Ch. 14 Hip and Pelvis

Question 1

If a pelvis is tilted laterally, which side is the one that has a largeer obturator foramen - the one closest to the table or the one furthest from the table?

Answer 1

The one closest to the table

It will also have a thinner acetabulum / iliac wing

Question 2

Properly positioned patellae will result in the projected angle of the femoral neck to the shaft being about ____ degrees.

Answer 2

135

Question 3

Criteria for VD hip radiographs considered straight:

Answer 3

Question 4

Answer 4

Black arrowheads: Circumferential femoral head osteophyte at the joint capsule
White arrowheads: Caudolateral curvilinear osteophyte at the trochanteric fossa

CHECK THIS, previously says that Morgan line is at the joint capsule?

Question 5

What is this view?

Answer 5

Inlet view, also known as the ventrocranial–dorsocaudal (V20°Cr-DCd) view

Question 6

What is this view?

Answer 6

outlet view, also called the ventrocaudal–dorsocranial (V20°Cd-DCr) view

Question 7

What is the outlet view? Is it helpful?

Answer 7

In a comparative study, the inlet and outlet views did not provide significant additional information to standard radiographs, but previously undetected fractures were visible on the inlet view. In patients with pelvic trauma, the inlet view may complement the standard radiographic examination.

So, outlet - not helpful, as an addition to normal rads.

Question 7

What is the inlet view? Is it helpful?

Answer 7

In a comparative study, the inlet and outlet views did not provide significant additional information to standard radiographs, but previously undetected fractures were visible on the inlet view. In patients with pelvic trauma, the inlet view may complement the standard radiographic examination.

Question 8

Which of these views is not helpful for identifying joint laxity?

1) DAR
2) Fluckiger
3) PennHIP

Answer 8

1) DAR

Question 9

Which view is this?

Answer 9

DAR

Question 9

Which view is this?

Answer 9

PennHIP

Question 10

Normal hips are considered those where the Norberg angle is greater than ______°

Answer 10

105°, although in some chondrodystrophic breeds this angle is generally smaller.
This angle is of little diagnostic value in animals younger than five months because the radiolucent cartilage of the dorsal acetabular rim in such animals has not yet been ossified, which could lead to a false calculation.

https://hjcam.hcavs.gr/en/v5-i1-canine-hip-dysplasia

Question 10

Which of these is in sternal and which is in dorsal recumbency?

• DAR
• Fluckiger
• PennHIP

Answer 10

• DAR - STERNAL
• Fluckiger - DORSAL
• PennHIP - DORSAL

Question 11

The Norberg angle is of little diagnostic value in __________________ because ________________.

Answer 11

animals younger than five months

the radiolucent cartilage of the dorsal acetabular rim in such animals has not yet been ossified, which could lead to a false calculation

https://hjcam.hcavs.gr/en/v5-i1-canine-hip-dysplasia

Question 12

This would be used for ..?

Answer 12

calculating a distraction index (DI)

Question 13

Which type of stress does the Fluckiger view use?

Answer 13

A movement similar to the Ortolani manouevre, Manual displacement of the femoral heads in a craniodorsal and lateral direction during pelvic radiography.

Question 13

How is the PennHIP DI calculated?

Answer 13

Distance between Femoral head centre to acetabular centre, divided by femoral head radius

Question 14

The acetabulum ossifies: (when)

Answer 14

6-8 weeks after birth

Question 14

Which ligament attaches the femur to the acetabulum?

Answer 14

Round ligament

“Extending from the fovea on the femoral head to the centre of the acetabular fossa is the round ligament, which attaches the femur to the acetabulum.”

Question 15

What is the SI cutoff in Fluckiger views for normal/mildly displastic?

Answer 15

92% per cent of the hips of dogs with an SI of **0.3 or less were classified as normal, borderline or mildly dysplastic (FCI HD grades A to C1).
SI value ** 0.3 and 0.5 : graded from normal to severely dysplastic.
SI value greater than 0.5: were 95% severely dysplastic (FCI HD grades C to E).

The Flückiger technique may help to identify cases of HD where hip conformation is unremarkable, second- ary degenerative changes have not yet developed, and laxity is the major issue.

Question 16

Physeal closure time in dogs of the acetabulum:

Answer 16

4-6 months

Question 16

What is this and who is more commonly affected by this?

Answer 16

Text: A smaller os coxa quartum, representing an apophysis, may develop as part of the craniodorsal acetabular rim. It is more commonly present in larger-breed dogs.

Caption: Illustration of an ossicle on the dorsal acetabular rim.

Question 17

What is the transverse acetabular ligament?

Answer 17

The trans- verse acetabular ligament represents the continuation of the fibrocartilage that encircles the acetabulum and covers the ventral aspect of the femoral head. It increases the circular restraint of the joint.

Question 18

Physeal closure time in dogs of the pelvic symphysis:

Answer 18

4-5 months

Question 19

Physeal closure time in dogs of the trochanters (both greater and lesser): What about cats?

Answer 19

9-12 months

Question 19

Physeal closure time in dogs of the iliac crest:

Answer 19

24-36mo (OR NEVER)

Question 19

Physeal closure time in dogs of the ischial tuberosity:

Answer 19

10-12 months

Question 20

Answer 20

gas-filled anal gland sacs

Question 20

Physeal closure time in dogs of the femoral head:

Answer 20

most breeds - by 8 months giant breeds - 11 months

Question 21

cat

Answer 21

** avulsion fracture of the round ligament** (confirmed at surgery) and dorsocranial luxation of the femoral head. The arrows indicate the fracture bed and arrowheads the avulsed fragment.

Question 21

What is the earliest radiographic sign of avascular necrosis of the femoral head?

Answer 21

Widened joint space, due to a thickened cartilage.

Question 21

dog

Answer 21

pseudoarthosis formation after chronic luxation of the right femoral head. Findings to note: - malformed femoral head - new bone on the ilial body - filling up of the acetabulum with new bone formation

Question 22

Answer 22

Caption: mineralized bodies (bursitis calcarea) in the tendon of the iliopsoas muscle (white arrow) and in the tendon of the psoas minor adjacent to the iliopectineal eminence (black arrow)

Question 22

The most common vertebral anomaly in cats is a transitional vertebra at ____________.

Answer 22

the sacrocaudal junction

Question 22

Typical signalment for this condition?

Answer 22

Young toy and small-breed dogs autosomall recessive inheritance in terrier (e.g. WHWT)

Question 22

Answer 22

dog with bilateral mineralization of the gluteal tendons (bursitis calcarea) (arrowed)

Question 22

Legg Calve Perthe's disease is usually unilateral/bilateral.

Answer 22

Unilateral in up to 90% of cases

Question 23

toy breed dog

Answer 23

advanced left-sided **avascular femoral head necrosis** Note the severe deformation and heterogeneous *osteolytic* areas of the left femoral head, secondary remodelling of the acetabulum and disuse *muscle atrophy*. Secondary *coxa vara* and a *widened joint space* are also present.

Question 23

cat

Answer 23

cat with severe metaphyseal osteopathy. There is bilateral extensive irregular lysis of the proximal femoral metaphyses.

Question 23

Findings associated with feline capital physeal dysplasia?

Answer 23

- Delayed physeal closure (also widening of the physis) - Lysis and remodeling of the neck > secondary fractures - Sclerosis of the epiphysis https://journals.sagepub.com/doi/10.1177/1098612X15598551 "Slipped capital femoral epiphysis in 17 Maine Coon cats"

Question 23

Which modality is one of the most sensitive for detecting Legg Calve Perthe's disease and how does this appear?

Answer 23

MRI of the femoral head: T1w: hypointense (compared with surrounding musculature) T2w: heterogenous Post T1w: heterogenous enhancement

Question 24

Put these in the correct choronological order: * femoral head collapses * heterogeneity of the proximal femoral epiphysis with areas of decreased and increased bone opacity * coxa vara * widened joint space * degenerative joint disease

Answer 24

1. widened joint space 2. heterogeneity of the proximal femoral epiphysis with areas of decreased and increased bone opacity Then, probably simultaneously: 3. femoral head collapses 4. degenerative joint disease 5. coxa vara

Question 25

Typical signalment of feline capital metaphyseal osteopathy?

Answer 25

young, male, neutered, overweight

Question 26

What would a flexed VD add to an assessment of a cat with capital metaphyseal osteopathy?

Answer 26

If there were a fracture, you could determine whether the greater and lesser trochanters were involved.

Question 27

Which dog breeds are predisposed to SCFE? cats?

Answer 27

Labradors Shetland Sheepdog Maine Coon

Question 28

11m Bull Terrier

Answer 28

bilateral metaphyseal sclerosis and femoral neck lysis. Diagnosis was bilateral SCFE

Question 29

What are some differences between SCFE and Legg-Calves-Perthe's?

Answer 29

SCFE/physeal dysplasia is more often bilateral, and affects the physis and metaphysis, with epiphyseal sclerosis. Earliest sign: widened physes. Signalment: Labrador, Sheltie, Maine Coon (young, male, neutered, overweight) LCP is usually (90%) unilateral, and affects the femoral head. Earliest sign: the joint space/cartilage is thicker. Signalment: small/toy breeds, terriers

Question 30

11m Bull Terrier with progressive non-weight-bearing lameness of the right limb over 3 weeks

Answer 30

There is bilateral metaphyseal sclerosis and femoral neck lysis. Diagnosis was bilateral SCFE with pathological fracture of the right femoral neck.

Question 31

Answer 31

Morgan line / CCO Caudolateral Curvilinear Osteophyte = caudal aspect of the femoral neck where joint capsule inserts CFHO Circumferential femoral head osteophyte = cranial (? circumferential) femoral head where joint capsule inserts

Question 32

What is the Norberg angle used for?

Answer 32

* Measure the degree of hip joint laxity * Score coxofemoral dysplasia * Determine the hip status of a dog (normal or dysplastic)

Question 33

What position /projection is needed to calculate the Norberg angle?

Answer 33

VD with femurs extended and parallel

Question 34

How is the Norberg angle calculated?

Answer 34

Two lines: 1. Line joining the centres of the femoral heads 2. Line extending from the femoral head centre to the craniolaterael aspect of the acetabulum

Question 35

As the femoral head subluxates, the Norberg angle ___________.

Answer 35

decreases

Question 36

There is a positive correlation between reduced Norberg angles and development of OA - T or F?

Answer 36

True

Question 37

Which breed type might have a decreased Norberg angle but normal hip joints?

Answer 37

small and miniature dog breeds

Question 38

WHat is the minimum age for PennHIP scoring?

Answer 38

16 weeks

Question 39

Normal or abnormal PennHIP assessment?

Answer 39

Abnormal, showing moderate subluxation in the distraction view.

Question 40

Normal or abnormal (GSD)

Answer 40

Broomstick conformation: this femoral head conformation may be seen especially in German Shepherd Dogs. The slender femoral neck merges without clear demarcation with the smaller femoral head. Although this conformation may be inherited it is not correlated with dysplasia and should therefore be regarded as a normal variant.

Question 41

Normal or abnormal in a Rottweiler?

Answer 41

Plump conformation: in contrast to broomstick confirmation (GSDs), dogs of some breeds (e.g. Rottweilers) show a plump conformation of the head without signs of dysplasia.

Question 42

In which dogs is a subtle Morgan's line often visible in normal joints?

Answer 42

Large or heavy dogs

Question 43

The Morgan line is associated with?

Answer 43

It is an enthesophyte (where the joint capsule inserts on the caudal aspect of the femoral head). It is correlated with a higher incidence of DJD later in life. It is also called CCO or Caudolateral curvilinear osteophyte.

Question 44

What is the puppy line? At what age is it relevant?

Answer 44

Puppy line: in young dogs, a thin straight line can be visible in the region of the Morgan’s line. This so-called puppy line disappears at the age of approximately 18 months. Image: arrow shows puppy line. Asterisk shows metaphyseal sclerosis. https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1740-8261.2009.01509.x?saml_referrer

Question 45

What is a normal Norberg angle in a cat?

Answer 45

95'

Question 46

How does a DI in cats compare to dogs?

Answer 46

Larger in cats, <0.4 can be normal, non-degenerative

Question 47

What is the DI cut-off for cats?

Answer 47

0.6

Question 47

What is the Norberg angle cutoff for cats?

Answer 47

<84'

Question 48

Where does osteochondroma affect cats more commonly than dogs?

Answer 48

Pelvis

Question 49

Answer 49

Metastasis of prostatic carcinoma to the sacrum as evidenced by lysis of the right side of the sacrum.

Question 50

Answer 50

Chondrosarcoma of the caudal pubis and ischium.

Question 51

Answer 51

4-month-old Persian kitten with mucopolysaccharidosis. Characteristic radiographic findings are dysplastic changes of all epiphyses, irregularly widened acetabula and bilateral coxofemoral subluxation (mimicking HD) with radiolucencies in the femoral necks. The caudal lumbar vertebrae are widened as a result of caudal beaking and foreshortening.