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ch 73 Osteochondrosis Flashcards

1
Q

osteochondrosis latens

A

early microscopic cartilaginous lesion

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2
Q

osteochondrosis manifesta

A

subclinical lesion that is macroscopically and radiographically apparent

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3
Q

osteochondrosis dissicants

A

disease if attached or loose cartilage flap is present

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4
Q

when is there first evidence of skeletons on radiographs

A

19-25 days post fertilization

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5
Q

growth plates contribute to ____ % of final bone length

A

75-80%

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6
Q

eiphysis contributes approximately _____ % of final bone length

A

20-25%

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7
Q

what is the incidence of osteochondrosis

A

8.1/1000pt

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8
Q

sex predisposition for OCD

A

males except for talus OCD

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9
Q

most common OCD locations in dogs

A

caudal humeral head
medial humeral condyle
lateral femoral condyle
medial or lateral trochlear ridge of the talus

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10
Q

most common OCD locations in cats

A

Centro-caudal aspect of proximal humeral condyle,
lateral femoral condyle

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11
Q

by what process do joints form between developing bones

A

segmentation and cavitation

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12
Q

when does the majority of longitudinal growth take place?

A

12-26wks

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13
Q

how do growth plates enlarger

A

via formation of new cartilage

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14
Q

what determines volume of newly formed cartilage

A

chondrocyte proliferation
chondrocyte enlargement
matrix formation

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15
Q

Humerus, diaphysis

age when ossification center appears
age when fusion occurs

A

birth

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16
Q

Humerus (proximal epiphysis)

age when ossification center appears
age when fusion occurs

A

1-2 wk

10-13 mo

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17
Q

Humerus (distal epiphysis)

age when ossification center appears
age when fusion occurs

A

1-2 wks
6-8 mo to shaft

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18
Q

Humerus (medial condyle)

age when ossification center appears
age when fusion occurs

A

2-3 wks

6wks to lateral condyle

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19
Q

Humerus (lateral condyle)

age when ossification center appears
age when fusion occurs

A

2-3 wks

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20
Q

Humerus (medial epicondyle)

age when ossification center appears
age when fusion occurs

A

6-8 wks

6 months to condyle

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21
Q

Radius (diaphysis)

age when ossification center appears
age when fusion occurs

A

birth

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22
Q

Radius (proximal epiphysis)

age when ossification center appears
age when fusion occurs

A

3-5 weeks

6-11 months

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23
Q

Radius (distal epiphysis )

age when ossification center appears
age when fusion occurs

A

2-4 weeks
8-12months

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24
Q

Ulna (diaphysis)

age when ossification center appears
age when fusion occurs

A

birth

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25
Q

Ulna (olecranon)

age when ossification center appears
age when fusion occurs

A

8 wk

6-10 month

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26
Q

Ulna (distal epiphysis)

age when ossification center appears
age when fusion occurs

A

8 wks

8-12 months

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27
Q

Femur (diaphysis)

age when ossification center appears

A

birth

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28
Q

Femur (proximal epiphysis)

age when ossification center appears
age when fusion occurs

A

2 weeks

7-11months

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29
Q

Femur (trochanter major)

age when ossification center appears
age when fusion occurs

A

8 weeks

6-10months

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30
Q

Femur (trochanter minor)

age when ossification center appears
age when fusion occurs

A

8 wk

8-13months

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31
Q

Femur (distal epiphysis)

age when ossification center appears
age when fusion occurs

A

8-11 months (fusion)

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32
Q

Femur (trochlea)

age when ossification center appears
age when fusion occurs

A

2 weeks

3 mo condyle to trochlea

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33
Q

Femur (medial condyle)

age when ossification center appears

A

3 wk

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34
Q

Femur (lateral condyle)

age when ossification center appears

A

3 wk

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35
Q

Tibia (diaphysis)

age when ossification center appears

A

birth

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36
Q

Tibia (medial condyle)

age when ossification center appears
age when fusion occurs

A

3 wk

6 wk to lateral condyle

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37
Q

Tibia (lateral condyle)

age when ossification center appears
age when fusion occurs

A

3 wk

6-12 mo to shaft

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38
Q

Tibia (tuberosity)

age when ossification center appears
age when fusion occurs

A

8 wk

6-8 mon to condyle
6-12 mo to shaft

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39
Q

Tibia (distal epiphysis)

age when ossification center appears
age when fusion occurs

A

3 wk

8-11mo

40
Q

Tibia (malleolus)

age when ossification center appears
age when fusion occurs

A

3 mo

5mo

41
Q

fibula (diaphysis)

age when ossification center appears

A

birth

42
Q

fibula (proximal epiphysis)

age when ossification center appears
age when fusion occurs

A

9 wk

8-12 month

43
Q

fibula (distal epiphysis)

age when ossification center appears
age when fusion occurs

A

2-7 wk

5 month

44
Q

Talus

age when ossification center appears

A

birth - 1 wk

45
Q

fibular

age when ossification center appears

A

birth-1wk

46
Q

define saltation

A

short period of active growth

47
Q

Hueter-Volkmann law

A

Proposes the growth is impeded by increased mechanical compression and accelerated by reduced loading

48
Q

what is expansion of the growth plate constrained by

A

ring of Lacroix

49
Q

Does Chondrocytic proliferation and matrix synthesis occur primarily in the daytime or nighttime?

A

daytime

50
Q

Does active mineralization primarily ocur in the daytime or nighttime?

A

nighttime

51
Q

What is the appearance and characteristics of cells in the resting zone of the growth plate cartilage

A

Chondrocytes are small, randomly orientated and scattered irregularly through the matrix

Cells divide slowly

52
Q

What is the appearance and characteristics of cells in the proliferative zone of the growth plate cartilage

A

chondrocytes are flat and relatively small
organized in columns
chondrocytes divide, slowly enlarge, and synthesize matrix

53
Q

What is the appearance and characteristics of cells in the hypertrophic zone of the growth plate cartilage

A

chondrocytes are spheroid and relatively large

cells RAPIDLY enlarge

54
Q

What are the appearance and characteristics of cells in the mineralization zone of the growth plate cartilage?

A

chondrocytes have obtained their final size/shape
newly formed matrix mineralizes

55
Q

what stimulates clonal expansion of chondrocytes in the proliferation zone

A

IGF-1

56
Q

what are the requirements for change into hypertrophic chondrocyte phenotype

A

Bone morphogenetic protein (BMP), Wnt/𝛽 catenin, Runx2, Runx 3, thyroid hormone, and other regulators

57
Q

during the process of endochondral ossification, who produces VEGF and what does VEGF control

A

produced by hypertrophic chondrocytes
controls vascular ingrowth

58
Q

what is enlargement of the epiphysis a function of

A

Chondrocyte proliferation
Chondrocyte enlargement
Matrix formation
Duration of chondrogenic activity in the chondro-epiphysis

59
Q

where do vessels of the chondro-epiphysis juncture originate from

A

perichondral plexus
vessels course within cartilage canals

60
Q

what is the heritability of OCD

A

10-45%

61
Q

Over-feeding is thought to cause stimulation of chondrocyte differentiation and proliferation via elevated hormones including…….

A

Elevated levels of growth hormone
IGF-1 triiodothyronine (T3)
Thyroxine (T4)
Insulin

62
Q

what are the zones of mature articular cartilage

A

superficial zone
transitional zone
radial zone
zone of calcified cartilage

63
Q

what are the differences between the inner layer and the growth plate

A

Inner layer is visually disorganized and does not have the ordered zonal and columnar arrangemen of the growth plate

Chondroepiphysis has an abundant vasculature

64
Q

when does the majority of longitudinal growth take place?

A

12-26 wks

65
Q

how to growth plates enlarge

A

via formation of new cartilage

66
Q

how does the increase in cartilage volume result in bone length growth

A

pushing articular-epiphyseal complex away from the metaphysis

67
Q

where is the newly formed cartilage converted into bone

A

Junction of growth plate and metaphysis via endochondral ossification

68
Q

who produces IGF-1

A

daughter cells in the resting zone

69
Q

what role do osteoclasts play in endochondral ossification

A

remove transverse matrix septa that separates apoptotoic hypertrophic chondrocytes from metaphyseal vasculature, leaving voids lacunae for new vessels to form

70
Q

What is the role of osteoprogenitor cells?

A

Differentiate into osteoblasts→lay down woven bone on calcified cartilage matrix, forming lattice of calcified cartilage and woven bone (=primary spongiosa)

71
Q

What is secondary spongiosa?

A

Lamellar bone that replaces the calcified cartilage (primary spongiosa) and woven bone

72
Q

What are the layers of the articular-epiphyseal complex?

A

Thin outer layer, thicker inner layer

73
Q

Characterize the outer layer

A

Contains avascular specialized immature articular cartilage that will mature into articular cartilage; has no role in endochondral ossification

74
Q

Characterize the inner layer

A

Functionally similar to the growth plate, responsible for epiphyseal enlargement and mineralization of new cartilage

75
Q

What are the zones of the outer layer of the articular-epiphyseal complex (secondary ossification center)?

A

Superficial zone, transitional zone, radial zone, and zone of calcified cartilage

76
Q

What is the radial zone?

A

Uncalcified cartilage

77
Q

What separates radial zone from the zone of calcified cartilage?

A

The tidemark

78
Q

What does the tidemark represent?

A

Completion of maturation process of the ossification zone

79
Q

Where does chondrocyte proliferation take place within epiphysis?

A

on the periphery

80
Q

Where does maturation take place?

A

Toward the center

81
Q

What is chondrification?

A

Redundant cartilage canals regress as the ossification front moves from center of epiphysis to newly formed epiphyseal cartilage

82
Q

What risk factors play a role in osteochondrosis?

A

Heredity, rapid growth, dietary factors, trauma

83
Q

How might microtrauma cause ununited anconeal processes?

A

Overgrowth of radius may cause shear forces in growth plate of anconeal process

84
Q

What is the primary lesion of osteochondrosis?

A

Unknown - proposed Focal necrosis of epiphyseal cartilage canals→cartilage ischemia and necrosis vs dyschondroplasia vs relative osteopenia

85
Q

At what point does the proposed causes of OCD (primary) occur?

A

At a point in development when the vessels originating from the perichondrium are being replaced by vessels from adjacent epiphyseal bone marrow

86
Q

How might the necrotic focus heal?

A

Through stages of granulation tissue and intramembranous ossification or deforms and becomes altered joint congruency, subchondral bone cyst, or fissure/cleft

87
Q

How are OCD lesions graded?

A

I cartilage surface normal, cartilage slightly thickened, minuscule subchondral defect

II cartilage surface mottled; cartilage more thickened

III discoid elevation of cartilage surface, large cleft, sclerotic subchondral bone

IV typical partially detached cartilage flap or separated flap and joint mice

88
Q

What are type I flaps vs type II flaps involving articular epiphyseal region?

A

Type 1 – occur at center of affected surface, away from vascular attachments (caudal humeral head, medial humeral condyle, medial or lateral femoral condyle)

Type 2- occur at joint margin, retain vascular attachments (talar ridges, coronoid process)

89
Q

How do type II flaps heal?

A

Endochondral ossification

90
Q

What is failure of endochondral ossification (osteochondrosis) characterized by if affecting the growth plate rather than articular surface?

A

Persistence of hypertrophic chondrocytes

91
Q

What is a retained cartilaginous core?

A

Local thickening of a growth plate

92
Q

What is found in the retained cartilage core?

A

Focal thickening of the growth plate , characterized by persistent, viable hypertrophic chondrocytes

93
Q

What are the proposed mechanism of retained cartilaginous cores occurring?

A

Damage to resting zone cartilage canals or metaphyseal blood supply

94
Q

What does damage to resting zone cartilage canals or metaphyseal blood supply cause?

A

Inhibits conversion of mineralized growth plate cartilage into metaphyseal bone , resulting in thickening of the hypertrophic zone of the growth plate

95
Q

When are retained cartilaginous cores of clinical consequence?

A

When they are associated w/reduced length of the ulna with secondary deformities (bowing)

96
Q

What is consequence of ulnar cartilaginous core (growth plate OC)?

A

Radial procurvatum, carpal valgus, elbow incongruity, short ulna

97
Q

How do articular flaps heal following detachment?

A

Fibrocartilage

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