Approach to Joint Dysplasia

Question 1

What is hip dysplasia?

Answer 1

Developmental disease of the coxofemoral joint

Question 2

What does hipdysplasia cause

Answer 2

laxity and inadequate coverage of the femoral head by the acetabulum

Question 3

What is the etiopathology of hip dysplasia?

Answer 3

Cause is unknown
it is a genetic disease with a complex inheritance pattern

Question 4

How do young dogs present with hip dysplasia?

Answer 4

Exercise intolerance, reluctancy to climb stairs and jump, muscular atrophy, bunny hopping, short gait, narrow stance

Question 5

How do old dogs present with hip dysplasia?

Answer 5

Degenerative joint disease so decreased activity level, change in behaviour associated with pain
shoulder muscle hypertrophy because of cranial weight shift

Question 6

What is the purpose of the ortolani test?

Answer 6

To examine the hip for laxity with the animal positioned in lateral recumbancy
rarely positive in mature dogs due to shallowness of the acetabulum and fibrosis of the joint capsule

Question 7

How do you assess joint laxity?

Answer 7

Measure the norberg angle (over 105 degrees is normal)

Question 8

What are the signs of bone remodelling?

Answer 8

Blunting of the acetabular rim, flattening of the femoral head, subluxation, thickening of the
femoral head, deposition of osteophytes which usually starts at the attachment of the joint
capsule (Morgan’s line)

Question 9

What is the definition of elbow dysplasia?

Answer 9

Group of developmental diseases with a genetic and
environmental component that overtime leads to
degenerative joint disease (DJD)

Question 10

What is medial coronoid process disease?

Answer 10

Cartilage erosions affecting the medial aspect of the canine elbow.
Ethiology: unknown. Might be correlated with mechanical overload and/or incongruity of the
elbow joint

Question 10

How does MCPD present?

Answer 10

Lameness unilateral or bilateral
Abnormal gait (stiff or stilted with
shortened steps)
Young dogs
Worse after exercise or immediately
after rest
large breeds» small/medium breeds

Question 11

What would you do on the clinical exam for MCPD?

Answer 11

Pain on full elbow extension.
Pain on flexion/extension of the elbow
and lateral rotation of the foot
Effusion, thickened joint(s).
< ROM
Crepitus

Question 12

What is osteochondritis dissecans of the medial humeral condyle?

Answer 12

Osteochondritis dissecans is a joint condition in which bone underneath the cartilage dies due to lack of blood flow. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion.

Question 13

How does osteochondritis dissecans of the medial humeral condyle present?

Answer 13

Forelimb lameness or stiffness and
stilted gait
Worse after exercise or immediately
after resting
Young dogs 5-8 months of age
Breeds: retrievers, Bernese mountain
dogs, Rottweilers, large/giant breeds.

Question 14

What do you notice on the clinical exam for osteochondritis dissecans of the medial humeral condyle

Answer 14

Joint swelling
Varus of the elbow and valgus of the
carpi
Pain on deep palpation over the
medial collateral ligament
In older patients: crepitus and < ROM

Question 15

What is ununited anoceal process?

Answer 15

Failure of the ossification centre of the anconaeus to fuse with the olecranon by 5
months of age
Ethiology: unknown possibly related to radioulnar incongruity

Question 16

How does UAP present?

Answer 16

Lameness intermittent and subtle or sever
and continuous
Young dogs 5-8 months of age- to diagnose
UAP the patient must be at least 20 weeks
old.
Breeds: GSD++, Saint Bernard, Basset
Hound
M> F

Question 17

What do you notice on a UAP Clinical examination?

Answer 17

Lameness with elbow in abducted position.
Varying degree of external rotation of the
manus
Elbow effusion
Pain on palpation especially extension

Question 18

What is radial-Ulnar Inconguency?

Answer 18

Anatomical malalignment of the articular surfaces which leads to inequal distribution of forces within the
elbow joint
Ethiology: congenital factors, trauma. Chondrodystrophic breeds are susceptible to asynchronous growth
between radius and ulna

Question 19

How does radial ulnar inconguency present?

Answer 19

Young dogs 5-7 months of age.
Large breeds/Chondrodystrophic breeds.
Forelimb lameness worse after exercise or a
period of rest.

Question 20

What would you notice on the clinical exam for radial-ulnar inconguency?

Answer 20

Lameness
Stiff gait
Muscular atrophy
Joint effusion
Pain on elbow extension
< ROM
Crepitus

Question 21

What is incomplete ossification of the humeral condyle?

Answer 21

Failure of the bony union between the medial and lateral portion of the humeral condyle

Question 22

How does incomplete ossification of the humeral condyle present?

Answer 22

Breed: spaniels++
Age varies from young to middle age
M>F
Weight bearing lameness worse after
exercise. Monolateral or bilateral
IOCH can lead to condylar fracture