Canine Juvenile Bone Disease

Question 1

Congenital issues

Answer 1

Apparent at or soon after birth
Uncommon
Ex - radial agenesis

Question 2

Developmental issues

Answer 2

Apparent during growth
Common
Elbow or hip dysplasia, OCD

Question 3

Idiopathic issues

Answer 3

During growth
Fast growing large breeds
Uncommon-common
Panosteitis, HOD

Question 4

Infectious issues

Answer 4

Any age
Uncommon
Septic arthritis, osteomyelitis

Question 5

Traumatic issues

Answer 5

Any age
Common
Fractures

Question 6

Nutritional/metabolic issues

Answer 6

Any age, susceptible during growth
Uncommon w commercial diets
2nd hyperPT, hypovitaminosis D

Question 7

Neoplastic issues

Answer 7

Any age
Cancer can peak under 1 year and then in old age
Osteosarcoma

Question 8

OCD

Answer 8

Osteochondritis dissecans, Failure of endochondral ossification
Osteochondrosis: thickening of cartilage
Non-clinical in SA
Osteochondritis dissecans: clinical form of disease, flap formation

Question 9

Normal progress of epiphysis

Answer 9

Outlayer becomes articular cartilage
Inner later becomes the epiphyseal ossification center
- undergoes endochondral ossification
- responsible for epiphyseal enlargement
- proliferation of chondrocytes near periphery = growth
- conversion of cartilage to bone in center = calcification

Question 10

Progress of OCD

Answer 10

Failure of ossification =
Cartilage thickens (drosis), loss of deep chondrocytes forms a cleft, causes a flap, flap can fall off = Dritis dissecans
Can lead to exposure of subchondral bone = jt inflame, DJD

Question 11

Common locations for OCD

Answer 11

Shoulder - caudal humeral head
Elbow - medial portion of condyle
Stifle - lateral > medial condyle
Tarsus - medial > lateral trochlear ridge

Question 12

Risk factors for OCD

Answer 12

Fast growing dogs
4-8 months
Male>female
10-45% heritable, large/giant breeds
Nutrient excess, micro trauma

Question 13

Presentation of OCD

Answer 13

4-8m old or later
Gradual onset, v rest, ^ exercise
Unilateral or bilateral
Joint effusion & pain on manipulation

Question 14

Diagnosing OCD

Answer 14

Radiographs
- distraction of subchondral bone
- flattening or convacity of normal contour
- sclerosis in margins
Contract arthrogram, ultrasound, CT, MRI

Question 15

Conservative management of OCD

Answer 15

NSAIDS, exercise v, diet changes, weight control

Question 16

Surgery treatment for OCD

Answer 16

Best options
Flap removal: open or arthroscopic
Debride all poorly attached cartilage, edges 90*, debride to bleeding subchondral bone

Question 17

Osteochondral grafts & synthetic cartilage for OCD

Answer 17

Grafts : OATS system, transfer cartilage from a non articular area
Synthetic : synACART, synthetic cartilage plug, no donor site morbidity

Question 18

Prognosis for joints w OCD

Answer 18

Shoulder - good/excellent
Elbow - guarded/fair
Stifle - guarded/fair
Tarsus - guarded
Will ultimately develop arthritis

Question 19

HOD

Answer 19

Hypertrophic osteodystrophy
Metaphyseal pain, swelling, hyperthermia

Question 20

signalment for HOD

Answer 20

Males>females
2-6 months
Rapidly growing, large/giant breeds (retrievers, GS, Weimaraner, Irish setters, boxers)

Question 21

Causes for HOD

Answer 21

Unknown
Could be heritable
Infection, nutritional, k9 distemper

Question 22

Effected bones & histo findings for HOD

Answer 22

Radius, ulna, tibia > all other bones
Disrupted metaphyseal trabeculae
- hemorrhage, hemosinderin deposits, necrosis, inflame, fibrosis adjacent & parallel to physis)
Irregular physis, subperiosteal hemorrhange/reactive bone

Question 23

Presentation of HOD

Answer 23

Swelling of metaphyseal regions of long bone
Variable degrees of pain, lameness, inflammation
Also systemic illness
- hyperthermia, hyporexia, anorexia, depression, diarrhea

Question 24

Diagnosing HOD

Answer 24

Radiographs
- lucent line at metaphyseal “double physis” appearance
Periosteal /endosteal prolif, widening of physis
Blood culture - immunocompromised

Question 25

HOP vs HOD

Answer 25

HOD - swelling near metaphyseal, lesion near physis HOP - diffuse periosteal prolif condition secondary to distant neoplastic or infectious masses

Question 26

Treatments for HOD

Answer 26

Pain meds, diet Systemic support - IV meds/fluids, nutrition, antibiotics

Question 27

Prognosis for HOD

Answer 27

Selflimiting, 7-10 days Mild = good prognosis Severe + systemic = guarded Recurrent, could lead to angular limb deformity - bridging physis, slowing physis growth on one side but bone grows on the other /hypertrophy

Question 28

Panoestitis

Answer 28

Self limiting inflammation disease of bone marrow in long bones

Question 29

Signalment of panosteitis

Answer 29

Large/giant breeds 5-18 months Males>females, 4:1 ratio

Question 30

Presentation of panosteitis

Answer 30

Acute onset, no trauma, shifting leg lameness, variable degrees of lameness, systemic illness is uncommon, painful on bone palpation

Question 31

Commonly affected bones - panosteitis

Answer 31

Ulna, radius, humerus, femur, tibia Forelimbs > hind limbs

Question 32

Histology for panosteitis

Answer 32

Early stages - empty space near adipose BM, vascular prolif, local bone formulation around nutrient foramen - vascular congestion & ^ interosseous pressure - ^ local bone, 2* periosteal reaction, enlarged haversian system - remodeling over time

Question 33

Diagnosing panosteitis

Answer 33

Early stages - difficult to observe Hall mark = intramedullary increase in radio density - loss of Normal trabecular pattern - changes in endosteum

Question 34

Treating panosteitis

Answer 34

Can spontaneously resolve Exercise restriction, analgesics, diet

Question 35

Prognosis of panosteitis

Answer 35

Mild = good Can reoccur

Question 36

PCLS

Answer 36

Puppy carpal laxity syndrome

Question 37

PCLS features

Answer 37

Young puppies, 6-16 weeks Hyperextension > 190 Hypoextension < 180 Genetics, environment, stress

Question 38

Conservative treatment for PCLS

Answer 38

Excellent prog! Exercise restriction, splinting (2 wks), adult diet (helps soft tissue form properly)

Question 39

Surgical treatment for PCLS

Answer 39

Rare, common in older dogs who were untreated as puppies & require tenotomy or Arthrodesis