Developmental Orthopedic Diseases in the Dog Flashcards
____ is seen in young, large breed dogs (GSD, labs, basset hounds, dobies) usually 5-12 months old
Panosteitis
Panosteitis CS—
Lameness, shifting leg lameness usually or bilateral stiff gait, usually intermittent
Pain on palpation of diaphysis of affected long bone
Panosteitis is not showing up on rads, but patient has symptoms. As a vet, what is your next step for this patient?
Rad findings can lag behind CS, so be careful as a vet to recheck rads in 1-2 weeks if lameness persists and do rest and carprofen in the meantime
Rad signs of panosteitis–
Increased density within medullary cavity (osteosclerotic foci) and blurring of the trabecular pattern, often near the nutrient foramen
Tx of panosteitis-
self limiting which is good…. Use conservative tx and prognosis is good to excellent back to normal function. signs of shifting leg lameness might continue until the dog is fully matured at 2 yrs old
___ is usually non painful condition resulting from failure of endochondral ossification leading to failure of cartilage matrix calcification and vascular ingrowth causing cartilage retention which causes thickening of the articular epiphyseal cartilage in the joint!!
Osteochondrosis
Osteochondrosis predispositions and causes–
genetics, rapid growth, Ca supplements, hormonal influences, ischemia and trauma
What are the most common anatomical sites to be affected with Osteochondrosis??? In what size dogs of what age?
super common in shoulder, stifle, elbow and tarsus of large breed dogs from ages 4-7 months
Pathophysiology of osteochondrosis eventually causing OCD lesion—»>
Thickened articular-epiphyseal cartilage complex causes poor diffusion of nutrients from synovial fluid–>chondrocytes are abnormal–> separation between noncalcified and calcified layers (tidemark) bc of cartilage flap causing OCD lesion
Clinical signs of osteochondrosis-
lameness, intermittent and worse with exercise, joint pain/effusions, muscle atrophy, development of osteoarthritis (OA)
Diagnosis of osteochondrosis—»»
Rads, if not seen then do CT or MRI. Will have pain on extension of the jt on PE, can also do positive contrast solution where contrast which fills joint and leaks through the fissure
usually Osteochondrosis only affects on leg. T/F
False!!! usually is bilateral
When is it okay to do conservative medical tx for osteochondrosis?
no clinical pain or joint mouse (detached fragment next to OCD lesion) of dog is less than 7 months with a small lesion
____ ____ cannot regrow
hyaline cartilage
Healing of osteochondrosis occurs by production of _____
fibrocartilage/scarring
Tx of osteochondrosis–>
Forage (drilling many holes with K wire), abrasion arthroplasty, curettage (just enough to get some bf, dont overdo)
Osteochondritis dissecans- most common locations are…
Caudal stifle, medial elbow, medial tarsus, medial shoulder
Osteochondritis dissecans tx-
arthroscopy and lavage
Prognosis of Osteochondritis dissecans over the shoulder vs. in other joints
in shoulder =good to excellent
in other joints =guarded due to OA and intermittent lameness, need to have p on lifelong management of OA
With Osteochondritis, what sized jts do better, smaller or larger?
Larger jts do better (like shoulder and hip)
What is the post op rehab for osteochondritis dissecans
restrict activity for four weeks, joint motion with minimal loading and swimming
Elbow dysplasia is related to ____ ____ genetically. Results in pain of elbow and _______ ___
Hip dysplasia; OA
? causes secondary OA and its etiology is excessive loading of the coronoid process from abn devo or incongruency of the joint
Medial coronoid process fragmentation
Medial coronoid process fragmentation dogs predisposed***:
IN LARGE BRREDS LIKE ROTTIES, LABS, GOLDENS, AND BERNESE MTN DOGS*** know
5-7 months old is first sign of lameness OR at 1-2 years of age when they show signs of OA
A dog comes in with bilateral short choppy gait, it is a 7 months old lab without signs of OA, what diagnosis am I thinking?
Elbow dysplasia
A dog comes in, he is a 2 year old rottie with bilateral stiff gait, elbows abducted with paw externally rotated at standing. He is showing slight signs of OA, what diagnosis am I thinking?
Elbow dysplasia
Pain on _____ of elbow with elbow dysplasia
hyperextension
We must diff .elbow pain from _____ pain
shoulder
Rad findings of fragmented medial coronoid process-
blunted medial coronoid with very rarely seeing a fragment and sclerosis of subchondral bone of trochlear notch, periarticular osteophytes
What are the benefits of sx for fragmented medial coronoid process?
excision of fragment via arthroscopy, will be able to see kissing lesion on humerus which is piece of broken off and it is scraping the cartilage, can also look for concurrent OCD which is be more lateral than the kissing lesion. ((((though these are all great things, studies show little different between sx and conservative life-long tx))))
Prognosis for fragmented medial coronoid process is ___ to _____. Why? What are long-term complications?
Fair to guarded. OA is inevitable, will need life-long medications
What is a developmental condition that is common in spaniels?
Incomplete Ossifications of humeral condyle (IOHC)
A spaniel comes, bilateral lameness with thoracic limb lameness with acute fracture of humeral condyle. What is the diagnosis???
Incomplete Ossifications of humeral condyle (IOHC)
Incomplete Ossifications of humeral condyle (IOHC) will have weak cartilage on the ___ side where the centers of ossification failed to complete at __-__ weeks old
left side; 8-12 weeks
Tx of IOHC is _____ procedure which has variable outcome
OATS (osteochondral autograft transfer system)
With _______ fracture, be sure to re-establish congruity of joint without any misaligning/steps/gaps
Intraarticular
What occurs in fast-growing large breed dogs (usually males), 2-8 months old?
Hypertrophic osteodystrophy (HOD)
Hypertrophic osteodystrophy (HOD) CS-
lameness/ reluctance to move, warm painful swelling of metaphysis, anorexic, fever!!!!, sick, depression, lethargic with swelling around joints
What will rads show with HOD?????
Double physeal line and sclerosis***
Tx of HOD and prognosis-
Supportive care, prognosis is good, most recover in 1-2 weeks, self limiting
What are some sequalae of HOD???
growth disturbances, systemic illness are rare but include cardio issues and pulmonary changes. Usually not fatal but can be without treatment in severe forms
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What is a common disease where there is aseptic necrosis of femoral head and neck which then leads to remodeling of the femoral epiphysis?
Legg-Calve-Perthes Disease
Legg-Calve-Perthes Disease CS-
Lameness, small and mini breeds 4-11 months old, hip pain and lameness, progressive, crepitus, muscle atrophy, 15-18% of cases are bilateral
Rads showing Legg-Calve-Perthes Disease –
flattening and irregular femoral head and moth-eaten look, occasional femoral neck fractures
T/F, conservative therapy is best for Legg-Calve-Perthes Disease.
False!!! Surgery is needed (FHO), prognosis will be good to excellent. Conservative tx does not usually work for this disease
Retained cartilage core aka ____ lesion causes are unknown. Presents itself mostly in what breeds?
Candlestick lesions; common in Danes, Irish Wolfhounds, Afghan hounds (not a very common condition)
Retained cartilage core are usually incidental findings. What do they look like on rads???
Cone shaped area of unmineralized, hypertrophic cartilage
where are candle stick lesions aka retained cartilage core usually found?
Most common site is distal ulnar physis
Tx for candle stick lesions aka retained cartilage core:
What is the prognosis??
Medical management if lameness present, surgery ONLY IF angular deformity occurs- corrective osteotomy
Prognosis is fair to good, most resolve uneventfully
Growth deformity of the limb can happen but is RARE
Craniomandibular osteopathy–
Non-neoplastic, non-inflammatory bone proliferation
Bones of skull involved, may result in ankylosis of the temporomandibular joint so patient cannot open jaw
**In Westies (not a common disease)
Clinical signs of Craniomandibular osteopathy, and when do they normal present themselves in the dog’s (Westie’s) life??
swelling and pain around mandible, inability to eat normally, drooling, weight loss, might have fever; usually occurs at 4-10 months of age
Rads showing Craniomandibular osteopathy
proliferative new bone formation in the mandible, temporal bones, occipital bones, and/or bulla. New bone will be spikey “spiculated”
What is the tx and prognosis for Craniomandibular osteopathy??
Tx is nonspecific, use pain meds and hand feed or tube feed
Prognosis- self-limiting, usually stops at maturity, deposited bone will often regress over time, fair to good prognosis with mild lesions, but guarded prognosis with extensive lesions where patient cannot eat or gets aspiration pneumonia because cannot properly eat food
