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BSAVA MSK > Ch 15 Stifle > Flashcards

Ch 15 Stifle Flashcards

1
Q

What is this measuring?

A

tibial plateau angle

Stifle (neutral position) and hock (flexed) parallel to the table;
1st line: intercondylar eminence/tubercles to centre of talus
2nd line: 90’ to this line
3rd line (to create the angle): cranial to caudal tibial plateau

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2
Q

Non-ossification of the (medial/lateral) fabella can be an occasional finding in the (cat/dog).

A

medial, cat

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3
Q

Where does the long digital extensor tendon originate?

A

Extensor fossa, lateral femoral condyle

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4
Q

The extensor fossa is located?

A

Lateral femoral condyle

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5
Q

The extensor fossa is the origin of the __________________

A

long digital extensor tendon

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6
Q

The patella is within which tendon?

A

quadriceps femoris; insertion is in the trochlear groove.

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7
Q

Which sesamoid is more proximal - popliteal or fabellae?

A

fabellae - they are within the gastrocnemius muscle

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8
Q

What are the 4 sesamoids of the stifle and where are they located, from proximal to distal (approximately), and what is their medial/lateral location?

A

patella, central
fabellae, lateral and medial
popliteal, lateral

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9
Q

Patellar fractures in cats has which typical signalment?

A

Young cats, no other breed/sex predisposition

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10
Q

What is the etiology of spontaneous patellar fractures in cats?

A

unknown, potentially osteogenesis imperfecta, considering concurrent pathologies (deciduous teeth, other fractures) are common

https://www.vettimes.co.uk/article/patellar-fractures-in-cats/

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11
Q

PADS / spontaneous patellar fractures in cats, can be bilateral - what is the average time between fracture of first and second patella?

A

about 6 months

https://www.vettimes.co.uk/article/patellar-fractures-in-cats/

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12
Q

Which other fractures can occurs with the syndrome of patellar fractures (PADS)?

A

https://www.vettimes.co.uk/article/patellar-fractures-in-cats/

” Furthermore, a significant proportion of cases go on to develop spontaneous fractures of other bones, the most common being proximal tibia, lateral humeral condyle, and ischium/acetabulum”

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13
Q
A

PADS / spontaneous transverse patellar fracture in a cat

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14
Q

Spontaneous patellar fractures in cats are usually where and which orientation?

A

Largely transverse and in the proximal-mid portion

https://www.vettimes.co.uk/article/patellar-fractures-in-cats/#f002

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15
Q
A

spontaneous tibial (2a) and acetabular (2b) fractures of cats with a history of patellar fractures.

https://www.vettimes.co.uk/article/patellar-fractures-in-cats/#f002

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16
Q
A

Chronic patellar fracture. Chronic fractures may occasionally be found as an incidental finding.

https://www.vettimes.co.uk/article/patellar-fractures-in-cats/#f002

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17
Q

Why do you need to differentiate bi/multi-partite fabellae from fabellar fractures?

A

Because fractures (of the lateral fabellae) may be associated with avulsion of the (lateral head of the) gastrocnemius

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18
Q

Which fabellae is more commonly bi/multipartite?

A

medial

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19
Q

Which breeds are predisposed to bi-partite/fragmented fabellae?

A

Poodles
Fox terriers

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20
Q

Which fabellae is smaller in cats - medial or lateral?

A

medial

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21
Q

tibial tuberosity avulsion is usually seen in ___________ (signalment)

A

young dogs, <8-10mo
Greyhounds and terriers appear to be predisposed (Gower et al, 2008)

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22
Q

5m crossbreed dog

A

tibial tuberosity avulsion fracture (arrowed) with associated mineralized fragments (arrowhead)

Image: the dog’s other leg showing Salter–Harris type II fracture of the proximal tibial physis (arrowed) and a fractured fibula (arrowhead)

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23
Q

5m crossbreed dog

A

Salter–Harris type II fracture of the proximal tibial physis (arrowed) and a fractured fibula (arrowhead)

Image: the dog’s other leg showing tibial tuberosity avulsion fracture (arrowed) with associated mineralized fragments (arrowhead)

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24
Q
A

10-month-old Domestic
Shorthair cat with a distal femoral physeal fracture (Salter–Harris type II)

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25
Q

3-year-old male cross-bred dog

A

avulsion of the long digital extensor tendon, showing an enlarged extensor fossa radiolucent defect (arrowed) and an associated mineralized fragment (arrowhead). This dog had a concurrent CCLR.

26
Q

3-year-old male cross-bred dog; What type of injury is this?

A

avulsion of the long digital extensor tendon, showing an enlarged extensor fossa radiolucent defect (arrowed) and an associated mineralized fragment (arrowhead). This dog had a concurrent CCLR.

27
Q

Where does the LDE originate?

A

Extensor fossa, lateral femoral condyle
It then runs down the muscular /extensor groove on the craniolateral tibia, and inserts on the distal phalanx of digits two through five.

28
Q

What are the 2 components of the gastrocnemius muscle?

A

Medial and lateral heads, which contain the fabellae/sesamoids in the tendon of origin.

29
Q

Which clinical signs and physical changes (e.g. stance, swelling) are possible with gastrocnemius avulsion?

A

Lameness, caudal stifle swelling, occasionally a plantigrade stance

30
Q

Which radiographic signs are possible with gastrocnemius avulsion?

(think displacement or fracture)

A
  • fabella may be distally displaced
  • fabella may be fractured
  • soft tissue swelling of the caudal fascial planes
31
Q

5-year-old German Pointer

A

gastrocnemius tendon avulsion, showing marked caudodistal displacement of one fabella (black arrow) with the other fabella in its normal position (white arrow)

32
Q

Acquired patellar luxation can be associated with _______________ in the cat.

A

hip luxation

33
Q

6-year-old Domestic Shorthair cat

A

severe ligamentous disruption - collateral and cruciate ligament injuries

34
Q
A

CCL disease

Top: acute
Bottom: chronic

35
Q

Where are these enthesophytes, specifically?

A

the trochlear ridhes, at the insertion of the joint capsule

36
Q

2-year-old Labrador Retriever

A

avulsion of the CCL, showing a mild joint effusion and a mineralized intra-articular fragment

37
Q

what is more common - avulsion of the origin or the insertion, of the CCL?

A

insertion

38
Q

What percentage of dogs (Sumner et al, 2010) with a CCLR have a full-thickness caudal cruciate ligament tear associated with marked synovitis?

A

25%

39
Q

Collateral ligament rupture usually happens in conjunction with another ligamentous injury - true or false?

A

True, it is rare for it to happen on its own, it usually happens in conjunction with cruciate ligament rupture.

40
Q

3y crossbreed dog

A

lateral collateral ligament tear, showing marked opening of the lateral joint space (arrowed).

41
Q

How do you diagnose patellar ligament rupture in radiographs? what other modality can be used readily?

A

The patella maintains the same (too proximal) position in flexed and extended lateral stifle projections.
US can also diagnose this, and assess stages of healing.

42
Q

What percentage of cases have concurrent meniscal tears at the time of CCLR?

A

25-50%

43
Q

What percentage of CCLR cases have late meniscal injury/tears?

A

15%

44
Q

Which meniscus is commonly injured?

A

Medial
Lateral meniscal tears are uncommon.

45
Q

5y crossbreed dog

A

patellar ligament rupture

Image: US showing disruption of the fibers (hypoechoic area) and thickening at rupture site
Post-op radiograph, patella is more distal now.

46
Q

US has poor sensitivity for meniscal tear diagnosis - true or false?

A

False; experienced operators with Hi-Hz (7.5-15 Hz) probes report 90% sensitivity

47
Q

Quadriceps contracture is a temporary condition - T or F?

A

False - it is a serious complication of inadequately managed femoral fractures, resulting in permanent stifle and hock extension and subsequent femoral and tibial osteopenia.

48
Q

What percentage of patellar luxations are medial?

A

80-90%; most of them anyway - usually toy/small breeds, but also med/large e.g. Labs

49
Q

Which other changes can be present with congenital MPL?

A
  • lateral deviation/bowing of the distal femur
  • medial deviation/bowing of the tibia (image)
  • coxa vara
50
Q

What is juvenile gonitis?

A

Presents as idiopathic stifle effusion in med/large breeds e.g. Boxer, Rottie, and can be associated with CCLR (uni/bilateral).

51
Q

Meniscal calcification is more common in which species?

A

Not dogs - usually CATS, rodents, rabbits.

Can be idiopathic, or 2nd to trauma (CCLR) or OA.

52
Q

Genu valgum results in the distal limb deviating _______________ly.

A

lateral

53
Q

Genu valgum can result in __________ patellar luxation.

A

lateral

54
Q

The stifle (distal femur) is an uncommon location for OCD in dogs - T or F?

A

True, it is uncommon, but can affect both the lateral and medial femoral condyles and has been reported in the cat.

55
Q

What is the most common location on the distal femur for OCD?

A

medial aspect of the lateral condyle

56
Q

Septic arthritis can occur secondary to OA - true or false?

A

True

57
Q

What is the most common fungal osteomyelitis in Europe?

A

Aspergillus

58
Q

Which neoplasia has a predilection for the stifle?

A

Synovial / histiocytic sarcoma
Osteosarcoma

59
Q

The stifle is a predilection site for changes secondary to hypervitaminosis A - T or F?

A

True; periarticular new bone

60
Q

3y DSH

A

synovial osteochondromatosis, showing multiple intra- and periarticular smooth mineralized opacities (arrowheads) located in the synovium

BSAVA MSK (9 decks)

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