Common conditions of the forelimb Flashcards
What do we look for when assessing FL lameness?
Head nod
Sink on Sound
What is the grading scheme out of 5 for lameness?
0: none
1: mild, lameness consistent at trot
2: mild-mod, obvious as walk, worse at trot
3: mod, obvious lameness both gaits
4: mod-severe, intermittent non-weight bearing
5: severe, non-weight bearing
What could cause shoulder lameness in young dogs?
ostepchondritis dissecans (OCD)
shoulder oa, shoulder soft-tissue injuries rotator cuff, trauma, instability
Where is osteochondrosis most often found in dogs?
elbow and shoulder
then stifle, tarsus
developmental disease in fast growing often high performance patients
How does osteochondrosis develop?
during development, cartilage becomes bone
requires blood supply: endochondral ossification
if problem with vasculature in cartilage: cartilage doesn’t form bone, thickened plug avascular, necrotic cartilage, may cause fissure/flap formation
What are the signs on Hx and PE indicating OCD of canine shoulder?
usually around 4-8mo
progressive FL lameness uni or bilateral
FL lameness, may have muscle atrophy shoulder region, pain on shoulder extension or flexion (not usually palpation)
normal xrays show very smooth margin of the bone, OCD has mineralised flap
What is the source of the pain in OCD?
the flap: surgical removal recommended and curettage defect
What is the prognosis for OCD?
if minimal OA, excellent long term prognosis if treated when young
bigger lesions and presenting when older = worse OA
What are the tx options for OCD?
surgical removal: arthrotomy, arthroscopic
spontaneous break off: improves comfort but could interfere with biceps
conservative: symptomatic improvement but flap removal is better
When are shoulder luxations prone to happen?
young toy breed - dysplastic
trauma associated
surgical management only
When are animals prone to shoulder instability?
most commonly medial
degeneration middle aged dogs
conservative/surgical
When are animals prone to bicipital disease?
degeneration middle aged dogs
acute overload
medical then sx tx
What animals are more prone to elbow disease?
MN large breed (rottie, lab)
bimodal peak disease
61% bilateral
What is elbow dysplasia?
umbrella term for several developmental pathologies
named developmental elbow disease and all the conditions cause OA
What are the 3 main conditions of developmental elbow disease?
fragmented medial coronoid process FCP/medial coronoid disease MCD
osteochondrosis humeral trochlea
ununited anconeal process UAP
*MCD is most common
What kind of dogs get elbow dysplasia frequently?
young medium-giant breeds or smaller chondrodystrophic dogs
35% bilateral
genetic heritability: rottweilers, retrievers, bernese mountain dogs
males
How do dogs develop elbow dysplasia?
growth disturbance causing asynchronous growth and abnormal loading
radial-ulna incongruity
Where is the pressure if the radius is short?
on medial coronoid
Where is the pressure if the radius is long?
anconeal process
Where is the pressure if there is trochlea notch dysplasia/hymero-ulna conflict?
broad, crazy, multiple points
When is FL lameness from elbow dysplasia usually found?
5-7mo but most diagnosed at 12mo
insidious chronic lameness
worse post rest or exercise +++
frequently bilateral, possibly shift sides, improve on NSAIDs
What are the signs on clinical exam for elbow dysplasia?
rotation paw
elbow close/away body
reduced weight bearing
muscle atrophy
elbow effusion: caudal and lateral to lateral epicondyle
ensure isolate elbow: don’t manipulate shoulder and carpus together
What are the 3 xray views needed for elbows?
CrCd
MLn
Mlf
What can radiographs help diagnose regarding elbow dysplasia?
usually: ununited anconeal process UAP, OCD humerus, incongruity
CT/arthroscopy can confirm dx
superimposition makes diagnosing medial cornoid disease MCD difficult
