27.6.2: Subchondral bone lucencies Flashcards
Clinical signs of subchondral cyst-like lesions (SCL)
- Lameness - more so than we would get with standard OCD. If SCLs are part of JOCC, may not be lame, but if part of osteoarthritis, will definitely be lame.
- Joint effusion
- Positive response to flexion
True/false: bone cysts occur in osteochondrosis only.
False
We see subchondral cyst-like lesions (SCLs) as part of osteochondrosis, but we also see cysts as a manifestation of OA.
Describe the lesions shown here
Subchondral cyst-like lesion in communication with the proximal interphalangeal joint
Subchondral cyst-like lesion in P1
Describe the lesion(s) shown here
- Large amount of remodelling on distal aspect of P1
- Complete joint collapse on medial aspect of pastern and coffin joints
- Radiolucent possible cyst on proximal P2
- There is a SCL + OA
Aetiology of SCLs
Most common sites of subchondral bone lucencies
Diagnostic approach to osteochondrosis and osteochondral fragments
Treatment options for subchondral bone lucencies
- Intralesional injection with corticosteroids
- Mesenchymal stem cells within the joint
- Arthroscopic debridement
- Transcondylar bone screw (standard cortical screw)
- Transcondylar bone screw (absorbable screw)
Treatment of SCLs: intra-lesional corticosteroids
Treatment of SCLs: mesenchymal stem cells within the joint
Treatment of SCLs: arthroscopic debridement
Has fallen out of favour recently. Better for joints with a meniscus.
Treatment of SCLs: transcondylar bone screw - standard cortical screw
- Recent studies showed screw helps new bone formation
- Done under GA
Treatment of SCLs: transcondylar bone screw - absorbable screw
Success rates for intracondylar screws used to treat SCLs
