Orthopaedics (SA) Flashcards
(287 cards)
1
Q
Where are two common sites of avulsion fracture?
A
Tibial Tuberosity
Lateral Malleolus
2
Q
what are the 3 main methods for fixing a fracture?
A
Plate and Screw
ESF
Pins and Wires
3
Q
What are the two major categories of plate for fixing a fracture?
A
Dynamic Compression Plate
Locking Plate
4
Q
In which type of bone are locking plates particularly useful?
A
Poor Quality Bone - Juvenile or Oseteopenic
5
Q
What is a disadvantage of a locking system?
A
Lag screws cannot be placed
6
Q
What do lag screws produce?
A
Interfragmental compression
7
Q
Name 3 advantages of a IM pin
A
Resists Bending
In Neutral axis of bone
Can use with other fixation devices
8
Q
Name 3 disadvantages of an IM pin
A
Cant resist rotation/shear
Interferes with medullary blood supply
difficult in chondrodystrophic breeds
9
Q
What type(s) of fracture can be fixed with an IM pin ALONE?
A
Mid diahpyseal transverse fracture
10
Q
What type(s) of fracture can be fixed with an IM pin alongside a plate?
A
comminuted fracture
Medium-long oblique simple fracture
11
Q
When is cerclage wire used?
A
with IM pin in long oblique fracture
12
Q
What type of fracture are pin and tension band wires used for?
A
Avulsion fracture
13
Q
How do pin and tension band wires fix a fracture?
A
Provide compression to avulsion fragment
14
Q
What is a grade 1 open fracture?
A
bone end pierced skin and retracted
15
Q
What is a grade 2 open fracture?
A
Fracture end exposed
16
Q
What is a grade 3 open fracture?
A
major ST loss and trauma
17
Q
What is a Salter-Harris type 1 fracture?
A
passes through entire growth plate. No bone involved.
18
Q
What is a Salter-Harris type 2 fracture?
A
passes along GP and through metaphysis
19
Q
What is a Salter-Harris type 3 fracture?
A
passes along GP and through epiphysis
20
Q
What is a Salter-Harris type 4 fracture?
A
passes through GP, Metaphysis and epiphysis
21
Q
What is a Salter-Harris type 5 fracture?
A
Crushing injury compressing GP - no displacement
22
Q
What is a Salter-Harris type 6 fracture?
A
Injury to perichondral structures
23
Q
Where does a healing fracture obtain its blood supply?
A
Periosteal Vessels
Surrounding Tissues
24
Q
What are the 6 stages of # healing?
A
- Haematoma
- Granulation
- Connective Tissue
- Fibrocartilage
- Callus formation
- Callus remodelling
25
In which type of fracture healing does callus formation NOT occur?
Direct Healing
26
Name 6 Fracture healing + factors.
```
Young
Healthy
Closed #
Single Injury
Closed Reduction
Low Energy
```
27
Name 6 Fracture healing - factors.
```
Old
Systemic/local Dz
High Energy
Open
Articular
Implants present
```
28
What type of fracture may benefit from external coaptation?
simple, stable and closed
29
Which patients are suitable for external coaptation
small dogs
| some cats
30
Where should a fracture be to be suitable for external coaptation?
Long Bone Diaphysis
31
How reducible should a # be to be considered for external coaptation?
>50% bone contact in 2 planes
32
Name 6 indications for ESF.
```
Long bone
Highly comminuted
Open/infected
Corrective osteotomy
Immobilising a joint
Adjunct to other fixation
```
33
Name 5 advantages to eSF
```
Minimal invasion
Allows access to open wound
Maintains limb length
Minimal complication rate
Inexpensive
```
34
Which two checks may be conducted to assess CrCL integrity?
Cranial Drawer
| Tibial Compression Test
35
Which Rx views are used to assess the stifle?
CrCd
| ML
36
What is the most common cause of HL lameness in the dog?
CrCL disease
37
What is the most common cause of CrCL disease in the dog?
Degeneration (+/- minor trauma)
38
What may cause CrCL Dz in predisposed breeds?
Inc collagen metabolism
Sloping angle of tibial plateau
IM disease
39
How may the affected leg be positioned in a standing dog with CrCL Dz?
Toe Touching
40
What may be noted on Cx of a dog with CrCL Dz? (2)
Stifle Effusion
| Medial Buttress
41
What are 3 Rx signs of CrCL disease?
Osteophyte Formation
Effusion (Compression of IP fat pad)
Cr Translation of Tibia
42
Which dogs with CrCL Dz may be managed conservatively?
<15kg
43
What does conservative management of CrCL Dz involve?
Restrict rest 6-8w
| Analgesia
44
Name 3 surgical techniques used in a patient with CrCL Dz.
TPLO
TTA
Lateral Suture
45
Which ligament is most commonly affected in meniscal tears?
Medial Meniscus
46
How long should conservative management be undertaken for meniscal injury?
4-6w
47
How should a meniscal injury non-responsive to conservative management be treated?
Surgical Removal
48
Which type of patellar luxation is most common?
Medial
49
What is developmental patellar lunation caused by?
Malalignment of the quadriceps complex
50
What is grade 1 patellar luxation?
Intermittent, immediate reduction
51
What is grade 2 patellar luxation?
frequent, self-reduction
52
What is grade 3 patellar luxation?
Permanent - can be replaced
53
What is grade 4 patellar luxation?
Permanent non-reducible
54
When should surgical Tx be undertaken for patellar luxation?
Recurrent Cx
55
What are the 3 different surgeries which may be performed for patellar luxation?
TTT
Trochlear Groove Deepening
Medial Retinaculum Release/Reinforcement
56
Where are OCD lesions found?
1. Caudal aspect humeral head
2. Medial part humeral condyle
3. Lateral femoral condyle
4. Medial trochlear ridge talus
57
3 Cx of OCD are...
Lame from 5m
Bilateral Crouching Gait
Join Effusion and discomfort
58
How is collateral ligament rupture diagnosed?
Abnormal joint movement in M or L direction
| Stressed Rx vs CL limb - widened joint space
59
How is Collateral ligament rupture treated?
Parapatellar surgery - repair ligament and re-attach
60
Which dogs commonly suffer form multiple ligament injury?
Working dog
61
how are multiple ligament injuries fixed?
Trans-articular external skeletal fixation
62
Name the most common SECONDARY disease of the stifle.
Osteoarthritis
63
Which animals are most susceptible to hip dysplasia?
Large Breed Dog
| Devon Rex Cat
64
What causes the pain associated with hip dysplasia?
Femoral head hitting dorsal acetabular rim
65
Describe the aetiopathogenesis of hip dysplasia.
poor ST cover > Laxity/instability of CF joint > OA
66
Which are the two groups of dogs that commonly present with hip dysplasia?
Immature <12m
| Adult dog with OA 2e to Hip Dysplasia
67
How do young dogs with hip dysplasia present? (4)
HL lame (uni/bilateral)
Bunny-hopping gait
Reluctant to exercise
+ ortolani test
68
How do adult dogs with hip dysplasia present? (4)
Stiff after exercise/rest
"bunny hop"
bilateral lameness
reduced ROM + pain
69
Which Rx views should be taken to check for hip dysplasia?
VD extended
| LM view
70
What are the 1e changes seen on Rx of Hip Dysplasia? (3)
wide joint space
medial divergence
Centre of FH lateral to dorsal acetabular edge
71
What are the 2e changes seen on Rx of Hip Dysplasia? (3)
Bone formation on femoral neck (morgan line)
Remodelling of FH/N
Remodelling of acetabular rim
72
What is the success rate for conservative management of Hip Dysplasia?
75-80%
73
Which surgical Tx may be appropriate for a young dog with Hip Dysplasia?
TPO
| Juvenile Pubic Symphisiodesis
74
Which surgical Tx may be appropriate for any dog with Hip Dysplasia?
FHNE
| Total Hip Replacement (>9m)
75
What is the principle behind JPS for Hip Dysplasia?
Electrocautery causes arrest of chondrocytes
Shorter Pubic bones
VL rotation of acetabulum = better congruity
76
Over what age does a JPS no longer work?
>22w
77
Which rare disease can be treated with a FHNE?
Legg-Calve-Perthes
78
Which dogs are most suitable for FHNE?
Small dogs <15kg
79
Which is the most appropriate surgical Tx for Hip Dysplasia in MOST dogs?
Total Hip Replacement
80
What is a common CI for Total Hip Replacement?
Chronic systemic illness
81
Which breeds are predisposed to LCP disease?
WHWT and Manchester Terrier
82
What is LCP Dz?
Ischaemia of the femoral head > deformity/collapse
83
How does LCP Dz present?
<5m
Unilateral lameness
pain on hip manipulartion
84
Which Rx should be taken to diagnose LCP?
Frog Leg
Vd Extended
ML
85
What is the best Tx approach for LCP?
Surgical (FHNE or Total Hip Replacement)
86
Which age of animal most commonly suffers capital physical #s?
4-7mo, 2e to trauma
Pain on manipulation
87
How are capital physeal #s treated?
3 diverging/parallel K wires
| Craniolateral or dorsal approach!
88
Which animals are commonly affected by CF luxation?
Small
Following RTA
<12m
89
Which direction of CF luxation is most common?
Craniodorsal
90
How is the leg carried in a case of CF luxation?
Flexion
| Stifle Out, Hock in
91
Which anatomical landmark is more prominent in the affected leg during CF luxation?
Greater Trochanter
92
Which Rx views are important to diagnose CF luxation?
VD
| Lateral
93
Common Ddx for CF Lux?
Hip Dysplasia
| Capital Physeal #
94
How should CF lux be initially Tx?
CLOSED reduction - followed by Ehmer sling & rest 7-10d
95
What are 2 common CIs of closed reduction for CF luxation?
Hip Dysplasia
| Avulsion # of femoral head
96
How long after CF luxation can closed reduction be performed?
48h
97
How should a CF lux patient be prepared for closed reduction?
GA
| TIE to table
98
How long should a dog be cage rested for post closed reduction of CF lux?
7-10d
99
Which approach is taken in open reduction of hip luxation?
Craniolateral
100
What is the first step of CF lux surgery?
Remove haematoma and bone fragments + lavage
101
Name 3 surgical options for open reduction of CF lux?
Toggle Fixation
Transarticular Pinning
Iliofemoral Suture
102
What is the most appropriate Tx for a single MT #?
External Coaptation
103
What is the most appropriate Tx for multiple MT #s?
Internal fixation
104
Two complications of MT # are...
1. ST injury
| 2. Synostosis
105
Which breed commonly sufffers from interphalangeal luxation?
Greyhounds
106
Name the 3 Tx options for interphalangeal luxation.
Reduce & wire collateral ligaments
Small ESF
Amputation
107
Name 3 indications for toe amputation
Neoplasia
Severe #
Severe IP luxation
108
Where are OCD lesions commonly found?
Medial/Lateral Trochlear Ridge
109
How do OCD lesions appear on Rx?
Flattened Trochlear Ridge
110
What si the best Tx for OCD?
Surgery
111
What is the most common type of # to the central tarsal bone?
Dorsal Slab
112
What is the best Tx for central tarsal bone #?
Lag screw
113
What is the underlying cause of talocrural instability?
Damage to medial/lateral collateral ligaments OR malleolar #
114
In Talocrural instability, what are the first-line and second-line Tx?
Surgery
| If fails - Pantarsal arthrodresis
115
How should open luxations of the tarsus treated?
Extensive lavage
| ESF
116
What is the main cause of calcaneoquartal instability?
Trauma or Degeneration (collie)
117
Where is calcaneoquartal instability located?
Between calcaneus and 4th TB
118
Degeneration of which ligament causes calcaneoquartal instability?
Plantar ligament
119
Where should an autogenous bone graft be taken from in dogs?
Proximal Humerus
120
Where should an autogenous bone graft be taken from in cats?
Ilium
121
Which approach should be taken for carpal arthrodesis?
Dorsal
122
Describe the POC for pan tarsal arthrodesis
Splint for 6-12w
Check weekly
Re-Rx after splint
ANALGESIA!!
123
What is the most common cause for achilles tendon rupture in dogs?
Trauma (RTA, severing)
124
What is the most common cause for AT rupture in Dobermans?
Gastrocnemius enthesiopathy - BILATERAL
125
How is AT rupture treated?
Attach loop pulleys to exposed tendon end and bone screw back in place with hock in extension
Cast 6w.
126
What is a unique sign of AT rupture in dobermans?
Toe Clenching - "crab" toes
127
What is the most common pelvic problem in dogs/cats?
Pelvic #
128
What should your first 4 priorities be when presented with a pelvic # patient?
ABC
Control Haemorrhage
Fluids/Shock Therapy
Analgesia
129
What nerve deficiency ould be present with an ilial #?
Sciatic
130
Which Rx view(s) should be taken to assess a pelvic #?
Lateral and DV
131
How many pelvic # cases would recover if managed conservatively?
75%
132
Which animals are better candidates for conservative Tx of pelvic #?
Smaller animals with # in NON weight-bearing axis
133
What is the conservative management for pelvic #?
```
Cage rest 4-6w
Turn often
Soft Bed
Check and manage bladder
Analgesia (opioid +NSAID)
```
134
What Tx is necessary for sacroiliac separation?
Surgical!
| Lag Screw OR Trans-ilial Pin
135
Which animals commonly suffer sacroiliac separation and why?
Cats - post RTA
136
What Tx is necessary for iliac shaft #?
Internal fixation
137
What Tx is necessary for acetabular #?
CONTROVERSIAL
| Sx - plate fixation possible. If small then FHNE.
138
Describe the post-op care for pelvic #s. (4)
Cage rest 4-8w
Short walk 5-10m.
Analgesia
Soft Bed
139
When should re-visits occur for Post-op pelvic #?
3d
7-10d
4-8w
140
What are the 3 Rx projections for assessment of the shoulder?
Mediolateral
Craniocaudal
Cranioproximal-Craniodistal
141
Which Rx view allows you to visualise the humeral head, glenoid and osteophytes of the shoulder joint?
ML view of the shoulder
142
What are the bony landmarks for should arthrocentesis?
Acromion
| Greater Tubercle
143
What are the 3 samples that should be taken for shoulder arthrocentesis?
Smear
EDTA
Blood Culture Medium
144
What needle & syringe should be used for shoulder arthrocentesis?
1-2" 21-23G needle
| 5ml syringe
145
How much Iohexol is injected for a low volume arthrography of the shoulder?
1ml
146
How much Iohexol is injected for a high volume arthrography of the shoulder?
5-8ml
147
Which lesions of the shoulder may be observed using arthrography?
Biceps Lesions
| Capsular Tears
148
What does US of the shoulder allow you to view?(5)
Infra/Supra-spinatus tendons
Teres minor
Caudal Humeral Head
Biceps Tendon
149
What are the 3 diseases of the shoulder a CT can detect?
OCD
Tendon calcification
OA
150
Which 3 anatomical landmarks may be visualised with arthroscopy of the shoulder?
Caudal humeral head
Glenohumeral ligaments
Bicipital Tendon
151
What age/breed predilections exist for shoulder OCD?
4-8m
| Giant Breed
152
When is shoulder OCD painful on Cx?
Extreme extension/flexion
| NOT palpation
153
Describe conservative treatment of shoulder OCD
Exercise until flap detaches.
NB: inferior to Sx.
154
How is shoulder OCD managed surgically?
Best Tx!
| Flap Removal and stimulation of fibrocartilage formation
155
What dogs commonly present with biceps tendinopathy?
Middle Age
| Medium-Large breed
156
Describe the lameness associated with biceps tendinopathy.
Progressive TL lameness.
| Worse after exercise.
157
When is biceps tendinopathy painful on Cx?
Shoulder flexion WITH concurrent elbow extension.
| check elbow to rule out Ddx
158
How may biceps tendinopathy be managed conservatively?
NSAIDs - usually helps
159
What medical management is available for biceps tendinopathy?
Intra-articular methylprednisolone
160
What surgical intervention is possible for biceps tendinopathy?
BEST Tx. Tenotomy +/- Tenodesis to proximal humerus
161
What is the long-term Px for surgical Tx of biceps tendinopathy?
Good
162
How may biceps brachia rupture be diagnosed on Cx?
Hyperextension of elbow when shoulder is in FULL flexion.
163
How many carpal bones does a dog have?
7
164
Which dogs are more high-risk for Radoiocarpal bone #?
Males
| Boxer, Springer, Pointer
165
Which are the two most common type of Radoiocarpal bone#?
Dorsal slab
Midbody sagittal
Communited
166
What is the Sx management for a Radoiocarpal bone #?
Lag screw & immobilise
OR
Carpal Arthrodesis
167
Which animals are prone to accessory bone #s?
Racing Greyhounds
168
What is the Sx management for an accessory bone #?
Lag screw OR remove if small fragment
169
What structure is damaged in a carpal hyperextension injury?
Flexor Retinaculum OR Palmar Fibrocartilage
170
Which Rx view is MOST useful in carpal hyperextension injury?
Stressed ML (compare with CL limb!)
171
What surgical Tx is most common for carpal hyperextension injury?
Pancarpal arthrodesis - Dorsal plate
172
Where is the plate most commonly placed for pancarpal arthrodesis?
Dorsally
173
Which location is biomechanically best for plate application in pancarpal arthrodesis?
Palmar - but more technically challenging than dorsal, so less common
174
What is the most common complication following pancarpal arthrodesis?
SSI (loosening second)
175
What are the 3 mainstays for postoperative management following pancarpal arthrodesis?
```
Analgesia
Exercise restriction (2w min)
External Coaptation (RJB 5-10d)
```
176
What is the most sensitive modality for diagnosing elbow disease? What does this allow us to visualise which is not possible with other techniques?
Arthroscopy
Cartilage
177
What is the advantage of using arthroscopy over CT or Rx in cases of suspected elbow disease?
Concurrent Dx and Sx
178
what needle should be used for arthrocentesis of the elbow?
21-23G 1-1.5" needle
179
What are the anatomical landmarks for elbow arthrocentesis?
Distal to M/L epicondyle
| Caudolaterally along anneal process
180
What 3 samples can be taken following elbow arthrocentesis?
Smear
EDTA
Blood Culture
181
How does synovial fluid present in a patient with elbow OA?
Low cellularity
| Mononuclear cells
182
How does synovial fluid present in a patient with IMPA/BIA?
Highly Cellular
| Neutrophilic inflm
183
Which two bones may be short, leading to elbow incongruency?
Radius - premature closure of GP
| Ulna - premature closure of ulna physis
184
A shortening of which bone may contribute to UAP?
Ulna
185
How may elbow congruency be improved in short ulna syndrome?
Osteotomy to induce bone lengthening
186
Which 3 dog breeds are most commonly affected by elbow dysplasia?
Labradors
Rottweilers
Burmese Mountain Dogs
187
Which 4 diseases are covered by the term "developmental elbow disease"?
FCP/Medial Coronoid Disease
OCD of medial humeral condyle
UAP
Elbow incongruity
188
What are the 4 factors predisposing to medial coronoid disease?
Genetics
Nutriton
Biomechanics
Gender (M>F)
189
Which is more common in MCD - short radius or short ulna?
Short radius (45% vs 14%)
190
How does mechanical overload cause MCD?
Disturbs EC ossification Weak points between cartilage and subchondral bone
Fissure and # as a result
191
How is MCD diagnosed?
CT/Scope - not likely to see on std Rx views
192
How can MCD be managed conservatively?
Analgesia
Neutrceuticals
WEIGHT control
Phsyio
193
What is the issue with surgical management of MCD?
Can remove # but numerous procedures for cure.
None particularly effective and all case-specific.
REFER!!!
194
What is the OATS procedure for OCD?
Transfer host osteochondral graft from unaffected site
195
Which breeds are commonly affected by UAP?
Basset
GSD
BMD
Mastiff
196
Is UAP more common in males or females?
Males
197
How often is UAP bilateral?
20-35% of cases
198
What causes UAP?
2e centre of ossification or joint incongruency
199
Characterise the lameness commonly associated with UAP.
Thoracic limb
Chronic
Worse after exercise
(+ LARGE EFFUSION)
200
Which Rx view is best for Dx of UAP?
Flexed ML
201
At what age does UAP become apparent on Rx?
16-20w
| Greyhound 14-15w
202
Why would a CT > Rx for UAP diagnosis?
Allows assessment of concurrent Dz
203
What is the most appropriate Tx for UAP?
CONSERVATIVE - if mild lameness
204
What are three common surgical approaches for UAP?
```
Anconeus Removal (if reattachment fails)
Anconeus reattachment
Ulnar osteotomy (+/- reattachment)
```
205
Which breeds commonly suffer from IOHC? (3)
Springers
Cocker Spaniels
Labradors
206
What may IOHC lead to if left untreated?
Fracture of humeral condyle
207
What may be seen on Rx of IOHC?
CrCd: Large fissures
208
Which is the most sensitive Diagnostic tool for IOHC?
CT
209
How may condylar #s be prevented in IOHC?
Prophylactic placement of transcondylar screw +/- lateral condylar plate
210
What are two surgical indications for IOHC?
Persistent lameness
| Early remodelling on lateral epicondylar crest
211
Characterise the lameness seen with panosteitis. (4)
Shifting
Varied Severity
Acute onset w/o trauma
FL >HL
212
At what point in the Dz process can panosteitis be appreciated on Rx and how?
10d + increased medullary radiodensity. Periosteal thickening
70-90d: medullary remodelling - normal again.
213
What is the most appropriate Tx for panosteitis?
analgesia
| SELF-limiting. will resolve.
214
Which dogs commonly present with metaphyseal osteopathy?
YOUNG (2-6m)
| Medium-large breed
215
How do dogs with metaphyseal osteopathy present clinically?
Mildly lame to severe collapse (pyrexia, anorexia, depression).
Swollen metaphysis present!
216
Where is metaphyseal osteopathy most common?
Distal Radius/Ulna
217
How can metaphyseal osteopathy be appreciate on Rx?
Band of inc radio density parallel to physis.
| Possibly widened GP.
218
How is metaphyseal osteopathy Tx?
Supportive care and analgesia.
| Self-limiting
219
Which breeds commonly suffer from craniomandibular osteopathy?
WHWT
Scottish Terrier
Cairn Terrier
220
At what age do dogs suffering from craniomandibular osteopathy present?
4-10m
221
What are the Clinical signs of craniomandibular osteopathy?
```
Mandible swelling
Inability to open mouth
Salivation
Weight loss
Pain when eating
```
222
What are the Rx changes associated with craniomandibular osteopathy?
Bilateral
| Proliferation on mandible/tympanic bulla
223
How is craniomandibular osteopathy treated?
Analgesia + support
224
What is the Px for craniomandibular osteopathy?
Self-limits around 1yo.
| Euthanasia may be required before this.
225
Which dogs are commonly affected by Legg-Calve-Perthes Disease?
4-11mo
| Mini Poodle, WHWT, Cairn/Manc/Yorkie
226
Characterise the lameness associated with L-C-P disease.
Varies: Mild intermittent lameness to acute non-wb lameness
+/- PL atrophy
+/- pain on hip manipulation
227
What is the aetiopathogenesis of L-C-P Dz?
Vascular Supply to femoral head from epiphyseal vessels compromised
228
How does L-C-P appear on Rx?
"apple-core" bone lysis of femoral head
229
What are the 3 Tx options for L-C-P Dz?
Conservative Tx
FHNE
THR
230
Which disease causes a slipped capital femoral epiphysis?
Feline Metaphyseal Osteopathy
231
Which cats are most likely to suffer from Feline Metaphyseal Osteopathy?
MN
Overweight
<2yo
232
What are the clinical signs of Feline Metaphyseal Osteopathy?
Subtle lameness prog to NWB.
Inability to jump.
Pain and crepitus on hip manipulation.
233
What are the EARLY Rx changes in Feline Metaphyseal Osteopathy?
Widening and lateral displacement of capital femoral growth plate
234
What are the LATE Rx changes in Feline Metaphyseal Osteopathy?
Displacement of proximal femoral metaphysis.
| Resorption/Sclerosis of femoral neck.
235
How is Feline Metaphyseal Osteopathy treated? (2)
FHNE
| THR
236
What is the colloquial name for Hypertrophic Pulmonary Osteoarthropathy?
Marie's Disease
237
Which animals are most commonly affected by Hypertrophic Pulmonary Osteoarthropathy?
Older dogs AND cats
| mean age 9yo
238
What is the aetiopathogenesis of Hypertrophic Pulmonary Osteoarthropathy?
Calc of periosteum and CT.
Due to vast congestion in periosteum.
Secondary to intrathoracic/abdominal neoplasia.
239
What are the clinical signs of Hypertrophic Pulmonary Osteoarthropathy?
Prog lameness over several months.
Firm swelling over distal extremities - initially painful.
+/- hyperthermia, WL, depression
240
What are the Rx changes associated with Hypertrophic Pulmonary Osteoarthropathy?
New periosteal bone formation - laid down at right angles to periosteum.
241
How is Hypertrophic Pulmonary Osteoarthropathy treated?
Remove Primary Tumour.
+ Symptomatic relief
242
What are the 3 categories of bone cyst?
Simple
Aneurysmal
Subchondral
243
Where are subchondral bone cysts found?
Adjacent to synovial membrane
244
What do aneurysmal bone cysts contain?
Blood sinusoids
245
What are the Rx changes characteristic of bone cysts?
Expansile, locally aggressive lucency.
Minimal periosteal reaction.
Metaphysis/diaphysis with eccentric location.
Thin cortex.
246
What are the 4 Tx options for bone cysts?
Surgical Drainage/Graft
Radiation Therapy
Excision
Amputation
247
Which dogs are most susceptible to Infraspinatus contracture?
Medium sized working dogs
248
How do dogs with infraspinatus contracture stand?
Shoulder abducted
Elbow adducted
External rotation of lower limb
249
What is the Tx for Infraspinatus contracture?
Infraspinatus tendinectomy
250
Which dogs are most susceptible to gracilis contracture?
GSD 3-7yo
251
How do dogs with gracilis contracture walk?
Affected limb jerk-like movement.
Hyeprflexion of tarsus.
Internal rotation of metatarsus.
252
Which dogs are predisposed to quadriceps contracture? (2)
Young, fast-growing.
OR
2e to femoral #.
253
What are the clinical signs of quadriceps contracture?
Extended stifle/tarsus.
Pain over Femur.
Difficulty walking.
254
What is the most appropriate Tx for gracilis contracture?
None
255
What is the most appropriate Tx for quadriceps contracture?
amputation
256
Following debridement and anastomosis, how long should a tendon be immobilised for?
3w
257
How many tendon ends foes the SDFT have?
4
258
How many tendon ends does the DDFT have?
4
259
What nutritional derangement(s) cause(s) Nutritional Secondary Hyperparathyroidism?
High P or Low Ca: Meat based!
260
What is the ideal Ca:P ratio for dogs?
1.2 : 1
261
What is the ideal Ca:P ratio for cats?
1 : 1
262
How does Nutritional Secondary Hyperparathyroidism cause lameness?
HypoCa > inc PTH > inc resorption.
BUT normal production.
so progressive skeletal demineralisation.
263
How does Nutritional Secondary Hyperparathyroidism present on Rx?
Decreased bone density.
Thin cortices.
"mushroom" metaphysis.
Pathological #.
264
how is Nutritional Secondary Hyperparathyroidism treated?
Rest
Change Diet + Ca supplements
NSAIDs
265
How does Hypovitaminosis D lead to osteopenia?
Low Vitamin D > Low Ca/P > cannot form bone.
266
What are the Cx of hypovitaminosis D?
Pathological #/bowed long bones.
Large costochondral jct.
Delayed dental eruption.
267
What changes may be notes on Rx of a dog suffering from hypovitaminosis D?
Thick GPs
Cupped metaphysis.
Osteopenia
Bowed Diaphysis
268
How does Renal osteodystrophy cause osteopenia?
Renal impairement > lack of P excretion.
HyperP --> HypoCa.
Inc PTH --> bone demineralisation.
ALSO impairs vit D production.
269
What are the clinical signs of Renal Osteodystrophy?
```
Pliable jaw.
Loose Teeth
Skeletal Pain
Pathological #s
Bowed long bones
```
270
Which patients are commonly affected by hypervitaminosis A?
Cats
| 2-9yo
271
What are the common clinical signs of a patient with hypervitaminosis A?
```
Scurfy Coat
Malaise
Neck paincervical stiffness
Abnormal posture
Lameness
```
272
What Rx changes may be noted on a patient with hypervitaminosis A?
Extensive exostoses of cervical/thoracic vertebrae.
Ankylosing spondylopathy of cervical/thoracic vertebrae.
DJD shoulder/elbow.
273
How is hypervitaminosis A treated?
CANT RESOLVE DAMAGE.
| Balanced diet to halt progression.
274
What is the best way to evaluate ST injuries of the shoulder?
US
275
What are the 4 indications for myelography?
1. Localisation of spinal lesion
2. Surgical planing
3. Rule out surgrey
4. Asses dynamic SC lesion
276
What is the 1e site of osteochrondrosis?
Lateral or Medial Femoral Condyle
277
how is feline cruciate/patellar Dz fixed?
Transarticular pin across stifle joint for 4 weeks (+ taESF)
278
Which Tx is reccomended for articular site fractures?
Fixation with pins
279
What is Juvenile Pubic Symphisiodesis?
Thermal arrest of pubic chondrocytes by electrocautery/staples - results in ventrolateral rotation of acetabulum and better congruity
280
Which dogs should undergo Juvenile Pubic Symphisiodesis?
<20w old - diagnose at 14-16w
281
Which dogs should undergo Juvenile Pubic Symphisiodesis?
<20w old - diagnose at 14-16w
282
How is a calcaneal avulsion # treated?
Pin and Tension Band wire
283
What is the best Tx for calcaneoquartal instability?
calcaneoquartal arthrodesis - dorsal approach, remove all cartilage and apply bone graft from proximal humerus
284
What should the post-op management be for calcaneoquartal arthrodesis?
Splint/cast 6w - Rx. Rest and analgesia.
Check weekly
285
What can be visualised with low volume arthrography of the shoulder?
OCD lesions of the humeral head
286
What are the clinical signs of carpal bone fractures?
```
NWB thoracic limb lameness
Abnormal stance
Effusion, swelling
crepitus and pain on ROM
Ml or CrCd instability
```
287
What are the signs of Carpal Hyperextension?
Palmigrade stance - pain and progression
