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Y3 MOD Orthopaedics > Developmental Orthopaedic Disease > Flashcards

Developmental Orthopaedic Disease Flashcards

1
Q

What is endochondral ossification?

A

Starting with a new cartilage template that is going to grow and develop - in utero

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2
Q

What is formed continuously during growth?

A

New cartilage

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3
Q

In which two locations in the bone is endochondral ossification occurring i.e. growth regions?

A
  • Metaphyseal growth plate (Epiphyseal side)

- Articular-epiphyseal cartilage complex

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4
Q

Describe the growth and development of cuboidal bones

A

Have secondary centres of ossification within them and they don’t have a growth plate so they grow by the Articular-epiphyseal cartilage complex mechanism of growth

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5
Q

Describe the histological anatomy of a growth plate

A
  • Resting cartilage
  • Zone of proliferation
  • Zone of hypertrophy
  • Zone of calcification of matrix
  • Matrix reabsorption and ossification
  • Secondary spongiosa
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6
Q

What is required in bone for mineralisation to take place?

A

Blood supply

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7
Q

How could the physeal growth plate malfunction?

A
  • Abnormal deposition of matrix
  • Abnormal mineralisation
  • Poor conversion to bone
  • Retention of cartilage
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8
Q

What are the results of physeal growth plate malfunction?

A
  • Slow growth

- Uneven growth

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9
Q

How could the articular-epiphyseal cartilage complex malfunction?

A
  • Abnormal deposition of matrix
  • Abnormal mineralisation
  • Retention of cartilage
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10
Q

What are the results of epiphyseal cartilage complex malfunction?

A
  • Slow growth
  • Uneven growth
  • Cartilage flaps
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11
Q

Which 3 factors are effected by endochondral ossification abnormalities?

A
  • Rate of growth
  • Direction of growth
  • Health of articular cartilage
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12
Q

Define chondrodysplasia

A

Abnormal endochondral ossification

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13
Q

Define osteochondrosis

A

Cartilage abnormalities

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14
Q

Define osteochondritis

A

Inflammation associated with disease

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15
Q

Define osteochondrosis/ osteochondritis dissecans

A

Cartilaginous or osteochondral flap/defects within the joint

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16
Q

At which stages can abnormalities leading to osteochondritis dissecans occur?

A
  • Disruption of blood supply
  • Abnormal chondrocyte maturation
  • Defective matrix production
  • Persistence of hypertrophic chondrocytes
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17
Q

What are chondrocytes?

A

The only cells found in healthy cartilage.

They produce and maintain the cartilaginous matrix, which consists mainly of collagen and proteoglycans.

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18
Q

What are the 2 consequences of abnormalities leading to osteochondritis dissecans?

A
  • Thickened, retained hypertrophic cartilage

- Disruption of the subchondral bone plate (AECC)

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19
Q

How does a disruption of the blood supply lead to osteochondritis dissecans?

A
  • Affects mineralisation of the subchondral bone
  • Alters biochemical and biomechanical properties of cartilage and subchondral bone
  • Affects ability to adapt to and withstand force (esp. shear)
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20
Q

Describe the pathophysiological steps in osteochondritis dissecans

A

Shear forces and weight-bearing ->
Separation at osteochondral junction ->
Cartilage flaps and fragmentation ->
Exposed subchondral bone

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21
Q

What clinical signs would be expected with osteochondritis dissecans?

A
  • Effusion = filling of the synovial structure with fluid in response to hyperaemia and increased leakiness of the capillaries (main sign)
  • Leads to pain and lameness
  • Osteoarthritis secondary to low grade inflammation caused by an OCD lesion
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22
Q

How does the cartilage appear in osteochondritis dissecans

A

Irregular, raised articular cartilage

23
Q

What are the 4 aetiological causes of osteochondritis dissecans?

A
  • Rapid growth
  • Genetic predisposition
  • Nutrition
  • Trauma
24
Q

What are some causes of rapid growth?

A
  • Genetic potential for growth: Breed, Family lines
    Hormonal influence: Testosterone
  • Nutritional influence: Excess energy and protein, Ca:P imbalances, Cu:Zn imbalances
25
Which radiographic abnormalities will be seen with osteochondritis dissecans?
- Irregular subchondral bone | - Osseous densities: mineralised cartilage, osteochondral fragments
26
Which bone abnormalities most commonly affected horses?
- Osteochondrosis: OCD and Subchondral bone cysts - Physitis - Angular limb deformities - Flexural deformities
27
Which bone abnormalities most commonly affected dogs?
- Osteochondrosis - Hypertrophic osteodystrophy - Legg Calve Perthes - Hip Dysplasia
28
Which bone abnormalities most commonly affected bovine?
- Osteochondrosis | - Flexural deformities
29
Describe the Aetiology of sub-chondral cyst like lesions
``` Abnormal endochondral ossification: - Retention of cartilage core - Collapse of cartilage Trauma- articular cartilage and SC bone: - Pressure from synovial fluid ```
30
What is physitis?
Enlargement of the physis - Inflammation - Disrupted endochondral ossification
31
What are the clinical signs of physitis?
Lameness | Stiff gait
32
Which age/spp are prone to hypertrophic osteodystophy?
Large breed dogs between 2-8 months of age
33
What is the cause of hypertrophic osteodystrophy?
Idiopathic - Infection - Viral (CDV) or bacterial - Over supplementation with vitamins and minerals - Vascular abnormality
34
Describe the pathogenesis of hypertrophic osteodystrophy
- Necrosis of the capillary loops of the cartilage of the metaphyseal physis (blood supply failure) - Cuff of metaplastic cartilage and bone
35
What are the clinical signs of hypertrophic osteodystrophy
- Lameness, fever, lethargy, painful bone - Primarily long bones – distal aspect - Bilateral and symmetric
36
What are some radiographic abnormalities seen in hypertrophic osteodystophy?
- Abnormal bone on diaphyseal side of physis - Decreased radiodensity parallel to physis - Irregular widening of the physis - Sub and extra-periosteal new bone
37
Which age/spp are affected by panosteitis?
5-18 months old, Large breeds of dog
38
Describe the pathogenesis of panosteitis
Fibrosis of bone tissue - Increased osteoblastic and fibroblastic activity - Disorganised trabecular formation in subchondral bone - Affects the whole bone
39
What is the cause of panosteitis?
Idiopathic
40
What are the clinical signs of panosteitis?
Acute lameness, shifting (multiple limbs) lethargy, pain
41
What are the radiographic abnormalities seen with panosteitis?
- Increased opacity of medullary cavity - Indistinct trabecular pattern - Increased endosteal opacity - Normal radiolucent bone marrow is much whiter in colour
42
Which spp/age is affected by Legg-Calve-Perthes disease?
4-11 months, toy breeds
43
Describe the pathogenesis of Legg-Calve-Perthes disease
- Avascular necrosis of the femoral head - Bone remains mechanically stable initially - When SCB loses mechanical strength – collapse of articular surface
44
What are the clinical signs of Legg-Calve-Perthes disease
- Acute onset lameness | - Fracture/collapse of the femoral head
45
What radiographic abnormalities are seen with Legg-Calve-Perthes disease
- Osteolysis of femoral head – SCB resorption - Collapsed and thickened femoral neck - Fracture
46
What is hip dysplasia?
- Genetic predisposition to laxity of the hip joint | - Abnormal anatomy of femoral head and acetabulum
47
Which 3 processes make up canine elbow dysplasia?
- Osteochondritis dissecans - Ununited anconeal process - Fragmented coronoid process
48
What are the two types of angular limb deformities?
Valgus – lateral deviation distally | Varus – medial deviation distally
49
Where are the potential locations for angular limb deformities?
- Metaphyseal growth plate - Epiphysis - Cuboidal bones - Metaphysis
50
Describe angular bone deformities in canines
- Asynchronous growth of a pair of bones - Radius and ulna > tibia and fibula - Differential growth between bones, after damage to one
51
How does differential bone growth occur in canine angular limb deformities?
* Trauma to growth plate – damage to BVs, replacement of normal tissue with fibrous tissue so the growth plate becomes unfunctional * Asynchronous growth: shorter (affected) bone acts to create bowing of longer bone - bend and rotate
52
Describe the pathogenesis of flexural deformities in equine and bovine species
- Disproportionate growth - Muscle-tendon unit vs bony skeleton - Bone functionally longer
53
What are the two types of flexural deformities in equine and bovine species?
Congenital - Newborn foals | Acquired - Rapidly growing foals and yearlings, acute or chronic

Y3 MOD Orthopaedics (7 decks)

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