Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Locomotion > 1.8 Degenerative Joint Disease > Flashcards

1.8 Degenerative Joint Disease Flashcards

1
Q

What is degenerative joint disease?

in simple terms

A

the end-stage of several different joint diseases in which progressive inflammation results in cartilage degradation

  • one of the most common orthopedic conditions seen in practice
  • incurable, but temorally manageable
  • inflammatory process, thus nearly all treatments are anti-inflammatory in nature
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Joint anatomy reference.

A
  • synoviocytes (type A and type B)
  • cartiliage matrix: 75% water, 15% type II colagen, 8% proteoglycans, 2% chondrocytes, < 1% elastic and reticular fibers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What common conditions can causes DJD?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Progression of DJD to osteoarthrosis (bone changes) reference.

A

Note: in the later stages of DJD, bone changes can be seen (bone lysis, new bone formation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the inflammatory cascade that leads to DJD?

A

complex and multifactorial process in which many inflamatory mediators are released from the soft tissue and bone

(2) Do not need to memorize this picture: just know that it is an INFLAMMATORY process, and thus all treatments aim to reduce this inflammation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is true about DJD and pain?

A

there are no pain receptors in articular cartilage, but there are within the joint capsule and subchondral bone

  • synovitis and joint distention are painful
  • exposure of the subchondral bone is painful
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What can synovial fluid analysis show in DJD?

A

while it can be useful in small animals (never LA), synovial fluid values can be very similar despite disease

  • we mostly only tap a joint to rule out infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What can radiographic analysis show in DJD?

A

radiographic findings correlate poorly with clinical signs in DJD

  • must take a thourough history and perform a physical exam to look for evidence of clinical DJD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do you look for on physical exam to identify DJD?

A
  • assess weight and body condition (major predisposing factor in DJD)
  • perform a lameness exam (identify lameness, score 1-10, localize, palpate and manipulate joint for heat/swelling/effusion/thickening and/or reduced ROM)
  • assess for muscular atrophy
  • intra-articular analgesia as a diagnostic tool (more specific than a peripheral nerve block)
  • synovial fluid analysis
  • radiography / US / MRI / CT (bone changes, effusion)
  • arthroscopy (visual assessment and biopsy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you treat DJD?

A
  1. weight control and exercise modification
  2. strategic analgesia (achieve comfort dueing exercise)
  3. anti-inflammatories: NSAIDs and corticosteroids
  4. joint supplements / nutraceuticals
  5. novel and emerging treatments
  6. salvage procedures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the most common medication for orthopedic problems in the horse (like DJD)?

A

NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the most common NSAIDs used in horses with DJD?

A
  1. phenylbutazone (most commonly used in horses)
  2. suxibuzone (derivative of phynylbutazone)

note: meloxicam and flunixin are more effective at reducing the inflammation than pain: more commonly used for soft tissue inflammation than DJD

all others are less commonly used or are expensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do intraarticular corticosteroids influence DJD progression?

A

most potent anti-inflammatory drug

  • inhibit prostaglandin, cytokine, and MMP (cartillage degrading enzyme: matrix metalloproteinases) synthesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the side effects of intraarticular corticosteroid use in horses for the treatment of DJD?

A

“very often the risks outweigh the reward”

  • negative effects on cartillage metabolism and healing
  • risk of iatrogenic joint infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are two supportive drugs for the treatment of equine DJD?

A
  1. glycosaminoglycans (GAGs): MMP inhibition, HA production stimulation, matrix synthesis
  2. sodium hyaluronate: structural component of articular cartillage matrix, confers viscoelasticity, anti-inflamatory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What supplements (PO) exist for equine DJD?

A

(1) matrix GAGs

(2) green-lipped mussel extract

  • anti-inflammatory

(3) methylsulphonylmethane (MSM)

  • sulphur source

(4) devil’s claw

  • anti-inflammatory
17
Q

What are the “other” treatments of equine DJD?

A
  1. IL receptor antagonist protein (IA injection): key inflammatory mediator in DJD
  2. tiludronate: inhibits bone resorption, anti-inflammatory
  3. clodronic acid: similar to tildren, with less side effects
  4. polyacrylamide hydrogel: inert, synthetic cushioning
  5. platelet-rich plasma / mesenchymal stem cells: little evidence
18
Q

What surgical treatments exist for equine DJD?

A

arthrodesis or facilitated ankylosis (salvage procedures)

note: facilitated ankylosis refers to a medical fusion and thus is different from arthrodesis, or surgical fusion, of two or more bones into a single structure

Locomotion (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions