2- Investigation and management of the juvenile lame animal

Question 1

Describe osteochondrosis

Answer 1

very common developmental condition of the articular cartilage

Question 2

what is osteochondrosis dissecans

Answer 2

when a flap of cartilage is formed

Question 3

where does osteochondrosis most commonly occur

Answer 3

elbow - very common - guarded prognosis

Question 4

What is elbow dysplasia

Answer 4

is a broad term that encompasses all manifestation of osteochondrosis seen in the elbow

Question 5

when does elbow dysplasia tend to occur

Answer 5

insidious onset at 5-7 months

Question 6

List the clinical signs associated with elbow osteochondrosis

Answer 6

history of chronic lameness worse on rising
hold the limb abducted and externally rotated
pain on flexion
joint effusion
pain on mainpulation

Question 7

what radiographic signs are seen in early cases of elbow dysplasia

Answer 7

may show minimal to no signs

Question 8

What do you see on radiograph with fragmented medial coronoid

Answer 8

early degenerative changes to the joint but rarely is the primary lesion seen

Question 9

what do we tend to see on radiograph with Osteochondrosis of the medial humeral condyle

Answer 9

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

Question 10

What do we see on radiograph with ununited anconeal process

Answer 10

fully flexed mediolateral view. Note this condition is a failure of ossification of the growth plate

Question 11

Describe arthroscopy

Answer 11

It involves the placement of cameras and instruments into the joint whilst it is inflated by a saline solution

Question 12

Describe conservative management of fragmented coronoid process

Answer 12

weight control
NSAIDs
cartrophen
platelet rish plasma
nutraceuticals

Question 13

Describe surgical management of fragmented coronoid process

Answer 13

removal of fragment +/- ulna osteotomy to correct joint incongruency
may improve in short term but long term does not reduce pathology

Question 14

what is the prognosis of fragmented coronoid process

Answer 14

guarded - irrespective of the technique

Question 15

Describe how osteochondrosis dessicans is managed

Answer 15

generally sugically
Remove fragment and curette deficit

Question 16

where does osteochondrosis dessicans occur in the elbow

Answer 16

exclusively on the medial condyle

Question 17

What is prognosis of osteochondrosis dessicans

Answer 17

fair

Question 18

Describe surgical management of ununited anconeal process

Answer 18

1. remove fragment-
2. reattachment of fragment with screw
3. Reattachment fragment and ulna osteotomy to lengthen the ulna
   Results of these techniques are variable

Question 19

Describe how to prevent elbow dysplasia

Answer 19

BVA kennel club elbow dysplasia scheme - breeding discouraged from any animal with a score greater than 0

Question 20

Describe signalment of shoulder osteochondrosis

Answer 20

Labrador or border collie
6-8 months

Question 21

List 4 things seen with shoulder osteochondrosis

Answer 21

Lame on rising
Worse after exercise
Pain on shoulder extension
Scapular muscle atrophy

Question 22

Describe surgical management of shoulder osteochondrosis

Answer 22

Remove the fragment and debride the deficit edges
OR
limited caudal arthrotomy

Question 23

Describe conservative management of shoulder osteochondrosis

Answer 23

vigorous exercise with analgesia to dislodge the flap

Question 24

what is the prognosis of shoulder osteochondrosis

Answer 24

best prognosis of all joints affected by this condition

Question 25

Describe the signalment of stifle osteochondrosis

Answer 25

6-12 months
Labrador retriever
Staffordshire bull terrier

Question 26

List 3 clinical signs of osteochondrosis of the stifle

Answer 26

Chronic lameness especially on rising
Joint pain
Joint effusion

Question 27

Describe the radiographic changes seen with stifle osteochondrosis

Answer 27

1. Flattened condyle on mediolateral view
2. Deficit to either the medial or the lateral femoral condyle on the caudocranial view

Question 28

Describe how to treat stifle osteochondrosis

Answer 28

generally surgical management

Question 29

What is the prognosis of stifle osteochondrosis

Answer 29

fair to guarded

Question 30

Describe the signalment of hock osterochondrosis

Answer 30

Labradors and Rottweilers
6-12 months old

Question 31

List 2 clincal signs of hock osteochondrosis

Answer 31

Lameness particularly after exercise
Joint effusion to both medial and lateral aspects of talocrural joint

Question 32

What is seen on radiographs with hock osteochondrosis

Answer 32

Widened joint space
Flattened aspect of the caudal trochlea
Sclerosis of the subchondral bone
Secondary arthritic changes

Question 33

Describe surgical management of hock osteochondrosis

Answer 33

1. Removal of the osteochondral fragment either arthroscopically or with an open arthrotomy
2. Salvage procedure:- pantarsal arthrodesis- fuse the joint

Question 34

Describe the prognosis of hock osteochondrosis

Answer 34

guarded to poor

Question 35

What can occur in Lumbosacral osteochondrosis

Answer 35

instability and disc extrusion/ protrusion and back pian