Bone and Joint Disease

Question 1

What is nutritional osteodystrophy?

Answer 1

• Normally young dogs or cats on all meat diets
• Lameness, pain and difficulty standing
• Radiography shows poor mineralisation
• Thin cortices
• Often folding fractures
• Treatment: put on adequate diet

Question 2

How does a short ulna occur?

Answer 2

• Ulnar growth plate becomes damaged
• radius continues to grow
• leg is deviated- carpal valgus

Question 3

What is patellar luxation?

Answer 3

Patella luxates medially or laterally
* Graded I-IV
* Both bone and joint disease

Question 4

How might you treat Nutritional metabolic hypervitaminosis A?

Answer 4

Cats fed exclusively on liver
* Presentation-stiff neck
* Extensive vertebral exostoses on cervical spine
* Treatment-removal of liver from the diet
* Some cats do not recover

Question 5

How might you treat metabolic-renal hyperparathyroidism?

Answer 5

Renal hyperparathyroidism
* Diseased Kidney cannot excrete phosphate
* Parathyroid stimulation leads to bone demineralisation
* Bones of the skull become soft
* Most commonly toy breeds
Treatment of underlying renal disease
Prognosis may be poor

Question 6

What causes osteomyelitis?

Answer 6

Can be caused by haematogenous spread
* Most commonly following fracture repair
* May see pain, lameness, swelling sinus tracts
Treatment-may involve implant removal/replacement and antibiotics

Question 7

What is the most common bone neoplasia?

Answer 7

most commonly osteosarcoma

Question 8

How might you treat an osteosarcoma?

Answer 8

Treatment-amputation and chemotherapy
Possibly limb sparing
Prognosis-usually poor in dogs
Metastasis less common in cats

Question 9

What is Maries disease?

Answer 9

Associated with a mass in the Chest
* Periosteal Reaction of Distal Bones
* Normally metacarpals and metatarsals
* If mass is removed then bony lesions improve
* Causes lameness and pain

Question 10

What kinds of dogs does craniomandibular osteopathy effect?

Answer 10

• Small dogs
• WHWT
• they may be unable to open their jaw

Question 11

What kind of dogs are affected by hypertrophic osteodystrophy?

Answer 11

Large breed dogs 4-6 months
* Also called metaphyseal osteopathy
* Pain at metaphysis
* Dogs may be unwell, pyrexic
* Radiographic changes around the metaphysis
* Causes proposed Vitamin C Deficiency, CDV
* Treatment-most patients recover with supportive care

Question 12

What kinds of dogs are affected by panosteitis?

Answer 12

• Usually affects German Shepherd Dog
• 5-12 months
• Often present unwell-pyrexic
• Improve with NSAIDS
• Return shortly after lame on another leg
• Radiography shows opacity inside the joint

Question 13

Name 5 ways you might be able to diagnose a bone disease

Answer 13

1. Radiography
2. Ultrasound
3. CT
4. MRI
5. Scintigraphy

Question 14

When might you perform a bone biopsy?

Answer 14

• Performed when lesions require histological characterisation or culture and
• sensitivity testing
• Provide definitive diagnosis when neoplasia is suspected
• determine prognosis
• formulate a treatment plan
• Osteomyelitis
• Culture and sensitivity help to guide treatment and antimicrobial
• choice
• Sample the centre of the lesion and transitional zone between normal and
  abnormal bone

Question 15

What animals are most likely to have osteoarthritis?

Answer 15

older animal
* gradual onset
* lameness mild to moderate to severe depending on stage of disease lamenessmay improve with
exercise
* reduced ROM and bony changes may be palpable in advanced cases

Question 16

What is developmental patellar luxation?

Answer 16

Stifle extensor mechanism-quadriceps, patella, patellar tendon

Question 17

What is a grade 1 patellar luxation?

Answer 17

Patella can be manually luxated but returns to normal position when released

Question 18

What is a grade 2 patellar luxation?

Answer 18

Patella luxates with stifle flexion or manual manipulation and remains luxated until stifle extension or manual replacement

Question 19

What is a grade III patella luxation?

Answer 19

Patella luxates continually. It can be replaced but reluxates spontaneously when manual pressure is removed

Question 20

What is a grade IV patella luxation?

Answer 20

Patella luxated continually and cannot be replaced

Question 21

What is osteoarthritis?

Answer 21

• Disease of the articular cartilage
• although many components contribute to disease progression and clinical signs

Question 22

What is the pathophysiology of osteoarthritis?:

Answer 22

• Inflammatory process begins in the synovium
• Initiates a cascade of inflammatory mediators
• Domino effect of infammatory process into secondary tissues
• These in turn release inflammatory mediators
• Enzymatic degredation of the cartilage

Question 23

What is the inflammatory response from septic arthritis?

Answer 23

Inflammatory response
– Vasodilation and influx of neutrophils
– Release of inflammatory cytokines/enzymes

Question 24

What is the effect of the fibrin clot from septic arthritis?

Answer 24

Fibrin clot traps bacteria
– Protect the bacteria
– Reduce synovial nutrient exchange

Question 25

What is the overall pathogenesis of septic arthritis?

Answer 25

Cartilage destruction and extension to subchondral bone
* Results in PAIN and swelling of the affected joint
* ➔Ultimately can result in degenerative osteoarthritis

Question 26

What is the normal appearance of synovial fluid?

Answer 26

Pale yellow/transparent, high viscosity
* Low in white bloods cells and total protein

Question 27

What is an abnormal appearance of synovial fluid?

Answer 27

Serosanguinous/turbid/reduced viscosity
* High white blood cells and total protein
* >90 % Neutrophils

Question 28

How might you diagnose joint disease?

Answer 28

Arthroscopy
* Allows direct visualisation of the joint
* Diagnostic and therapeutic
* Commonly used for diagnosis and treatment of elbow diseas

Question 29

How might you manage joint disease?

Answer 29

Provide analgesia
* Control articular inflammation
* Limit damage to the articular cartilage
* Promote healing
* Improve quality of life