Osteoarthritis

Question 1

___ arthritis is very uncommon and is an immune mediated inflammatory disease of the joints in which the articular cartilage is eroded (most common is rheumatoid arthritis)

Answer 1

Erosive

Question 2

What is immune mediated polyarthritis

Answer 2

slightly common, neutrophils invade the joint –>pain and swelling of that joint, auto immune disease but is non-erosive

Question 3

Osteoarthritis (OA) is verryyy common aka ____

Answer 3

DJD (degenerative joint disease)

Question 4

Primary arthritis is rare (idiopathic), secondary is very common, what are some examples?

Answer 4

cruciate ligament tear, luxating hips, etc.

Question 5

____ arthritis is rare, ____ arthritis is common

Answer 5

primary is rare; secondary is common

Question 6

What are some pathologic changes caused by arthritis???

Answer 6

Synovitis, cartilage destruction, subchondral sclerosis, new bone production, osteophytes, enthesophytes (where the body tries to stabilize the region)

Question 7

What results from synovitis?

Answer 7

Pain and degradation of the cartilage

Question 8

What happens to synovial fluid with OA?

Answer 8

Synovial fluid changes to become less viscous less proteoglycans and more water

Question 9

Is cartilage destruction reversible?

Answer 9

nope

Question 10

How does subchondral sclerosis show up on rads?

Answer 10

Sclerotic bone, will show up on rads will more density (whiter)- will be like an ice skating rank

Question 11

PE findings with OA

Answer 11

pain, lame, stiff at rest, soreness a activity, crepitus on manipulation, decreased ROM, thickened joint capsule +/- muscle atrophy

Question 12

What are the diagnostics for OA in the order to do them–>

Answer 12

PE, rads, +/- arthrocentesis

Question 13

On rads, OA will show varying signs. What are some of the signs?

Answer 13

vary due to trauma and chronicity, subchondral sclerosis, osteophyte formation, narrowed joint spaces, joint effusion, periarticular thickening

Question 14

Normal synovial fluid characteristics

Answer 14

Usually clear to yellow, good viscosity, protein is less than 2.5mg/dl, not very cellular but may see leukocytes and monocytes

Question 15

Abnormal synovial fluid characteristics-

Answer 15

Cloudy, yellow orange, red, less viscous, protein may be increased, cell count is usually elevated (RBCs and reactive WBCs)

Question 16

T/F surgery is common for OA

Answer 16

False, surgery is not common for tx of osteoarthritis

Question 17

Multimodal management for OA includes….

Answer 17

• NSAIDS
• Chondroprotective agents
• Weight management
• Controlled exercise
• Fatty acids
• Adjunctive therapies

Question 18

Regenerative therapies that can be used in OA includes _______ stem cells obtained from bone marrow, adipose, umbilical blood/tissue, muscle, other

Answer 18

Mesenchymal

Question 19

Mesenchymal stem cells secrete trophic factors, ____ and _____

Answer 19

cytokines and chemokines

Question 20

What is the goal of stem cell regenerative tx for OA?

Answer 20

decrease pro inflammatory mediators and increase anti inflammatory ones. But do not regrow cartilage, only regrow anti inflammatory mediators

Question 21

what is it called when the superficial layers of cartilage is lost?

Answer 21

Fibrillation

Question 22

Joint capsule thickening includes folds (___) protruding into the jt space

Answer 22

vili

Question 23

Fissures developing tell you the issue is in what cartilage layer?

Answer 23

deep cartilage layer

Question 24

____ means frictionless, smoothed and polished at site of cartilage erosion from bone to bone rubbing

Answer 24

Eburnated

Question 25

for septic arthritis do we use IV abx or inject abx directly into the site?

Answer 25

IV or oral only!!! (unless opening the jt and then can do lavage with long acting abx like abx beads implanted into the site)

Question 26

____ disease can cause inflamm. non-erosive polyarthritis, though 95% of dogs affected are asymptomatic

Answer 26

Lyme disease

Question 27

What is non diagnostic of Lymedisease associated non erosive polyarthritis?

Answer 27

Rads are not useful

Question 28

to find tendonitis of the shoulder, what position do you want?

Answer 28

Maximum flexion of shoulder and extended elbow! Pull dog arm back

Question 29

We use the 90-90 tension test for what part of the body?

Answer 29

The crus (which is the area between the tarsus and stifle) to check for calcaneal rupture

Question 30

**What are our cranial drawer landmarks?

Answer 30

lateral fabella, patella, fibular head, and tibial tuberosity

Question 31

What are the primary stabilizers of the coxofemoral region?

Answer 31

jt capsule, ligament of the head of the femur, dorsal acetabular rim

Question 32

What are the secondary stabilizers for the coxofemoral region?

Answer 32

Perarticular muscles (gluteals), acetabular labrum (outer layer of acetabulum) hydrostatic pressure

Question 33

immature dogs are 2x as likely to have ___ ___ fx instead of hip luxation

Answer 33

capital physeal fracture

Question 34

Dog looks like hes crossing his legs with a ____ luxation

Answer 34

coxofemoral