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Small Animal Surgery > Radiographic Evaluation, Complications and Neoplasia > Flashcards

Radiographic Evaluation, Complications and Neoplasia Flashcards

1
Q

Why do we take post-op RADs?

A

To see if repair is acceptable or if changes need to be made

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2
Q

What 3 things are we checking on re-check RADs?

A

Is bone healing?
Are implants stable?
Any other concerning changes?

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3
Q

What are the 4 A’s of systematic assessment?

A

Apposition
Alignment
Apparatus
Activity

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4
Q

What is meant by Apposition?

A

Are fragments well apposed?

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5
Q

What is meant by Alignment?

A

Are joints above and below fracture aligned properly?

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6
Q

What is meant by Apparatus?

A

Is the fixator/implants appropriately placed and are they loosening or failing?

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7
Q

What is meant by Activity?

A

Is there evidence of:

  • Bone healing
  • Infection
  • Osteopenia
  • Malunion
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8
Q

What is the average healing time for a fx?

A

6-8 weeks

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9
Q

What are 5 things that affect bone healing?

A 
Configuration/severity
Soft tissue damage
Stability
Presence of infection
Patient factors
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10
Q

What is delayed union?

A

Healing is prolonged, but callus is visibe

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11
Q

What is malunion?

A

Failure to reestablish normal form and function

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12
Q

What are the two types of nonunion?

A

Viable

Nonviable

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13
Q

What is viable nonunion?

A

Active fx with cartilage and fibrous tissue between fx ends

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14
Q

What is a nonviable nonunion?

A

Fracture ends are sclerotic with rounded bone edges and visible fracture gap

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15
Q

What are 4 types of “fracture disease”?

A

Joint stiffness
Musclecontracture/scarring
Disuse osteoporosis
Ligamentous laxity

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16
Q

What is quadriceps contracture?

A

Often irreversible replacement of muscle fibers by fibrous tissue, severe decrease in limb mobility

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17
Q

What 4 things can share quadriceps contracture as a complication?

A

Distal femoral fractures
Young patients
Prolonged immobilization
Extensive muscle/ST trauma

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18
Q

What are 4 clinical signs of quadriceps contracture?

A

Tight band at level of quad
Extension of tarsus and stifle with major decrease in ROM
Muscle atrophy
Difficulty ambulating on limb

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19
Q

What are 3 ways to prevent quadriceps contracture?

A

Use stable, rigid fixation to promote early limb use
Passive range of motion
NSAIDs

NOTE: Prevention is IMPERATIVE, treatment rarely successful

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20
Q

What is the prognosis for quadriceps contracture?

A

Poor for full fxn

Guarded for partial fxn

21
Q

What is disuse osteoporosis?

A

Decrease in stress application to the bone = increased osteoclast activity… Wolff’s Law

22
Q

When do we see muscle atrophy?

A

Secondary to disuse or immobilization

23
Q

Is muscle atrophy permanent or reversible?

A

Reversible, can take a long time though

24
Q

What is ligamentous laxity?

A

Loose ligaments and joint instability associated with muscle atrophy

25
Q

How can ligamentous laxity be fixed?

A

Should resolve with improved muscle tone

26
Q

What is cartilage atrophy?

A

Atrophy of cartilage after prolonged immobilization of a joint

27
Q

What is digital flexor contracture?

A

Associated with improper casting/splinting of the elbow/antebrachial fx

28
Q

How do you prevent digital flexor contracture?

A

Lumb must be in weight-bearing position

29
Q

What is a fracture associated sarcoma associated with?

A

Severe inflammation

30
Q

What are 3 causes of severe inflammation that might result in a fracture associated sarcoma?

A

Comminuted fx
History of complications
Implant corrosion

31
Q

What are 4 types of primary bone neoplasia?

A

Osteosarcoma
Chondrosarcoma
Fibrosarcoma
Hemangiosarcoma

32
Q

What are 2 types of metastatic bone neoplasia?

A

Multiple myeloma

Lymphoma

33
Q

What are the 2 common types of digital tumor in a dog?

A

SCC

Melanoma

34
Q

What are the 5 common types of digital tumor in a cat?

A 
SCC
FSA
AdCa
OSA
HSA
35
Q

What constitutes 85% of canine skeletal tumors?

A

Osteosarcoma

36
Q

Who is predisposed to OSA?

A

Large and giant breed dogs 18-24 months of age or ~7years (Bimodal age distribution)

37
Q

What is the most common site for OSA

A

Appendicular skeleton, with predilection for metaphyseal region of long bones

NOTE: Away from the elbow, towards the knee

38
Q

What does the hx look like with OSA?

A

Chronic, progressive lameness (pathologic fx may result in acute and severe worsening of lameness)
May respond to pain management (pathologic fx may present response)

39
Q

What will exam findings be with OSA?

A

Pain +/- swelling on palpation of affected area

Disuse muscle atrophy

40
Q

What are 4 major radiographic changes you’ll see with osteosarcoma?

A

Cortical lysis
Periosteal reaction
Mineralization of soft tissue
Lack of distinct border

41
Q

What is the gold standard for diagnosing OSA?

A

NOTE: Be sure to take multiple samples from center of the mass

42
Q

What is often present in most patients at time of initial diagnosis?

A

Micromets (seen in lung, other bones and LNs)

43
Q

What 3 things should staging of OSA include?

A

3 view RADs or CT (CT is better)
Aspiration of any enlarged LNs
CBC/Chem/UA (Increased ALKP = poorer prognosis)

44
Q

What 3 things does palliative OSA treatment include?

A

Pain mangement
Bisphosphenates (inhibit osteoclasts)
Radiation (helps with pain management)

45
Q

Does amputation help mean survival time with OSA?

A

Not really, 3-4 months

46
Q

How much does amputation and chemo help OSA survival times?

A

MST increases to ~9-12 months

47
Q

What is a limb sparing surgery?

A

Local removal of OSA with wide margins, then bone replaced (allograft, autograft, prosthesis, regenerated bone)

48
Q

What lesion has the best outcome for limb sparing surgery?

A

Distal radial lesion

Small Animal Surgery (13 decks)

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