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Module 7 > Osteoarthritis & Other Joint Pathology > Flashcards

Osteoarthritis & Other Joint Pathology Flashcards

1
Q

what is osteoarthritis

A

destructive disease of synovial joints, which can affect one or more joints and can vary in severity

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2
Q

what are the risks/predisposing factors of osteoarthritis

A
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3
Q

what is primary osteoarthritis

A

no predisposing cause

occurs in old age

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4
Q

what is secondary osteoarthritis

A

underlying abnormality in joint or supporting structures

  1. hip dysplasia
  2. rupture of cranial cruciate ligament
  3. misaligned limb fractures
  4. angular limb deformities
  5. aseptic necrosis
  6. metabolic bone diseases with collapse of subchondral bone, inherited defects in cartilage or collagen formation and septic arthritis
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5
Q

what type of osteoarthritis is common in dogs

A

secondary to chondrodystrophy, dysplasia or OCD

medium and large breeds most common in major weight bearing joints

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6
Q

what is osteoarthritis in horses

A

interphalangeal metacarpophalangeal and hock most common

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7
Q

how does osteoarthritis develop

A

multifactorial condition, but gross and histological changes are similar regardless of cause

non specific lesions; similar across primary and secondary degenerative joint disease

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8
Q

what clinical signs are common in osteoarthritis

A

joint enlargement or deformity, pain and articular malfunction (reduced range of motion)

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9
Q

what is the pathology of osteoarthritis

A

first lesions are roughening of the cartilage in areas of weight-bearing –> loss of proteoglycans from the matrix and unmasking of collagen fibrils –> fibrillation

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10
Q

what pathology is seen here

A

roughening of cartilage in areas of weight bearing

loss of proteoglycans from matrix and unmasking of the collagen fibrils –> fibrillation

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11
Q

what is progressive erosion of fibrillated cartilage accompanied by

A

sclerosis of the subchondral bone

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12
Q

what is seen here

A
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13
Q

what is seen here

A
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14
Q

what is seen here

A
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15
Q

what occurs in advanced lesions

A

the articular cartilage may be completely absent and exposed bone polished to a smooth surface by rubbing against the opposing bone –> eburnation

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16
Q

what pathology is seen here

A

aburnation

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17
Q

what are the processes shown here

A

normal

fibrillation

eburnation

18
Q

what is shown here

A

formation of osteophytes at the margin of articular cartilage and bone

small nodular outgrowth of bone covered by hyaline cartilage

19
Q

what changes also occur in the joint

A

thickening of the joint capsule and hypertrophy of synovial villi

20
Q

what pathology is seen here

A

thickening of the joint capsule and hypertrophy of synovial villi

21
Q

what other pathology may occur

A

rare or low numbers of inflammatory cells may be present

22
Q

what is the pathology shown here

A

hypertrophied synovial villi

low numbers of lymphocytes and plasma cells

23
Q

what lesions can be seen

A
24
Q

what lesions are shown here

A
25
Q

what lesions are seen

A
26
Q

what is the pathogenesis in the development of osteoarthritic changes in joints

A
  1. primarily degenerative in nature, accompanying inflammatory changes are secondary
  2. disruption of balance between degradation and repair cartilage matrix in favour of matrix breakdown leads to loss of proteoglycans and damage to collagen fibrils
  3. leads to loss of viscoelastic properties of articular cartilage, and further loss of cartilage with biomechanical trauma
27
Q

what occurs in the balance between synthesis and degradation of cartilage matrix

A

synthesis: anti-inflammatory cytokines, TIMPs (tissue inhibitor of MMPs), growth factors, collagen synthesis, proteoglycan synthesis
degradation: proinflammatory cytokines, MMPs (matrix metalloproteinases, collagenases, stromelysin, gelatinases), aggrecanases, prostaglandins, nitric oxide

28
Q

what degrading enzymes lead to the early loss of matrix components

A
  1. metalloproteinases
  2. serine proteinases
  3. cysteine proteinases
  4. aggrecanse
29
Q

why do degradtive enzymes have an effect

A

natural inhibitors of these enzymes are normally present in articular cartilage but are deficient in degenerative joint disease

30
Q

what else is involved in the pathogenesis

A

various cytokines and growth factors –> inflammatory response

IL-1 and TNF-alpha increase the synthesis of metalloproteinases and plasminogen activators and induce the resorption of cartilage

IL-1 also stimulates fibroblasts to synthesize collagen and may contribute to fibrous thickening of joint capsule

31
Q

what are inflammatory changes secondary to

A

stimulation of IL-1 and TNF-alpha by synoviocytes following release of degraded collagen and proteoglycan fragments from degenerate cartilage

32
Q

what is bacterial arthritis

A

following bacteremia

common in horses and food animals

sequel to neonatal bacteremia

33
Q

what does bacterial arthritis cause

A

bacterial lodge in highly vascular synovial membrane

results in polyarthritis

hot, painful swollen joints, destruction of cartilage +/- extension into adjacent bones (osteomyelitis)

spread of infection from nearby soft tissues (uncommon)

34
Q

how is bacterial arthritis caused

A

implantation, penetrating wound –> affects one joint, mixed bacterial population

35
Q

what pathology is seen

A

fibrinous arthritis in the carpus

abundant yellow fibrin fills the recesses of the joint

articular cartilage is smooth and unaffected

36
Q

what is seen here

A

suppurative arthritis

suppurative exudate fills the elbow joint and extends into the surrounding tendon sheaths and soft tissue

suppurative osteomyelitis of the proximal ulna (arrow)

37
Q

what are common aetiologies of bacterial arthritis

A
  1. coliform arthritis (E. coli) –> neonatal septicemia in farm animals
  2. staphylococcal arthritis (S. aureus) –> common in farm animals and monoarticular arthritis in dogs
  3. erysipelothrix rhusiopathiae –> causes porcine erysipelas which can result in articular lesions –> erysipelas infection in sheep usually follows cuts or abrasions
  4. chlamydial arthritis (C. pecorum) –> cause of arthritis in calves and lambs
  5. mycoplasmal arthritis (M. hypopneumoniae and M. hyosynoviae in pigs, M. bovis in cattle, mycoplasma in sheep)
  6. borreliosis (lyme disease) –> dogs, multiple joints affected
38
Q

what is viral arthritis

A

caprine arthritis-encephalitis virus

39
Q

what is fungal arthritis

A

rare with systemic fungal infections (blastomyces, histoplasma, cryptoccocys)

40
Q

what is immune mediated polyarthritis

A

inflammatory but not infectious diseases of joints

dogs and cats

divided into erosive polyarthritis/non-erosive polyarthritis based on presence or absence of cartilage destruction

non-erosive polyarthritis –> most common form, see joint effusions with increased neutrophils

no cartilage destruction

idiopathic polyarthritis most common type affecting young sporting and large breeds

most often no known underlying disease

can also secondary to other inflammatory

infectious or neoplastic disease

41
Q

what is seen here

A

immune mediated polyarthritis

ex. rheumatoid arthritis

Module 7 (50 decks)

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