Investigation and Management of Wounds Associated with Synovial Cavities

Synovial contamination is characterised by acute synovitis, an influx of leukocytes, inflammatory proteins and inflammatory mediators. infection is established once bacte- ria have colonised the synovial membrane and started to reproduce. infection induces a catabolic synovial state, with generation of pannus and destruction of articular carti- lage, tendons and ligaments.

Assessment
Most horses with synovial infection are severely lame, although this may be less in the acute phase, or with open and draining wounds. other influencing factors include injury to associated structures (e.g. tendon laceration, fracture/fragmentation) and recent administration of nSaiDs.

Common clinical findings include heat, pain, distension and local venous engorgement. Wounds may be remote from a synovial cavity when the horse is weight bearing, but directly overlying with the leg flexed, such as is common at the time of a kick injury. Synovial fluid may be observed draining from the wound, and this will be viscous and form a string between your fingers.

Diagnostic imaging
Radiography should be performed routinely. features which may be identified include foreign material, fractures/fragmentation, osteitis/osteomyelitis and intrasynovial gas. ultrasonography often complements radiographic assessment, although wounds may limit diagnostic value due to associated gas preventing penetration of the ultrasound beam. ultrasound may identify foreign material, tendon or ligament pathology, intra- synovial gas and osteochondral defects. [...]