditions

Immune-mediated

Miscellaneous

Predisposing factors

General
  • Septic conditions:
  • Carpal fractures:
    • Poor conformation, especially misalignment of radius, ulna or MC3 results in increased axial compressive forces on one side and tensional forces on the opposite side   Musculoskeletal: conformation  .
    • High motion joint often damaged at high speeds due to over-extension of joint(s)   Carpus: fracture - chip  .
  • Poor conformation, eg offset knee (bench knee), back-at-the-knee (calf-knee), carpal varus/valgus   Carpus: angular deformity 01 - valgus    Carpus: angular deformity 02 - valgus    Carpus: angular deformity 03 - valgus and toe out  predispose to abnormal joint stresses which can   →   the development of joint pathology.

Pathophysiology

  • The carpal joint is the articulation between the carpal bones and the metacarpal bones distally, and the radius and ulna proximally.
  • Three distinct joint spaces are recognized: the antebrachiocarpal, the midcarpal and the carpometacarpal joints; with intercarpal joints forming the articulations between the carpal bones in each layer.
  • The antebrachiocarpal and midcarpal joints are hinge joints with the vast majority of movement occurring here.
  • The carpometacarpal and intercarpal joints are arthrodial, allowing little opening movement.
  • See also Joint: synovial pathobiology   Joint: synovial pathobiology  .

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

Other sources of information

  • Ross M W (2003) The Carpus. In: Diagnosis & Management of Lameness in the Horse. Eds: Ross M W & Dyson S J. Saunders, USA. pp 376-393.

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