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Musculoskeletal dysfunction > Bone and joint pathology > Flashcards

Bone and joint pathology Flashcards

(55 cards)

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1
Q

What is the role of osteoclasts?

A

Bone resorption

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2
Q

What is the role of osteoblasts?

A

Synthesis and secretion of bone matrix

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3
Q

What does the classification of a fracture depend on?

A

Anatomical location

Extent of bone damage

Direction of fracture line

Number of fragments

Stability

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4
Q

Define diaphyseal

A

fracture of the midshaft

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5
Q

Define metaphyseal

A

Fracture within the metaphyseal region of the bone

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6
Q

Define epiphyseal

A

fractuce or the epiphyseal plate

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7
Q

Define condylar

A

fracture through one condyle

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8
Q

Define a complete fracture

A

Extends all the way through the bone

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9
Q

Define an incomplete fracture

A

Fracture does not extend full thickness

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10
Q

Define a greenstick fracture

A

Incomplete fracture in immature bone. Bone bends and fractures through the outside cortex

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11
Q

Describe a fissure fracture

A

Crack formation but periosteum remains intact

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12
Q

Define a transverse fractuce

A

Perpendicular to the long axis

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13
Q

Define an oblique fracture

A

Runs at an angle to the long axis

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14
Q

Define a spiral fracture

A

Spirals along the long axis

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15
Q

Define a comminuted fracture

A

Overlapping fracture lines - fragments

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16
Q

Define a stable fracture

A

not displaced and some weight bearing force can be applied

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17
Q

Define an unstable fractuce

A

Cannot withstand any force without displacing

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18
Q

Describe an avulsion fracture

A

Caused by intrinsic pull from muscle contraction

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19
Q

Describe primary bone healing

A

Occurs when there is anatomical reduction of fracture fragments

Minimal interfragmentary strain

Good blood supply

Fracture gap <1mm

e.g. fissures or surgically fixated fractures (plates)

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20
Q

Describe secondary bone healing

A

Most common

Fracture gap and/or interfragmentary strain

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21
Q

What happens within the interfragmentary gap (<1mm)

A

Granulation tissue and angiogenesis

Within days, lamellar bone deposited

Transverse to long axis

In approx. 3 weeks:

Haversian remodeling

New lamellar bone is orientated longitudinally

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22
Q

What are the three stages of secondary/indirect bone healing?

A

Inflammatory (2 - 3 weeks)

Repair (2 weeks – 12 months)

Regeneration (can be years!)

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23
Q

Describe the inflammatory stage

Study These Flashcards
A

Periosteum, soft tissue and blood vessels are torn.  haematoma

Acute inflammatory cells to migrate to the area (chemotaxis).

Phagocytosis of necrotic debris

Angiogenesis and mesenchymal stem cells migrate

Fibroblasts then create a ‘soft callus’ containing type III collagen.

24
Q

Describe the repair stage

Study These Flashcards
A

Mesenchymal cells  chondrocytes  cartilage

Endochondral ossification

Soft callus is mineralised to woven bone.

Immature bone

Irregularly arranged collagen fibres

First ‘hard’ or ‘primary’ callus

25
Describe the remodelling phase
Woven bone is remodelled to lamellar bone Haversian remodelling of cortical bone Callus reduces so that bone is back to normal shape/size Can take years!
26
What complications can occur?
Soft tissue trauma Introduction of infection Malunion Non-union Viable vs non-viable Implant failure
27
Describe osteitis
Osteo-’  relating to bone ‘-itis’  inflammation of Can be introduced by Penetrating injury Spread from surrounding tissues Extension of suppurative arthritis Haematogenous spread Bone loss via necrosis stimulates new bone growth Bacteria can reside in cavities / areas of necrosis  treatment difficult!
28
Describe panosteitis
‘Growing pains’ Young, growing large breed dogs German shepherd dogs Golden retriever Basset hound Dobermans Labrador retriever
29
What are the clinical signs of panosteitis?
Clinical signs present at around 5 – 18 months of age Long bone lameness of 2-5 weeks duration Shifts legs Recurs Eventually remodelled and excess bone removed
30
Describe metaphyseal osteopathy
hypertrophic osteodystrophy’ Young, growing giant breeds Great Dane Wolf hound Unknown aetiology ?Inappropriate supplementation vit/min ?live canine distemper vaccination
31
What are the clinical signs of metaphyseal osteopathy?
Clinical signs Lameness Fever / pyrexia Swollen, painful metaphyses of long bone Most animals respond spontaneously
32
Describe craniomandibular osteopathy
Non-neoplastic Developmental disease affecting growing terrier breeds Genetic link Resorption of bone leads to replacement with immature bone Targets bones of the skull
33
Describe the clinical signs of craniomandibular osteopathy?
Clinical signs 4-8 months of age Swollen mandible Difficultly in opening mouth Dysphagia (difficulty eating) Usually self-limiting at approx. 1 year of age Slow replacement with mature bone Pain relief and soft diet
34
Describe osteoporosis
Condition that leads to reduced bone mass Combination of factors Calcium deficiency Starvation Reduced activity Can be reversible in young animals – not adults!
35
Explain the process of osteoporosis
Cortical and trabecular bone is reduced in thickness Trabeculae are eventually lost Bone lacks density Prone to pathological fractures
36
Describe rickets and osteolamacia
Rickets – young animals Osteomalacia – mainly adult animals Vitamin D or phosphorous deficiency Dysfunction of mineralisation Accumulation of unmineralised bone
37
What are the clinical signs of rickets?
Disease of cartilage undergoing endochondral ossification at the growth plate Clinical signs Bone pain and swelling Stiff gait Lameness Bowed limbs Folding fractures
38
What are the clinical signs of osteomalacia?
Disease affecting the osteoid Clinical signs Failure to thrive Pathological fractures Deformities of spine (lordosis, kyphosis etc)
39
Describe fibrous osteodystrophy
Widespread resorption of bone Primary hyperparathyroidism – tumours of the parathyroid gland Secondary hyperparathyroidism – an increase in PTH which is renal or nutritional in origin
40
Describe nutritional secondary hyper-parathyroid hormone
Young animals Diet deficient in calcium / excessive in phosphorous  PTH secretion All meat diets in dogs/cats High bran/grain diet in horses Increase in osteoclast resorption and proliferation of fibrous tissue
41
Describe renal secondary hyper-parathyroid hormone
Chronic renal failure Inability to excrete phosphorous  hypocalcaemia  PTH secretion Reduction in the production of vitamin D Reduction in calcium absorption
42
What are the clinical signs of fibrous osteodystrophy?
Bone pain Deformity of mandibular / maxilla Due to loss of bone and replacement with fibrous tissue ‘Rubber jaw’
43
Describe neoplasia
Most common is osteosarcoma ‘Away from the elbow – towards the knee’ Present with: Lameness ++ pain Swelling +/- pathological fracture
44
Describe angular limb deformities (small animal)
Most common in the forelimbs – radius and ulna Immature animals: Osteotomy of the ulna Animals close to skeletal maturity: Corrective osteotomy of radius and ulna Realigns the joints Stabilisation – ECF +/- internal plate. +/- limb lengthening
45
Describe how the joint responds to injury
Inflammation leads to a loss of matrix components Altered pressure and permeability of joint Reduction of joint lubrication Disruption of collagen fibres of cartilage
46
Describe cartilage repair
Limited blood supply If just articular cartilage damaged: Chondrocytes do not fill defect ? Some cartilaginous flow when loaded If subchondral bone involved: Highly vascularised Fibrous tissue fills the defect  fibrocartilage
47
Describe pannus
‘Inflammatory granulation tissue’ Occurs in response to injury to synovial membrane Arises from insertion of membrane Spreads over articular cartilage Fibrovascular and histiocytic  lysis of cartilage
48
Describe arthritis
‘Arth’ – relating to the joint ‘-itis’ – inflammation of Inflammation of the articular structure Categorised based on Cause Duration Exudate
49
Describe degenerative joint disease
Osteoarthritis Destructive disease of articular cartilage Young or adult animals Due to: Abnormal loading e.g due to trauma Infection Immune mediated Developmental
50
Describe treatment of osteoarthritis
Medical Weight loss Controlled exercise Pain relief Surgical Joint replacement Arthrodesis
51
Describe bacterial arthritis
More common in farm animals and horses 1. Bacteraemia secondary to Navel ill Ingestion Inhalation 2. Puncture wounds Treatment is debridement and flushing of the joint + ABx
52
Describe rheumatoid arthritis
Chronic, erosive polyarthritis Immune mediated Antibodies produced due to unknown stimulus Immune complex ingested by neutrophils Produce enzymes that injury surface Treatment Pain relief Steroids +/- chemotherapy
53
Describe osteochondrosis
Focal/multifocal areas of failure of endochondral ossification Involves growth plate and articular / epiphyseal complex No exact cause known Nutrition Excessive growth Trauma
54
Describe the process of osteochondrosis
Delay in endochondral ossification Abnormal vascularisation and mineralisation Cartilage weakens Cracks/fissures/flaps form Flaps can fracture off
55
Describe treatment for osteochondrosis
Pain relief! Surgery always recommended Remove flap and joint mice Curette subchondral bone Stimulates fibrocartilage production

Musculoskeletal dysfunction (12 decks)

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