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CHAPTER 1: Clinical Pathology: Clinical chemistry > Diagnostic imaging: Small animal orthopedics > Flashcards

Diagnostic imaging: Small animal orthopedics Flashcards

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1
Q

What particular feature of the ends of a bone varies among animals?

A

There is variation in the physeal closure time among animals.

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2
Q

For the appendicular skeleton, how are fractures defined?

A

Fractures are defined by the following:

(i) Limb and bone involved
(ii) Fracture type
(iii) Direction of displacement
(iv) Articular involvement
(v) Soft tissue changes

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3
Q

What is the name of the special classification in animals with open physis?

A

Salter-Harris classifications are special classifications in animals with open physis?

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4
Q

In the case of fracture healing, how can we evaluate the initial postoperative radiographs?

A

In the case of fracture healing, we can evaluate the initial postoperative radiographs using the 4A’s :

(i) Apposition
(ii) Alignment
(iii) Appliance
(iv) Articular surface

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5
Q

By which process does healing usually occur and what can be seen on radiographs over 8 weeks?

A

Healing is usually through secondary bone formation that is seen on radiographs as the following:

(i) First week: Increase in the width of the fracture gap
(ii) At 10 to 14 days, variable amount of callus begin to appear.
(iii) At 4 to 8 weeks, fracture is less distinct with larger amounts of relatively smooth callus.

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6
Q

List 7 complications of fracture.

A

(i) Nonunion: Lack of progression of healing after 16 weeks
(ii) Malunion: Fracture healed in abnormal alignment
(iii) Osteomyelitis:Variable osteoproductive and lytic
(iv) Implant fracture: Broken or migration of implants
(v) Angular limb deformity:Common in premature closure of the distal ulnar physis
(vi) Sequestrum formation: Portion of bone lacking vascular supply is not incorporated in healing process
(vii) Fracture associated sarcomas: Rare, approximately 5 years after fracture

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7
Q

How is aggressive bone disease defined?(3)

A

Defined by:

(i) type of periosteal reaction
(ii) type of bone lysis, and
(iii) zone of transition between normal and abnormal bone

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8
Q

What are the different types of periosteal reaction from least to most aggressive?(5)

A

Types of periosteal reaction from least to most aggressive: smooth, lamellar, irregular, sunburst, amorphous

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9
Q

What are the different types of bone lysis from least to most aggressive?

A

Types of bone lysis from least to most aggressive: geographic, moth eaten, permeative

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10
Q

What is the relationship between the length of the zone of transition and the aggressiveness of the disease?

A

The longer the zone of transition, the more aggressive the disease

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11
Q

What is the most common type of primary bone neoplasia?

A

Osteosarcoma is the most common type of primary bone neoplasia(away from the elbow and toward the knee plus distal tibia). Usually does not cross joints.
NOTE: Neoplasia is characterised by a variable degree of osteolysis and production.

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12
Q

Give examples of infectious disease which will have a variable degree of osteolysis and osteoproduction.

A

Infectious disease will have a variable degree of osteolysis and osteoproduction:

a. Granulomatous or fungal disease
b. Osteomyelitis

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13
Q

What can help with providing a definitive diagnosis?

A

A bone biopsy is often required to get a definitive diagnosis.

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14
Q

Relating to congenital disorders, define the following:

(i) Polydactyly
(ii) Syndactyly

A

1.Polydactyly: one ormore extra digits
2.Syndactyly:Bony fusion of one or more digits
Many types of dwarfisms and skeletal dysplasia occur but are uncommon. These usually result in abnormal ossification and shape/length of the skeleton.

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15
Q

Give two examples of developmental disorder that is a disease of young, large to giant breed dogs.

A

Panosteitis and hypertrophic osteodystrophy ares disease of young, large to giant breed dogs.
Most common in the German Shepherd(can be seen in older shepherds) and basset hiund.

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16
Q

What can be seen on radiographs for each type of developmental disorder?
In which dog breeds is panosteitis more common?

A

Panosteitis(check folder for radiographs picture-5)
Radiographs: Increased intramedullary opacity of long ones.
Most common in the German shepherd(can be seen in older shepherds) and basset hound
Hypertrophic osteodystrophy(check picture 6)
Radiographs: abnormal lucent lines(double physeal line) in the metaphysis(most commonly the distal antebrachium).

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17
Q

Which condition in dogs would usually predipose them to hypertrophic osteopathy?

A

Hypertrophic osteopathy generally affects older dogs secondary to a thoracic (and less commonly abdominal) mass.

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18
Q

What can be seen on radiographs with hypertrophic osteopathy?

A

Radiographs: Palisading periosteal reaction and soft tissue swelling of multiple long bones; bilaterally symmetrical.

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19
Q

Describe the progression of the periosteal reaction in hypertrophic osteopathy.

A

Hypertrophic osteopathy: the periosteal reaction starts distally and eventually progresses up the limb.

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20
Q

What type of radiograph is usually recommended in the case of hypertrophic osteopathy and why?

A

Hypertrophic osteopathy: always take a thoracic radiograph to check for a mass.

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21
Q

Give examples of disorders that can affect the axial skeleton: spine.(7)

A 
1/Atlantoaxia subluxation
2/Cervical spondylopathy
3/Lumbosacral instability
4/Intervertebral disk disease
5/Spondylosis deformans
6/Neoplasia
7/Diskospondylitis
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22
Q

Define atlantoaxial subluxation. Which breeds are usually affected?
What should one be careful when taking radiographs in this case?

A

Congenital malformation or hypoplasia of the dens
Young small and toy breeds.
Be careful to avoid excessive flexion of the neck in these patients during radiography.

23
Q

Describe radiographic findings with atlantoaxial subluxation.

A
  • Widening of the space between the atlas and spinous processes if the axis
  • Abnormal or absent dens
24
Q

What other terms can be used to describe cervical spondylopathy?
In which dog breeds is cervical spondylopathy more common?

A

Wobbler syndrome, cervical vertebral instability

Young Great Danes and older Doberman pinschers

25
Q

What are the radiographic findings with cervical spondylopathy?(6)

A
  • Malformation of the vertebral bodies(C5-C7)
  • Malalignment of the vertebral bodies
  • Invertebral disk space narrowing
  • Spondylosis deformans
  • Sclerosis of the vertebral end plates
  • Degenerative changes of the articular facets
26
Q

What are the radiographic findings for lumbosacral instability?(4)

A

Radiographic findings:
NOTE: These same findings are found in dogs with degenerative disease that do not have signs of neurologic disease)
-Narrowing of invrtebral disk space at L7-S1
-Spondylosis deformans at L7-S1
-Sclerosis of the end ploates at L7-S1
-Malalignment of the sacrum and L7

27
Q

What other diagnostic tool is usually used to confirm lumbosacral instability?

A

Often need computed tomography(CT) or magnetic resonance imaging(MRI) to confirm.

28
Q

Which dog breeds are predisposed to intervertebral disk disease?

A

Most common in chondrodystrophic breeds(dachshund).

29
Q

What are some radiographic findings in intervertebral disk disease?

A
  • Narrowing or wedging of the intervertebral disk space
  • Narrowing of the intervertebral foramina
  • Increased opacity in the spinal canal
  • Narrowing of the joint space at the articular facets
30
Q

Intervertebral disk disease

What procedure can be used to confirm a lesion prior to surgery?

A

Myelography is performed to confirm a lesion prior to surgery.

31
Q

What is spondylosis deformans?

A

Spondylosis deformans is degenerative change of the spine.

32
Q

What are some radiographic findings with spondylosis deformans?

A

Smooth new bone formation that may be bridging at the ventral(and sometimes lateral) vertebral endplates.

33
Q

In the case of neoplasia, how many vertebrae are usually affected by primary bone tumors?

A

Primary bone tumors generally affect one vertebra.

34
Q

Can spincal cord tumors be usually detected without myelography?

A

Spinal cord tumors usually cannot be detected without myleography.

35
Q

What changes can result from extension of neoplastic disease from the caudal abdomen and perineal tissues ?

A

Eextension of neoplastic disease from the caudal abdomen and perineal tissues can result in osteolytic and osteoproductive changes at L5 through the sacrum and caudal vertebrae.

36
Q

What is diskospondylitis?

A

Diskospondylitis is infection of the invertebral disk space and adjacent vertebral endplates.

37
Q

What are some radiographic findings with diskospondylitis?

A

Radiographic findings:

  • Osteolysis of the vertebral endplates
  • Multiple sites may be affected.
  • Widening or collapse of the interverterbral disk space.
38
Q

Give examples of two types of trauma that can happen at the axial skeleton(spine).

A

Trauma

(i) Compression fractures
(ii) Subluxation and luxation

39
Q

Give examples of conditions that can affect the axial skeleton(skull).

A
  • Ear disease
  • Nasal disease
  • Dental disease
  • Others(Cranial mandibular osteopaythy, neoplasia)
40
Q

What can be seen on radiographs with:

(i) Otitis externa
(ii) otitis media
(iii) Nasopharyngeal polyps

A

Ear disease

  1. Otitis externa: Thickening and mineralisation of the external ear canals, with partial to complete occlusion of the normally air filled canals
  2. Otitis media: Soft tissue or fluid opacity of the tympanic bulla with occasional changes in the bulla wall in severe cases
  3. Nasopharyngeal polyps: May see increased soft tissue opacity of tympanic bulla and nasopharynx
41
Q

What are the two different types of nasal disease?

A

Destructive and non-destructive rhinitis.

42
Q

What are 4 different causes of destructive rhinitis?

A 
Destructive rhinitis
Causes:
(1)Neoplasia:Adenocarcinomas most common
(2)Fungal rhinitis
(3)Chronic foreign bodies
(4)Chronic inflammatory disease
43
Q

What are some radiographic findings with destructive rhinitis?(3)

A
  • Increased soft tissue opacity in the nasal passages and frontal sinuses
  • Destruction of the nasal turbinates
  • Destruction of the bones surrounding nasal passages, usually most severe with neoplasia
44
Q

What are three causes of non-destructive rhinitis?

A
  • Inflammatory disease
  • Bacterial rhinitis
  • Foreign bodies
45
Q

What is the most common type of dental disease?

A

Peridontal disease is the most common type of dental disease.

46
Q

What are some radiographic findings of periodontal disease?

A

Radiographic findings include:

(i) Widening of the periodontal space
(ii) Loss of the radiopaque lamina dura
(iii) Root resorption
(iv) Tooth loss

47
Q

Which breeds are usually affected by cranial mandibular osteopathy?(CMO)

A

Cranial mandibular osteopathy affects terrier breeds.

48
Q

What are some radiographic findings of cranial mandibular osteopathy?

A

(1) Irregular new bone involving the mandibles and occasionally parietal, frontal and maxillary bones.
(2) Can result in temporomandibular joint(TMJ) ankylosis.

49
Q

What is the most common type of neoplasia in the skull and what processes usually characterise such conditions?

A

Neoplasia: Can occur anywhere on the skull. Osteosarcoma is most common, with a variable degree of osteolysis and osteoproduction.

50
Q

What are the different categories of joint disease?(5)

A

Remember VITAMIND

  1. Traumatic
  2. Degenerative
  3. Neoplastic
  4. Inflammatory
  5. Developmental
51
Q

Give examples of trauma that can occur to the joints. What type of radiograph may be helpful in demonstrating instability?

A
  • Luxations and fractures

- Stress radiographs may be helpful to demonstrate instability.

52
Q

Give examples of degenerative causes of joint instability.

A

Commonly stifle secondary to cranial cruciate rupture, coxofemoral joints secondary to hip dysplasia and elbow and shoulder joints.

53
Q

What are some radiographic findings with joint disease?(7)

A
  • Increased synovial mass/intraarticular swelling
  • Decreased joint space width
  • Periarticular osteophyte formation
  • Enthesopathy:New bone at soft tissue attachment sites
  • Subchondral bone sclerosis
  • Subchondral cystic changes in severe cases
  • Mineralisation of soft tissues: Intra articular or peri articular

CHAPTER 1: Clinical Pathology: Clinical chemistry (11 decks)

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