Subsolar Abscess and Penetrating Wound to the Foot

Subsolar Abscess and Penetrating Wound to the Foot


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Basic Information image



Definition


Infection of the subsolar tissues of the foot, primarily including abscessation but also may include penetrating foreign body, septic synovitis of the navicular bursa, distal digital sheath, or tendons and ligaments.



Synonym(s)


Sole abscess, gravel, nail, street nail



Epidemiology



Risk Factors




• Moist ground conditions that soften the hoof and sole


• Presence of detritus in the stall or pasture that could penetrate the sole (such as nails)



Clinical Presentation



Disease Forms/Subtypes


Slowly progressive sole abscess, acute injury to deeper structures after foreign body penetration that results in acute lameness that subsequently results in deep infection, septic synovitis, tenosynovitis, or osteomyelitis



History, Chief Complaint


Acute lameness that becomes more pronounced over several days. Often starts as a mild lameness (grade 2 of 5) that progresses to non–weight-bearing lameness.



Physical Exam Findings


The horse often points with the affected foot, and that distal limb usually has a pronounced digital pulse. Application of hoof testers to the affected sole usually results in a very painful response directly over the abscess site. Examination of the sole may reveal a tract, site of foreign body penetration, actual foreign body in place, a soft and painful area overlying the abscess, or combination of the above.



Etiology and Pathophysiology




• Softening of hoof, exposure to foreign body penetration, penetration of the sensitive laminae with a high nail at shoeing, poor quality hoof lamellae and white line


• Chronic hoof or sole abscessation frequently occurs with chronic laminitis.



Diagnosis image



Differential Diagnosis




• Sole abscess


• Deep sole bruise


• Laminitis


• Septic arthritis, septic tenosynovitis


• Fracture of the distal phalanges or navicular bone



Initial Database




• Lameness evaluation, especially palpation of digital pulses and hoof tester application.


• Radiographs are warranted if a foreign body is in place or to rule out fracture and osteomyelitis.

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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on Subsolar Abscess and Penetrating Wound to the Foot

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