Ch. 14 Hip and Pelvis Flashcards
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?
The one closest to the table
It will also have a thinner acetabulum / iliac wing
Properly positioned patellae will result in the projected angle of the femoral neck to the shaft being about ____ degrees.
135
Criteria for VD hip radiographs considered straight:
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?
What is this view?
Inlet view, also known as the ventrocranial–dorsocaudal (V20°Cr-DCd) view
What is this view?
outlet view, also called the ventrocaudal–dorsocranial (V20°Cd-DCr) view
What is the outlet view? Is it helpful?
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.
What is the inlet view? Is it helpful?
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.
Which of these views is not helpful for identifying joint laxity?
1) DAR
2) Fluckiger
3) PennHIP
1) DAR
Which view is this?
DAR
Which view is this?
PennHIP
Normal hips are considered those where the Norberg angle is greater than ______°
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
Which of these is in sternal and which is in dorsal recumbency?
- DAR
- Fluckiger
- PennHIP
- DAR - STERNAL
- Fluckiger - DORSAL
- PennHIP - DORSAL
The Norberg angle is of little diagnostic value in __________________ because ________________.
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
This would be used for ..?
calculating a distraction index (DI)
Which type of stress does the Fluckiger view use?
A movement similar to the Ortolani manouevre, Manual displacement of the femoral heads in a craniodorsal and lateral direction during pelvic radiography.
How is the PennHIP DI calculated?
Distance between Femoral head centre to acetabular centre, divided by femoral head radius
The acetabulum ossifies: (when)
6-8 weeks after birth
Which ligament attaches the femur to the acetabulum?
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.”
What is the SI cutoff in Fluckiger views for normal/mildly displastic?
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.
Physeal closure time in dogs of the acetabulum:
4-6 months
What is this and who is more commonly affected by this?
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.
What is the transverse acetabular ligament?
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.
Physeal closure time in dogs of the pelvic symphysis:
4-5 months
Physeal closure time in dogs of the trochanters (both greater and lesser):
What about cats?
9-12 months
Physeal closure time in dogs of the iliac crest:
24-36mo (OR NEVER)
Physeal closure time in dogs of the ischial tuberosity:
10-12 months
gas-filled anal gland sacs
Physeal closure time in dogs of the femoral head:
most breeds - by 8 months
giant breeds - 11 months
cat
** 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.
dog
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
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)
The most common vertebral anomaly in cats is a transitional vertebra at ____________.
the sacrocaudal junction
Typical signalment for this condition?
Young toy and small-breed dogs
autosomall recessive inheritance in terrier (e.g. WHWT)
dog with bilateral mineralization of the gluteal tendons (bursitis calcarea) (arrowed)
toy breed dog
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.
cat
cat with severe metaphyseal osteopathy. There is bilateral extensive irregular lysis of the proximal femoral metaphyses.
Findings associated with feline capital physeal dysplasia?
- 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”
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
- widened joint space
- 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
11m Bull Terrier
bilateral metaphyseal sclerosis and femoral neck lysis. Diagnosis was bilateral SCFE
11m Bull Terrier with progressive non-weight-bearing lameness of the right limb over 3 weeks
There is bilateral metaphyseal sclerosis and femoral neck lysis. Diagnosis was bilateral SCFE with pathological fracture of the right femoral neck.
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
What is the Norberg angle used for?
- Measure the degree of hip joint laxity
- Score coxofemoral dysplasia
- Determine the hip status of a dog (normal or dysplastic)
How is the Norberg angle calculated?
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
There is a positive correlation between reduced Norberg angles and development of OA - T or F?
True
Which breed type might have a decreased Norberg angle but normal hip joints?
small and miniature dog breeds
WHat is the minimum age for PennHIP scoring?
16 weeks
Normal or abnormal PennHIP assessment?
Abnormal, showing moderate subluxation in the distraction view.
Normal or abnormal (GSD)
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.
Normal or abnormal in a Rottweiler?
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.
The Morgan line is associated with?
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.
What is the puppy line? At what age is it relevant?
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
What is a normal Norberg angle in a cat?
95’
How does a DI in cats compare to dogs?
Larger in cats, <0.4 can be normal, non-degenerative
What is the DI cut-off for cats?
0.6
What is the Norberg angle cutoff for cats?
<84’
Where does osteochondroma affect cats more commonly than dogs?
Pelvis
Metastasis of prostatic
carcinoma to the sacrum as evidenced by lysis of the right side of the sacrum.
Chondrosarcoma of the caudal pubis and ischium.
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.
