Ortho 1 Flashcards
(40 cards)
what is panosteitis?
a self limting disease of the long large bones of large and giant breed dogs (usually young animals/juveniles).
most commonly affects the ulna, then the radius, humerus, femur, and tibia
what causes panosteitis?
exact cause is unknown; could be a result of high protein and calcium in the feed. dogs that weigh more are at an increased risk
how do you diagnose panosteitis?
signalment, history, PE, and radiographs. no systemic signs of illness are present
on rads: patchy opacities (thumb marks)
you see a 5mo bernese mountain dog with a painful right left forelimb. on radiographs you see circumscribed cortical bone opacities in the medullar of the ulna. how will you treat this dog?
exercise restriction, NSAIDs, or if severe pain, hospitalization and opioids. prognosis is good to excellent.
what are the major risk factors for OA?
age: as chondrocytes age they produce lower quality matrix and they are less able to respond to the environment and are not able to repair themselves as well
obesity: increased load on the joints
spaying/neutering: increased risk of many ortho diseases
briefly describe the pathogenesis of OA
there are changes in ALL tissues of the synovial joint: the articular cartilage, subchondral bone, osteophyte and entheophyte formation, synovial inflammation, and fibrosis
difference between osteophyte and enthesophyte
osteophyte: outgrowth of bone at the margin of an articular surface
enthesophyte: a bone spur forming at ligament or tendon insertion into bone, growing in natural direction of pull of ligament/tendon
OA is usually secondary to…
some other joint abnormality like instability, laxity, fracture, etc.
clinical signs of OA in dogs and cats
dogs: reluctance to exercise, exercise intolerance, stiffness, lameness, inability to jump, behavioral changes, abnormal gait, muscle atrophy, joint swelling, joint effusion, crepitation, gradually worsening
cats: more hidden, reduction in activity, reluctance to jump, unkept appearance, not being able to jump as high
what do you expect to see on rads with OA?
osteophytosis, enthesophytes, effusion, soft tissue swelling, subchondral sclerosis, intra-articular mineralization, subchondral cysts
______ is the most valuble and cost effective means to assess joints
arthroscopy
if there is any doubt about underlying disease process of the joints, you should
do arthrocentesis and evaluation
best way to manage OA? (non surgical)
weight management
exercise modification
NSAIDs
solensia for cats
omega 3s
what surgical treatment options are there for OA?
joint debridement and micropick, joint replacement, joint excision (femoral head osteotomy), arthrodesis (fusing joints), amputation
osteochondrosis is a disorder of the process of ________
endochondral ossification
describe the difference between these terms:
osteochondrosis latens
osteochondrosis manifesta
osteochondrosis dissecans
latens: an early microscopic lesion
manifesta: subclinical lesions on rads but clinically present
dissecans: cartilage flaps present, clinical signs present
where does the dog tend to get osteochondrosis?
the humeral head, medial humeral condyle, on the femoral condyles, trochlear ridges of the talus
what causes osteochondrosis?
usually inherited as polygenetic trait
joint morphology/conformation plays a part as well
rapid growth (large/giant breeds)
describe the pathogenesis of osteochondrosis?
not fully understood, suspect an avascular necrosis of developing epiphyseal cartilage (damage to vessels)
could also be a defect in the subchondral bone
a 6mo lab comes to you with lameness and exercise intolerance, mainly in the front legs. on PE, you find some joint effusion in the shoulder joints and the dog seems painful. differential? next steps for diagnosis?
osteochondrosis
i would do rads to look for: flattening of subchondral bone, concavity, sclerotic bone, mineralized cartilage flaps, joint mice
if available, arthoscopy is also a good option
in which cases can you non surgically manage osteochondrosis? what does non surgical management include?
young dogs with mild clinical signs, no joint mice, or are in unimportant location
in dogs with advanced secondary OA where it’s hard to remove a flap (like on the talus)
NSAIDs, exercise restriction, crate confinement, dietary supplements like omega 3s, glucosamine, weight control, calorie restricted diet
true or false: in young dogs with shoulder OCD, you should recommend vigorous exercise
true!
what surgical options are available for treating oesteochondrosis?
arthrotomy or arthroscopy, flap excision and joint mouse retrieval
what are the goals of doing a surgical procedure for oestochondrosis?
relieve clinical signs and restore pain free function
prevent or delay onset of secondary OA
