SA: Developmental Orthopedic Disease

Question 1

Hypertrophic Osteopathy

Answer 1

Diffuse periosteal reaction around distal bones associated with thoracic/abdominal mass

Question 2

Clinical Signs: Hypertrophic Osteopathy

Answer 2

Lethargy, anorexia, unwillingness to move and unspecific signs more common than lameness
Swollen, painful distal extremities

Question 3

Diagnosis: Hypertrophic Osteopathy

Answer 3

PE: abdominal palpation
U/s, thoracic and abdominal radiographs
Limb radiograps

Question 4

Answer 4

Hypertrophic osteopathy

Question 5

Pallisade formation

Answer 5

Hypertrophic osteopathy
Bilaterally symmetric periosteal reaction
Smooth/regular or rough/aggressive
Soft tissue swelling

Question 6

Etiology of Hypertrophic Osteopathy

Answer 6

Most commonly associated with pulmonary neoplasia but any mass can induce it

Question 7

Answer 7

Hypertrophic Osteopathy

Question 8

Answer 8

Hypertrophic Osteopathy

Question 9

Pathophysiology of Hypertrophic Osteopathy

Answer 9

Question 10

Treatment: Hypertrophic Osteopathy

Answer 10

Remove/treat primary lesion

Question 11

Developmental Orthopedic Disease

Answer 11

Caused by disturbances in the development and maturation of the musculoskeletal system, in particular of the articular and metaphyseal cartilage

Question 12

Answer 12

Ectrodactyly
Developmental orthopedic disease

Question 13

Osteochondrosis Dissecans

Answer 13

Disruption of endochondral ossification (due to rapid growth)
Causes pain, effusion, lameness, OA

Question 14

What 4 joints can be affected by OCD?

Answer 14

Shoulder
Elbow
Stifle
Tarsus

Question 15

Diagnosis: OCD

Answer 15

Shoulder: rads
Elbow/tarsus/stifle: CT

Question 16

Prognosis: OCD

Answer 16

Shoulder: excellent (esp caudal lesions)
Elbow/tarsus/stifle: fair to poor

Question 17

Answer 17

Shoulder OCD
Flattening of caudal humeral head

Question 18

Answer 18

Shoulder OCD
Flattening of caudal humeral head

Question 19

Treatment options for OCD

Answer 19

Question 20

Answer 20

Shoulder with OCD

Question 21

Hypertrophic osteodystrophy

Answer 21

‘Metaphyseal osteopathy’
Disruption of metaphyseal trabeculae in long bones of young, rapidly growing dogs

Question 22

Signalment: Hypertrophic osteodystrophy

Answer 22

3-6m
Giant/large breeds

Question 23

Clinical Signs: Hypertrophic osteodystrophy

Answer 23

Slight limb to nonweightbearing to recumbent
Swollen, hot, painful metaphysis (usually bilateral)
Episodic signs
Systemic illness

Question 24

Answer 24

Hypertrophic osteodystrophy

Question 25

Answer 25

Hypertrophic osteodystrophy

Question 26

Answer 26

Hypertrophic osteodystrophy

Question 27

Differentials: Hypertrophic osteodystrophy

Answer 27

Septic arthritis/panosteitis

Question 28

Pathogenesis: Hypertrophic osteodystrophy

Answer 28

Disturbance of metaphyseal blood supply Delayed endochondral ossification Retained cartilage Trabecular fracture causes lifting of the periosteum and new bone production (Codman's triangle)

Question 29

Treatment: Hypertrophic osteodystrophy (Mild)

Answer 29

Supportive: NSAIDs, GI protectants, rest

Question 30

Prognosis: Hypertrophic osteodystrophy (mild)`

Answer 30

Good to excellent Relapses may occur Angular limb deformities (recheck rads q2w!!)

Question 31

Treatment: Hypertrophic osteodystrophy (severe)

Answer 31

Enteral nutrition Antibiotics

Question 32

Prognosis: Hypertrophic osteodystrophy (severe)

Answer 32

Guarded to poor Long term support needed Angular limb deformities

Question 33

Signalment: Panoestitis

Answer 33

7-16m Large/giant breeds (GSD)

Question 34

Etiology: Panosteitis

Answer 34

Idiopathic Osseous compartment syndrome due to protein rich diet

Question 35

Clinical Signs: Panosteitis

Answer 35

**Acute shifting limb lameness** Pain with direct pressure over affected **diaphyseal** region Radius/ulna, then humerus, femur, tibia Intermittent fever, lethargy, anorexia

Question 36

Differentials: Panosteitis

Answer 36

Elbow/hip dysplasia

Question 37

Radiographs: Panosteitis

Answer 37

Increased radiolucency at nutrient foramen Unifocal increased intramedullary density Multiple, coalescing foci of increased radiodensities indistinct endosteal surfaces Mild periosteal reaction *At least 7 day lag behind clinical symptoms*

Question 38

Answer 38

Panosteitis

Question 39

Answer 39

Panosteitis

Question 40

Answer 40

Panosteitis

Question 41

Answer 41

Panosteitis

Question 42

Treatment: Panosteitis

Answer 42

Self-limiting Check diet NSAIDs

Question 43

Prognosis: Panosteitis

Answer 43

Excellent, but multiple bouts happen frequently

Question 44

Compare hypertrophic osteodystrophy, panosteitis, and hypertrophic osteopathy

Answer 44