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CVSOH BVSc4 > Lame - Joint pathology > Flashcards

Lame - Joint pathology Flashcards

1
Q

What are 3 types of joints in the body?

A

Fibrous joints
Cartilaginous joints
Synovial joints

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2
Q

What are the three main components of synovial joints?

A

Joint cartilage
Joint capsule
Subchondral bone

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3
Q

What does cartilage outside of synovial joints rely on for providing nutrients and new chondrocytes?

A

Perichondrium

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4
Q

What is different about joint cartilage in synovial joints to normal cartilage?

A

It has no perichondrium so relies on alternating compression ad release of normal weight bearing to help the diffusion of fluid with nutrients and waste products into and out of the cartilage

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5
Q

What can cause cartilage atrophy?

A

Constant static weight bearing
Lack of weight bearing

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6
Q

What affects joint cartilage healing?

A

Lack of blood supply

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7
Q

Where can inflammation in the synovial joint arise from?

A

The synovium or the subchondral bone
Subarticular growth cartilage of the epiphysis in young animals
Not the joint cartilage - lack of vasculature means no inflammatory response

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8
Q

Where can pain originate from in the synovial joint?

A

Synovium and subchondral bone
Similar to inflammation - no nerves in joint cartilage so no pain

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8
Q

What creates the cartilage matrix?

A

Chondroblasts

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9
Q

What is the cartilage matrix made up of?

A

Collagen
Elastin fibres
Hyaluronic acid
Proteoglycans

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10
Q

What gives cartilage its stiffness?

A

Bonds between collagen and elastin and glycosaminoglycans

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11
Q

What gives cartilage its shock absorbing ability?

A

The water molecules in the matrix - if water retention is affected then cartilage integrity is affected

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12
Q

How can cartilage be damaged?

A

Chondrocyte damage
Enzymes produced by inflammatory cells penetrating the matrix and degrading the collagen and proteoglycans

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13
Q

What happens to the appearance of cartilage when its matrix is compromised?

A

Dehydrates, shrivels, turns dull yellow/brown
Eventually erodes away and exposes the subchondral bone

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14
Q

What is ankylosis?

A

Fusion of joint surfaces

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15
Q

What makes up the surface of the joint capsule?

A

Villi

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16
Q

What are the villi in the joint capsule covered by?

A

The synovial lining

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17
Q

What is the synovial lining made up of? What function do they have?

A

Synovial A cells - clear debris from synovial fluid
Synovial B cells - Produce components that make synovial fluid viscous and lubricating

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18
Q

What are the three synovial responses to injury?

A

Villous hypertrophy and hyperplasia
Synovial cell hypertrophy and hyperplasia
Pannus formation

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19
Q

Which synovial responses to injury are accompanied by inflammation (synovitis)?

A

Villous hypertrophy and hyperplasia
Synovial cell hypertrophy and hyperplasia

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20
Q

What are the consequences of synovitis?

A

Impaired joint fluid drainage
Compromised fluid lubricating properties - B cells secrete other substances instead when there is inflammation

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21
Q

What cells release inflammatory mediators into the synovial fluid?

A

Mononuclear cells
Synovial A cells

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22
Q

What diseases is pannus formation in the synovial joint associated with?

A

Infectious fibrinous synovitis
Some immune-mediated diseases

23
Q

What is a pannus?

A

A fibrovascular tissue that arises from the synovial membrane and spreads like a blanket over the joint cartilage, damaging it

24
Q

What type of cell infiltrates the synovial joint during pannus formation?

A

Macrophages - inside the fibrovascular tissue, destroy the joint cartilage

25
Q

What can pannus formation cause in the synovial joint?

A

The fibrous tissue of the pannus becomes a bridge between joint surfaces, creating an ankylosis, a fixed fusion of the joint

26
Q

What is eburnation?

A

Exposure of subchondral bone due to loss of joint cartilage
The subchondral bone is unprotected causing it to increase in density
If the cartilage ulcerates, the subchondral bones can rub against each other making them smooth and shiny

27
Q

What are osteophytes?

A

Bone spurs that project from the periosteum and persist once formed

28
Q

Where are osteophytes found?

A

Sometimes just in the joint cavity
Sometimes protrude from the periosteal surface of the bone

29
Q

What causes osteophyte formation?

A

Joint injury
Mechanical instability within the joint
Inflammatory mediator release within the joint from cell death

30
Q

What is the most common joint disease in animals?

A

Degenerative joint disease (DJD)
(Also known as osteoarthritis)

31
Q

What is degenerative joint disease?

A

Non infectious disease
Structural and functional failure of joint homeostasis resulting in damage to the joint cartilage

32
Q

What are the risk factors for degenerative joint disease?

A

Genetics
Conformation
Joint angles
Pelvic muscle mass
Diet/exercise/weight
Age

33
Q

What are some triggers of degenerative joint disease?

A

Accumulated repetitive micro‐damage
A major traumatic event
Secondary to metabolic and biochemical factors

34
Q

What are the consequences of degenerative joint disease?

A

The inflammation and lesions cause cartilage damage, increased friction and grinding between adjacent subchondral bones
Joint mobility is compromised

35
Q

What is the most important predisposing factor for degenerative joint disease?

A

Osteochondrosis dissicans

36
Q

What is osteochondrosis dissicans?

A

Focal failure of blood supply to growing cartilage so failure of endochondral ossification of the normal growth plate in young animals
Then normal stresses or injury cause cracks and fissures in the cartilage

37
Q

Where does endochondral ossification occur?

A

Occurs at the highly vascularized physeal growth plate and the articular-epiphyseal growth cartilage

38
Q

What is the aetiology of osteochondrosis dissicans?

A

Multifactorial
Genetics
Rapid growth rate
Vascular factors
Trauma

39
Q

What happens to the growth plate during osteochondrosis?

A

Cartilage is quickly replaced by bone - endochondral ossification
The blood vessels feeding the cartilage cant penetrate so ischaemia and necrosis of cartilage occurs
Dead growth plate cartilage is weak and causes subchondral bone above it to fracture up to the joint cartilage
Synovitis occurs

40
Q

What does osteochondrosis often result in formation of in horses?

A

Developmental bone cysts - subchondral bone cysts within the epiphyseal trabecular bone

41
Q

What are ‘true cysts’ that result from osteochondrosis?

A

Develop after the vascular failure during osteochondrosis
Microfractures cause bone to cave in and joint cartilage to fold and break
Joint fluid enters the cyst

42
Q

What is a ‘pseudocyst’ that results from osteochondrosis?

A

When an area of dead necrotic cartilage becomes surrounded by the ossification front, making the necrotic area appear as a radiolucent, ‘empty’ cavity on radiographs

43
Q

What causes hip dysplasia?

A

Is a genetic inherited condition in large/giant breeds

44
Q

What is hip dysplasia?

A

Lack of conformity of the femoral head and acetabulum causing instability and chronic subluxation of the hip joint
Causes severe secondary DJD

45
Q

What are the different routes of infection of joints?

A

Haematogenous spread - in blood
Spread from osteomyelitis
Spread from soft tissue
Diagnostic or therapeutic procedures
Penetrating damage

46
Q

What is the name for inflammation of a joint?

A

Arthritis

47
Q

What will acute inflammation of the synovial joint cause changes to?

A

Only the synovial fluid

48
Q

What changes occur to the synovial joint in acute suppurative and fibrinous arthritis?

A

Fluid becomes watery and may be cloudy if neutrophils or fibrin are present
May be red if there is haemorrhage

49
Q

What changes occur to the synovial joint in subacute suppurative or fibrinous arthritis?

A

Thinned cartilage
Exudates may be present
Synovial membrane may be infiltrated by lymphocytes and plasma cells
Hyperplasia of the synovial lining cells - to increase fluid production

50
Q

What changes occur to the synovial joint in chronic suppurative arthritis?

A

Extensive cartilage erosion and ulceration
Exudates reach subchondral bone
Granulation tissue replaces synovial membrane
Lymphoplasmacytic inflammation
Joint capsule thickened and fibrotic
Joint fusion

51
Q

What changes occur to the synovial joint in chronic fibrinous arthritis?

A

Cartilage may ulcerate - especially if there is pannus formation
Cartilage replaced with fibrous tissue, fusing joint

52
Q

What pathogens more commonly cause fibrinous arthritis?

A

Gram negative bacteria
eg. E. coli, mycoplasma

53
Q

What pathogens more commonly cause suppurative arthritis?

A

Gram positive bacteria
eg. staph, strep

54
Q

What animals are bacterial arthritis common in?

A

Calves, lambs, foals, piglets
Secondary to neonatal bacteraemia
Not common in dogs and cats

55
Q

What are the clinical signs of bacterial arthritis?

A

Lameness
Swelling of synovial joints - fill of serofibrinous to suppurative exudate

CVSOH BVSc4 (86 decks)

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