Interactive Case Tutorial

 Review the history and signalment for the client  Evaluate the radiographs provided  Explore the interactive images and compare the answers given with your own interpretations. When you’ve clicked on the image, click the same spot again to make the label disappear.  Answer the questions regarding a diagnosis and recommendations  Review the radiologist’s findings

 Signalment: 10 month old Thoroughbred colt  History: laying down more, lame in the thoracic limbs, mildly painful in carpi  Study: lateral and DP views of bilateral carpus

Normal fat pad Normal carpal bones Normal chestnut Extracapsular soft tissue swelling Solid periosteal reaction and lipping at metaphysis Widened and irregular medial physis

Normal fat pad Normal carpal bones Normal chestnut Extracapsular soft tissue swelling Solid periosteal reaction and lipping at metaphysis Widened and irregular medial physis

 Provide a diagnosis based on your findings. Submit Significant epiphysitis/physeal dysplasia affecting the distal radial physis bilaterally Feedback Continue

 Provide your recommendation for this client. Submit Medical management with phenylbutazone Complete stall rest for 4 weeks Grass hay only with normal vitamin/mineral supplement for 4 weeks Feedback Continue

 The distal radial metaphysis and epiphysis are broadened at the medial aspect with smooth periosteal reaction  The distal radial physis is widened at the medial aspect with sclerosis  Mild extracapsular swelling is centered at the distal radial physis medially  There may be mild carpal valgus (little metacarpus is included so difficult to determine)  All findings are bilateral

 Clinical signs improved over the next 4 weeks  For the next 6-8 weeks can hand walk for 5 minutes twice daily after which hand walking can be increased 5 minutes every 2 weeks