Bovis ISSN 2398-2993

Tarsal bursitis and cellulitis

Synonym(s): hock lesions

Contributor(s): Sophie Mahendran , Paul Wood

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Introduction

  • Cause: peritarsal bursitis is a chronic cellulitis involving the lateral aspect of the tarsal/hock joints.
  • Signs: visible swelling over the tarsal joint/hock, with or without hair loss or skin abrasions.
  • Diagnosis: diagnosis of exclusion through clinical examination. Ultrasonography may be used.
  • Treatment: if an uncomplicated bursitis, no treatment is necessary. Herd level management changes required.
  • Prognosis: good in uncomplicated cases, especially if management changes are made to reduce continued trauma to the site.

Pathogenesis

Etiology

  • Tarsal bursitis is a chronic cellulitis involving the lateral aspect of the hock joints.
  • It is usually bilateral
  • Presence of tarsal bursitis can be an i.ndicator that cow welfare and comfort needs to be improved on farm.
    • The condition is associated with discomfort.
    • It occurs as a result of repeated physical conflicts between the animals and their housing environment:
      • Collisions of the cows with cubicle fittings due to inadequate cubicle design and dimensions.
      • It is particularly associated with the quality of the lying area in terms of softness and friction.
      • It occurs as a result of repeated abrasion on rough or hard surfaces.
  • Also linked to cows that are already lame, who may have increased difficulty in standing up and lying down, so increasing the risk of contusions to the hock area.

Predisposing factors

General

  • Housing management with poor cow comfort.
    • Low comfort cubicles.
    • Absence of deep bedding in cubicles.
      • Insufficient blood circulation due to reduced softness and elasticity of the lying surface.
  • Disinfection and desiccation agents (eg lime powder- and formaldehyde-based compounds) are associated with greater odds of hair loss and swelling.
    • Due to the irritating nature of these products, which can cause chemical burns when moisture is present.
  • Generally lower in organic herd compared to conventional systems.
    • Organic herds tend to spend longer grazing, have more space and more use of loose straw housing.

Specific

  • Larger cows tend to have more hock lesions.
  • Dirtier hocks are associated with fewer hock lesions.
  • Potential protective effect of dirt (extra elastic layer) or simply that ulcerations are harder to notice on dirty hocks.
    • However, dirty hocks may predispose to abscess formation, within increased pathogen entry though any abrasions that occur on the hock.

Pathophysiology

  • Caused by prolonged high local pressure on hard surfaces or edges or by abrasive lying surfaces.
  • There may be impeded blood circulation in areas of the limb and body exposed to prolonged high pressure due to high body weight and non-elastic lying surface.
  • There are animal-related risk factors such as body condition, with a reduced risk of lesions with increasing body condition score.
    • In high BCS cows possibly due to more fat coverage over the bony tarsal area -> more protection
    • In low BCS cow possibly related to thinning of the digital cushion in the foot, leading to increased lameness risk and therefore more time spent lying down.
  • The presence of lesions may lead to disorders of gait due to mechanical restriction of joint flexion, infection at the site of the lesion, or pain associated with the lesion.
  • Tarsal bursitis predisposes to arthritis, which can progress to have severe inflammation with excessive fluid in the tarsocrural joint.
    • The skin on the joint is swollen and warm, potentially progressing to synovial effusion.
    • A reduction in the use of the joint can be noted, although the degree of lameness varies greatly according to severity and accompanying swelling and pain.
  • If the lesion becomes infected, it can lead to abscessation or septic arthritis.
    • The animal may become severely lame with a discharging tract over the lateral aspect of the joint.

Timecourse

  • Caused by chronic repeated injury and impacts to the tarsal area.

Epidemiology

  • Reported prevalence of hock lesions is as high as 50-71% of cows in cubicle housing systems.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers


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