Developmental Orthopedic Diseases in the Dog

Question 1

____ is seen in young, large breed dogs (GSD, labs, basset hounds, dobies) usually 5-12 months old

Answer 1

Panosteitis

Question 2

Panosteitis CS—

Answer 2

Lameness, shifting leg lameness usually or bilateral stiff gait, usually intermittent
Pain on palpation of diaphysis of affected long bone

Question 3

Panosteitis is not showing up on rads, but patient has symptoms. As a vet, what is your next step for this patient?

Answer 3

Rad findings can lag behind CS, so be careful as a vet to recheck rads in 1-2 weeks if lameness persists and do rest and carprofen in the meantime

Question 4

Rad signs of panosteitis–

Answer 4

Increased density within medullary cavity (osteosclerotic foci) and blurring of the trabecular pattern, often near the nutrient foramen

Question 5

Tx of panosteitis-

Answer 5

self limiting which is good…. Use conservative tx and prognosis is good to excellent back to normal function. signs of shifting leg lameness might continue until the dog is fully matured at 2 yrs old

Question 6

___ is usually non painful condition resulting from failure of endochondral ossification leading to failure of cartilage matrix calcification and vascular ingrowth causing cartilage retention which causes thickening of the articular epiphyseal cartilage in the joint!!

Answer 6

Osteochondrosis

Question 7

Osteochondrosis predispositions and causes–

Answer 7

genetics, rapid growth, Ca supplements, hormonal influences, ischemia and trauma

Question 8

What are the most common anatomical sites to be affected with Osteochondrosis??? In what size dogs of what age?

Answer 8

super common in shoulder, stifle, elbow and tarsus of large breed dogs from ages 4-7 months

Question 9

Pathophysiology of osteochondrosis eventually causing OCD lesion—»>

Answer 9

Thickened articular-epiphyseal cartilage complex causes poor diffusion of nutrients from synovial fluid–>chondrocytes are abnormal–> separation between noncalcified and calcified layers (tidemark) bc of cartilage flap causing OCD lesion

Question 10

Clinical signs of osteochondrosis-

Answer 10

lameness, intermittent and worse with exercise, joint pain/effusions, muscle atrophy, development of osteoarthritis (OA)

Question 11

Diagnosis of osteochondrosis—»»

Answer 11

Rads, if not seen then do CT or MRI. Will have pain on extension of the jt on PE, can also do positive contrast solution where contrast which fills joint and leaks through the fissure

Question 12

usually Osteochondrosis only affects on leg. T/F

Answer 12

False!!! usually is bilateral

Question 13

When is it okay to do conservative medical tx for osteochondrosis?

Answer 13

no clinical pain or joint mouse (detached fragment next to OCD lesion) of dog is less than 7 months with a small lesion

Question 14

____ ____ cannot regrow

Answer 14

hyaline cartilage

Question 15

Healing of osteochondrosis occurs by production of _____

Answer 15

fibrocartilage/scarring

Question 16

Tx of osteochondrosis–>

Answer 16

Forage (drilling many holes with K wire), abrasion arthroplasty, curettage (just enough to get some bf, dont overdo)

Question 17

Osteochondritis dissecans- most common locations are…

Answer 17

Caudal stifle, medial elbow, medial tarsus, medial shoulder

Question 18

Osteochondritis dissecans tx-

Answer 18

arthroscopy and lavage

Question 19

Prognosis of Osteochondritis dissecans over the shoulder vs. in other joints

Answer 19

in shoulder =good to excellent

in other joints =guarded due to OA and intermittent lameness, need to have p on lifelong management of OA

Question 20

With Osteochondritis, what sized jts do better, smaller or larger?

Answer 20

Larger jts do better (like shoulder and hip)

Question 21

What is the post op rehab for osteochondritis dissecans

Answer 21

restrict activity for four weeks, joint motion with minimal loading and swimming

Question 22

Elbow dysplasia is related to ____ ____ genetically. Results in pain of elbow and _______ ___

Answer 22

Hip dysplasia; OA

Question 23

? causes secondary OA and its etiology is excessive loading of the coronoid process from abn devo or incongruency of the joint

Answer 23

Medial coronoid process fragmentation

Question 24

Medial coronoid process fragmentation dogs predisposed***:

Answer 24

IN LARGE BRREDS LIKE ROTTIES, LABS, GOLDENS, AND BERNESE MTN DOGS*** know

5-7 months old is first sign of lameness OR at 1-2 years of age when they show signs of OA

Question 25

A dog comes in with bilateral short choppy gait, it is a 7 months old lab without signs of OA, what diagnosis am I thinking?

Answer 25

Elbow dysplasia

Question 26

A dog comes in, he is a 2 year old rottie with bilateral stiff gait, elbows abducted with paw externally rotated at standing. He is showing slight signs of OA, what diagnosis am I thinking?

Answer 26

Elbow dysplasia

Question 27

Pain on _____ of elbow with elbow dysplasia

Answer 27

hyperextension

Question 28

We must diff .elbow pain from _____ pain

Answer 28

shoulder

Question 29

Rad findings of fragmented medial coronoid process-

Answer 29

blunted medial coronoid with very rarely seeing a fragment and sclerosis of subchondral bone of trochlear notch, periarticular osteophytes

Question 30

What are the benefits of sx for fragmented medial coronoid process?

Answer 30

excision of fragment via arthroscopy, will be able to see kissing lesion on humerus which is piece of broken off and it is scraping the cartilage, can also look for concurrent OCD which is be more lateral than the kissing lesion. ((((though these are all great things, studies show little different between sx and conservative life-long tx))))

Question 31

Prognosis for fragmented medial coronoid process is ___ to _____. Why? What are long-term complications?

Answer 31

Fair to guarded. OA is inevitable, will need life-long medications

Question 32

What is a developmental condition that is common in spaniels?

Answer 32

Incomplete Ossifications of humeral condyle (IOHC)

Question 33

A spaniel comes, bilateral lameness with thoracic limb lameness with acute fracture of humeral condyle. What is the diagnosis???

Answer 33

Incomplete Ossifications of humeral condyle (IOHC)

Question 34

Incomplete Ossifications of humeral condyle (IOHC) will have weak cartilage on the ___ side where the centers of ossification failed to complete at __-__ weeks old

Answer 34

left side; 8-12 weeks

Question 35

Tx of IOHC is _____ procedure which has variable outcome

Answer 35

OATS (osteochondral autograft transfer system)

Question 36

With _______ fracture, be sure to re-establish congruity of joint without any misaligning/steps/gaps

Answer 36

Intraarticular

Question 37

What occurs in fast-growing large breed dogs (usually males), 2-8 months old?

Answer 37

Hypertrophic osteodystrophy (HOD)

Question 38

Hypertrophic osteodystrophy (HOD) CS-

Answer 38

lameness/ reluctance to move, warm painful swelling of metaphysis, anorexic, fever!!!!, sick, depression, lethargic with swelling around joints

Question 39

What will rads show with HOD?????

Answer 39

Double physeal line and sclerosis***

Question 40

Tx of HOD and prognosis-

Answer 40

Supportive care, prognosis is good, most recover in 1-2 weeks, self limiting

Question 41

What are some sequalae of HOD???

Answer 41

growth disturbances, systemic illness are rare but include cardio issues and pulmonary changes. Usually not fatal but can be without treatment in severe forms

Question 42

Blank

Answer 42

///

Question 43

What is a common disease where there is aseptic necrosis of femoral head and neck which then leads to remodeling of the femoral epiphysis?

Answer 43

Legg-Calve-Perthes Disease

Question 44

Legg-Calve-Perthes Disease CS-

Answer 44

Lameness, small and mini breeds 4-11 months old, hip pain and lameness, progressive, crepitus, muscle atrophy, 15-18% of cases are bilateral

Question 45

Rads showing Legg-Calve-Perthes Disease –

Answer 45

flattening and irregular femoral head and moth-eaten look, occasional femoral neck fractures

Question 46

T/F, conservative therapy is best for Legg-Calve-Perthes Disease.

Answer 46

False!!! Surgery is needed (FHO), prognosis will be good to excellent. Conservative tx does not usually work for this disease

Question 47

Retained cartilage core aka ____ lesion causes are unknown. Presents itself mostly in what breeds?

Answer 47

Candlestick lesions; common in Danes, Irish Wolfhounds, Afghan hounds (not a very common condition)

Question 48

Retained cartilage core are usually incidental findings. What do they look like on rads???

Answer 48

Cone shaped area of unmineralized, hypertrophic cartilage

Question 49

where are candle stick lesions aka retained cartilage core usually found?

Answer 49

Most common site is distal ulnar physis

Question 50

Tx for candle stick lesions aka retained cartilage core:

What is the prognosis??

Answer 50

Medical management if lameness present, surgery ONLY IF angular deformity occurs- corrective osteotomy
Prognosis is fair to good, most resolve uneventfully
Growth deformity of the limb can happen but is RARE

Question 51

Craniomandibular osteopathy–

Answer 51

Non-neoplastic, non-inflammatory bone proliferation
Bones of skull involved, may result in ankylosis of the temporomandibular joint so patient cannot open jaw
**In Westies (not a common disease)

Question 52

Clinical signs of Craniomandibular osteopathy, and when do they normal present themselves in the dog’s (Westie’s) life??

Answer 52

swelling and pain around mandible, inability to eat normally, drooling, weight loss, might have fever; usually occurs at 4-10 months of age

Question 53

Rads showing Craniomandibular osteopathy

Answer 53

proliferative new bone formation in the mandible, temporal bones, occipital bones, and/or bulla. New bone will be spikey “spiculated”

Question 54

What is the tx and prognosis for Craniomandibular osteopathy??

Answer 54

Tx is nonspecific, use pain meds and hand feed or tube feed

Prognosis- self-limiting, usually stops at maturity, deposited bone will often regress over time, fair to good prognosis with mild lesions, but guarded prognosis with extensive lesions where patient cannot eat or gets aspiration pneumonia because cannot properly eat food