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SAS FINAL > Osteoarthritis and osteochrondritis dissecans > Flashcards

Osteoarthritis and osteochrondritis dissecans Flashcards

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1
Q

_____ joins bones with a fibrous joint capsule that is continuous with the periosteum of the joined bones

A

synovial joint

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2
Q

_____ permits motion while providing stability for load transfer b/t bones

A

synovial joints

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3
Q

Hips, stifle, elbow and shoulder are examples of _____ joints

A

synovial

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4
Q

Synovial joints are made up of what type of cartilage?

A

hyaline/articular cartilage

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5
Q

T/F: Hyaline/Articular cartilage is highly vascular

A

FALSE: relatively avascular

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6
Q

Where do joints get their nutrients?

A

synovial fluid

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7
Q

Is osteoarthritis inflammatory?

A

No- non inflam degenerative joint disease

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8
Q

What are the three factors of osteoarthritis (non-inflam DJD)?

A

articular cartilage degeneration

marginal bone hypertrophy, aka osteophytosis

synovial membrane changes4

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9
Q

T/F: Dysplasia, DJD, trauma and neoplasia are examples of inflammatory arthropathy

A

FLASE- non inflammatory

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10
Q

Inflammatory causes

A

infectious: bact, viral, rickettsia, fungi, mycoplasms, protozoa, spirochetes

non-infectious: erosive vs nonerosive

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11
Q

Inflammatory non-infectious causes of arthopathy

A

erosive: rheumatoid, feline chronic progressive polyarthritis
nonerosive: immune-mediated polyarthritis, chronic inflam induced polyarthritis, systemic lupus erythematosus

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12
Q

Diagnosis of osteoarthritis

A

history and clinical signs: acute vs chronic, dog vs cat

physical exam: muscular asymmetry, joint enlargement, CREPI

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13
Q

What does CREPI stand for?

A

Crepitus (cracking/crunching when moving joint)

Range of motion

Effusion

Pain

Instability

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14
Q

What are the risk factors for osteoarthritis?

A

Size and growth rate: 45% of OA dogs are large breeds

Breed and genetics: labs & german shepards are predisposed

Advanced age: 50% of OA dogs are 8 to 13 years old

Obesity

Repeated trauma & mechanical stress

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15
Q

Clinical signs of mild osteoarthritis (OA)

A

dogs: stiffness, decreased activity, limping
cats: decreased activity

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16
Q

Clinical signs of moderate OA

A

dogs: pain, muscle atrophy, difficulty rising
cats: reluctance to jump, climb stairs, groom

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17
Q

Clinical signs of severe OA

A

dogs: loss of range of motion, vocalization, creptius, lethary, inappetence
cats: limping, muscle atrophy, inappropriate elimination

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18
Q

OA radiographic changes for inflammatory/infectious

A

subchondral bone may be sclerotic or lytic

+/- periarticular bone formation

+/- joint space narrowing

+/- capsule distension and soft tissue swelling

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19
Q

OA radiographic changes for noninfectious- nonerosive

A

soft tissue swelling and joint capsule w/o bony changes- multiple joints affected

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20
Q

OA radiographic changes for noninfectious- erosive

A

joint space collapse

subchondral bone proliferation

periosteal new bone production

soft tissue swelling

-multiple joints affected

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21
Q

OA radiographic changes in non inflammatory DJD

A

soft tissue swelling & intracapsular distension

diminished joint space

periarticular osteophytosis

subchondral bone plate usually intact but may be sclerotic

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22
Q

OA radiographic changes in non inflammatory- trauma

A

depends on trauma (fracture luxation)

ultimately leads to DJD

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23
Q

OA radiographic changes in non inflammatory- neoplasia

A

soft tissue swelling and intracapsular distension

destruction of the subchondral bone plate (often on both sides of the joint) with aggressive bone proliferation

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24
Q

What testing can we use to diagnose osteoarthritis (OA)?

A

computed tomography (CT) -bony changes

MRI- evaluate soft tissue structure: tendons and ligaments

ultrasound

bone scintigraphy

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25
T/F: bone scintigraphy diagnoses OA
FALSE- it localizes OA (radioactive isotope specific for inflam w/in a joint)
26
What can differentiate b/t inflammatory Vs non-inflammatory arthropathies?
Joint tap/Joint fluid analysis looking at the cellular content inflam has neutrophils
27
List some examples of OA medical management
weight management nutritional supplements exercise moderation physical rehabilitation anti-inflam medications and other pain management
28
What types of nutritional supplements are good for management of OA?
omega 3 fatty acids- anti inflam chrondroprotectants- glucosamine/chondroitin and ASU (avocado soybean unsaponifiables)
29
What type of exercise is recommended for P with OA?
low impact activity leash walks, swimming, hill work
30
Physical therapy options for OA
stregth endurance range of motion laser therapy
31
List some options for pain management of OA
NSAIDs- want to spare the kidneys and stomach (COX-1, COX-2, EP4 blockers) Corticosteroids NOT recommended with DJD PSGAGs Acupuncture
32
Osteochondrosis is a disturbance in _____ that leads to \_\_\_\_\_
endochondral ossification cartilage retention/thickening
33
What is the issue with increased cartilage thickness?
can result in malnourished, necrotic chondrocytes
34
Osteochondrosis leads to resultant clefts at the junction of ____ and \_\_\_\_
calcified and non-calcified tissue clefts are fissues that develop w/in the cartilage
35
Normal activity with osteochondrosis can create vertical fissures and result in \_\_\_\_\_
cartilage flap (OCD)
36
What does the bottom circle show an example of?
osteochondosis- clefts
37
What are some risk factors for osteochondrosis?
age, gender, breed (genetics), rapid growth, nutritional excesses (Ca)
38
The cause of osteochondrosis is multifactoral. What are the two factors?
genetic and nutritional factors
39
T/F: Females are more likely to develop osteochondrosis
FALSE males more likely
40
What breed of dogs are mostly presented with osteochondrosis?
large/giant breeds
41
When do we usually see clinical signs of osteochondrosis?
usually at 4-8 months but can present later
42
T/F: osteochondrosis usually presents as a bilateral disease
FALSE: it is a bilateral disease but presents with unilateral lameness so make sure to evaluate the other side
43
How can we diagnose osteochondrosis?
physical exam findings dependent on location radiographs CT/MRI arthroscopy
44
When examining a dogs shoulder joint, if they have osteochondrosis they will show pain when?
hyperextension of the shoulder, flexion of the shoulder
45
Does osteoarthritis have an acute or gradual onset?
gradual onset that is worse after exercise
46
Osteochondrosis is usually lameness on what limb?
unilateral forelimb lameness
47
Early signs on shoulder osteochondrosis on a lateral radiograph?
flattening of the subchondral bone of caudal humeral head
48
Later signs on osteochondrosis on a lateral radiograph?
Saucer shaped radiolucent area
49
What is the arrow pointing to?
saucer shaped radiolucent area osteochondrosis
50
What are some way to conservatively manage shoulder OCD?
rest diet NSAIDs
51
What diet helps in the conservative management of shoulder OCD?
control energy, calcium, vitamin D intake
52
Surgery is usually the recommened treatment for shoulder OCD. We try conservative treatment first as long as what 3 indications are true?
small defect minimal to no lameness very young dog (\<6 months)
53
\_\_\_\_ is the standard of care for dogs with shoulder OCD treatment
surgical treatment
54
What is preffered with surgical tx of shoulder OCD... arthroscopy or arthrotomy?
arthroscopy
55
What does surgical treatment of shoulder OCD entail?
flap removal and joint lavage debridement of bone with curette or shaver defect heals with fibrocartilage
56
Prognosis of shoulder OCD with surgery
px much better w/ sx than w/o near-normal function w/ sx * pet dog- good to excellent * working dog- fair to good * assuming sx is done prior to onset of DJD
57
If surgery is not performed on a OCD shoulder, what can we expect to see?
DJD
58
OCD on the distal humerus is the ____ joint
elbow
59
How does elbow joint OCD present?
unilateral lameness- acute vs chronic, worse after exercise and stiff in the AM
60
When examining the elbow joint on a P with OCD, you will see pain when doing what to the joint?
pain on elbow extension and lateral rotation of the forearm
61
What does elbow joint OCD look like on radiographs?
radiolucent concavity of distal aspect of medial humeral condyle
62
What does this rad show?
OCD of the elbow joint
63
T/F: early intervention for elbow OCD will prevent DJD
FALSE
64
What is the best chance for a good prognosis with elbow OCD?
early intervention
65
What tx is *worse* for elbow OCD... arthroscopy or arthrotomy?
arthrotomy is worse
66
T/F: short term medical management of elbow OCD has a good prognosis
FALSE- expect long term treatment
67
How does stifle joint OCD present?
young, large breed dog w/ hindlimb lameness stifle effusion and crepitus
68
What does stifle joint OCD look like on radiographs?
radiolucent concavity on medial aspect of lateral femoral condyle (most comon) medial condyle can also be affected
69
What does this radiograph show?
OCD of the stifle joint
70
Tarsus OCD is seen in what dogs?
large breeds- Rotties
71
How does Tarsus OCD present?
unilateral hindlimb lameness- acute vs chronic- worse after activity or rest
72
When examining OCD of the tarsus, the P will exhibit pain when?
flexing the hock
73
Radiographic signs of an OCD tarsus
radiolucent concavity on medial (more frequent) or lateral trochlear ridge of talus
74
Tarsus OCD prognosis
gaurded to poor
75
\_\_\_\_\_ is ideal for treatment of tarsus OCD
arthroscopy
76
T/F: arthrotomy and fragment removal may be no better than medical management for tarsus OCD
TRUE
77
T/F: surgery for tarsus OCD will prevent the development of OA
FALSE: does not prevent
78
T/F: surgery for tarsus OCD will eliminate the lameness
FALSE: does not eliminate the lameness surgery improves function somewhat
79
End stage OCD is also known as?
DJD
80
Prognosis of OCD is dependent on?
when diagnosis was made and level of DJD present
81
List the joints in order of best prognosis to least for OCD
shoulder stifle elbow tarsus

SAS FINAL (4 decks)

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