2- Investigation and management of the juvenile lame animal Flashcards
Describe osteochondrosis
very common developmental condition of the articular cartilage
what is osteochondrosis dissecans
when a flap of cartilage is formed
where does osteochondrosis most commonly occur
elbow - very common - guarded prognosis
What is elbow dysplasia
is a broad term that encompasses all manifestation of osteochondrosis seen in the elbow
when does elbow dysplasia tend to occur
insidious onset at 5-7 months
List the clinical signs associated with elbow osteochondrosis
history of chronic lameness worse on rising
hold the limb abducted and externally rotated
pain on flexion
joint effusion
pain on mainpulation
what radiographic signs are seen in early cases of elbow dysplasia
may show minimal to no signs
What do you see on radiograph with fragmented medial coronoid
early degenerative changes to the joint but rarely is the primary lesion seen
what do we tend to see on radiograph with Osteochondrosis of the medial humeral condyle
small deficit seen on the medial condyle. The mineralised cartilage flap can occasionally be seen and there are associated degenerative changes to the the joint
What do we see on radiograph with ununited anconeal process
fully flexed mediolateral view. Note this condition is a failure of ossification of the growth plate
Describe arthroscopy
It involves the placement of cameras and instruments into the joint whilst it is inflated by a saline solution
Describe conservative management of fragmented coronoid process
weight control
NSAIDs
cartrophen
platelet rish plasma
nutraceuticals
Describe surgical management of fragmented coronoid process
removal of fragment +/- ulna osteotomy to correct joint incongruency
may improve in short term but long term does not reduce pathology
what is the prognosis of fragmented coronoid process
guarded - irrespective of the technique
Describe how osteochondrosis dessicans is managed
generally sugically
Remove fragment and curette deficit
where does osteochondrosis dessicans occur in the elbow
exclusively on the medial condyle
What is prognosis of osteochondrosis dessicans
fair
Describe surgical management of ununited anconeal process
- remove fragment-
- reattachment of fragment with screw
- Reattachment fragment and ulna osteotomy to lengthen the ulna
Results of these techniques are variable
Describe how to prevent elbow dysplasia
BVA kennel club elbow dysplasia scheme - breeding discouraged from any animal with a score greater than 0
Describe signalment of shoulder osteochondrosis
Labrador or border collie
6-8 months
List 4 things seen with shoulder osteochondrosis
Lame on rising
Worse after exercise
Pain on shoulder extension
Scapular muscle atrophy
Describe surgical management of shoulder osteochondrosis
Remove the fragment and debride the deficit edges
OR
limited caudal arthrotomy
Describe conservative management of shoulder osteochondrosis
vigorous exercise with analgesia to dislodge the flap
what is the prognosis of shoulder osteochondrosis
best prognosis of all joints affected by this condition
Describe the signalment of stifle osteochondrosis
6-12 months
Labrador retriever
Staffordshire bull terrier
List 3 clinical signs of osteochondrosis of the stifle
Chronic lameness especially on rising
Joint pain
Joint effusion
Describe the radiographic changes seen with stifle osteochondrosis
- Flattened condyle on mediolateral view
- Deficit to either the medial or the lateral femoral condyle on the caudocranial view
Describe how to treat stifle osteochondrosis
generally surgical management
What is the prognosis of stifle osteochondrosis
fair to guarded
Describe the signalment of hock osterochondrosis
Labradors and Rottweilers
6-12 months old
List 2 clincal signs of hock osteochondrosis
Lameness particularly after exercise
Joint effusion to both medial and lateral aspects of talocrural joint
What is seen on radiographs with hock osteochondrosis
Widened joint space
Flattened aspect of the caudal trochlea
Sclerosis of the subchondral bone
Secondary arthritic changes
Describe surgical management of hock osteochondrosis
- Removal of the osteochondral fragment either arthroscopically or with an open arthrotomy
- Salvage procedure:- pantarsal arthrodesis- fuse the joint
Describe the prognosis of hock osteochondrosis
guarded to poor
What can occur in Lumbosacral osteochondrosis
instability and disc extrusion/ protrusion and back pian