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JAS Smith Review > Diseases of the Bone, Joints and Connective Tissue p1087-1148 > Flashcards

Diseases of the Bone, Joints and Connective Tissue p1087-1148 Flashcards

1
Q

List 7 factors implicated in the development of physitis.

A
  1. Genetic component in fast growing race horses
  2. Mineral imbalances
  3. Excessive exercise on hard surfaces
  4. Overweight foals
  5. Excessive or deficient calcium intake
  6. High levels of carbohydrates
  7. Growth spurts
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2
Q

How would a copper deficiency cause a physitis in a foal?

A

Copper is needed for cross-linking of collagen. Without it, copper is weakened and micro fractures can occur.

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3
Q

This signalment has been found to have the most affected animals with osteochondrosis.

A

Young, intact male, purebred

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4
Q

In the following species, list the most likely locations for osteochondrosis.

Equine
Bovine
Swine

A

Equine - hock (DIRT lesions, lateral trochlear ridge of the talus, medial malleolus); stifle (lateral trochlear ridge of the femur, medial trochlear ridge of the femur, trochlear groove, distal end of the patella)

Bovine - similar to equine

Swine - medial condyle of the femur and humerus

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5
Q

List the important zones of cartilage scaffolding that is occurring during endochondral ossification. Start just under the articular cartilage.

(5)

A

Zone of resting chondrocytes - these divide to form the next zone
Zone of proliferation - these cells proliferate rapidly, organizing into columns perpendicular to the long axis of growth
Zone of hypertrophy - cells are swelling and becoming vacuolated, columns become more organized; increasing amounts of extracellular matrix to form next zone
Zone of calcification - mineralization is occurring
Zone of ossification - blood vessels are in avoiding and bone is forming, creating the primary spongiosa, ultimately remodeled into mature bone

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6
Q

What are proposed etiologies of osteochondrosis? And the pathology behind the clinical signs?

A

Proposed etiologies - trauma as a causative factor, lack of vascularization, nutritional influences, low copper levels or high zinc concentrations, heritability

Pathophysiology - once endochondral ossification is disrupted, areas become replaced with thickened cartilage; shear forces can act on the abnormal cartilage, causing fissure formation

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7
Q

Non-medical treatment of osteochondrosis consists of what?

A

Rest, diet evaluation and controlled exercise.

NSAID use, as well as IA corticosteroids, hyaluronic acid and poly sulfates glycosaminoglycans have minimal evidence to support their use

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8
Q

Differentiate between varus and valgus limb deformities.

A

Varus - medial deviation distal to origin of deformity

Valgus - lateral deviation distal to origin of deformity

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9
Q

What are potential causes of angular limb deformities?

A

Intrauterine malposition, relative immaturity, hereditary predisposition, rapid growth, dietary imbalances, osteochondrosis and trauma

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10
Q

Incomplete ossification is an important cause of angular limb deformities in horses. What bones is this seen most in?

A

Epiphyses and cuboidal bones of the carpus and tarsus are primarily affected.

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11
Q

Ruminants in confinement may experience endochondral dysplasia and angular limb deformities. List two reasons why?

A

Elevated dietary iron leads to increased serum levels of phosphorus, inhibiting 1,25-dihydroxycaholecalciferol synthesis by the kidney. This in turn leads to rickets due to in low Vitamin D absorption.

Primary Vitamin D deficiency from the diet/indoor confinement.

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12
Q

When should animals with angular limb deformities be externally suppported, as opposed to stall confinement with controlled exercise?

A

If a foal has an angular limb deformity of greater than 10 degrees, with evidence of incomplete ossification, external support should be provided by either tube casts or splints.

Those with ALDs less than 10 degrees and complete ossification of cuboidal bones, can be managed with stall rest and controlled exercise.

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13
Q

What are two ways of surgically correcting angular limb deformities?

A

Growth retardation - this occurs by place in a screw in the convex side, stopping growth on the long side and allowing the concave side to catch up; implant may need to be removed

Growth acceleration - this occurs by periosteal transaction and elevation on the concave side; this allows for rapid correction without overcorrection and no implants need to be removed; if not corrected by 4-6 weeks, then further correction is needed

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14
Q

Spider lamb syndrome (SLS) or ovine hereditary chondrodysplasia is found primarily in what breed?

A

Suffolk and Hampshire

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15
Q

Spider lamb syndrome (SLS) has what mode of inheritance? Mutation of the ovine fibroblast growth factor receptor 3 (FGFR 3) leads to loss of receptor function in homozygotes. Why is this a problem?

A

SLS has a simple autosomal recessive mode of inheritance. Mutation of FGFR3 causes chondrocyte proliferation and endochondral bone elongation. FGFR3 typically is a negative bone growth regulator.

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16
Q

Septic arthritis most commonly occurs in foals by inoculation of organisms in joints by what route?

A) Periarticular wound infections
B) Iatrogenic inoculation
C) Hematogenous inoculation
D) Traumatic inoculation

A

C) Hematogenous inoculation

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17
Q

Septic arthritis most commonly occurs in adult horses by inoculation of organisms in joints by what route?

A) Periarticular wound infections
B) Iatrogenic inoculation
C) Hematogenous inoculation
D) Traumatic inoculation

A

D) Traumatic inoculation, followed by iatrogenic inoculation

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18
Q

There are five types of hematogenous articular infections described. Type S. Type E. Type P. Type T. Type J.

What part of the joint do each of these types refer to?

A 
Type S - Synovium 
Type E - Epiphysis 
Type P - Physis 
Type T - Small tarsal or carpal bones
Type J - Joint invasion
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19
Q

In one study, ___% of horses examined within 24 hours of an open joint wound developed septic arthritis versus ___% of horses examined within 2-7 days of injury and ___% of horses examined after 7 days.

A

In one study, 53% of horses examined within 24 hours of an open joint wound developed septic arthritis versus 92% of horses examined within 2-7 days of injury and 100% of horses examined after 7 days.

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20
Q

Plasma fibrinogen of ___ mg/dL or greater was useful as an indicator of physeal or epiphyseal osteomyelitis, with a PPV and NPV of 84.2% and 98.2%, respectively.

A) 400
B) 600
C) 900
D) 1200

A

C) A fibrinogen of 900 mg/dL or greater

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21
Q 
With the following characteristics of synovial fluid, what joint condition is described? 
Color - clear
Clarity - transparent 
Fluid volume - low
Viscosity - high 
WBCs/uL - < 500 
PMNs (%) - <25
Total protein - < 1
Glucose - equal to blood
Gram or other stain - no bacteria seen

A) Normal
B) Septic
C) DJD
D) Inflammatory

A

A) Normal joint fluid is described

22
Q 
With the following characteristics of synovial fluid, what joint condition is described? 
Color - yellow/green, serosanguineous
Clarity - turbid  
Fluid volume - increased
Viscosity - low
WBCs/uL - > 30,000
PMNs (%) - > 75
Total protein - > 2.5
Glucose - < 25 mg/dL
Gram or other stain - some bacteria seen

A) Normal
B) Septic
C) DJD
D) Inflammatory

A

B) Septic joint fluid is described

23
Q 
With the following characteristics of synovial fluid, what joint condition is described? 
Color - yellow
Clarity - transparent 
Fluid volume - low
Viscosity - variable
WBCs/uL - < 5000
PMNs (%) - 25
Total protein - < 1
Glucose - equal to blood
Gram or other stain - no bacteria seen

A) Normal
B) Septic
C) DJD
D) Inflammatory

A

C) DJD is described based on the joint fluid characteristics

24
Q 
With the following characteristics of synovial fluid, what joint condition is described? 
Color - yellow to iridescent
Clarity - translucent 
Fluid volume - increased
Viscosity - low (usually)
WBCs/uL - 2,000-10,000
PMNs (%) - > 75
Total protein - > 1
Glucose - lower than blood
Gram or other stain - no bacteria seen

A) Normal
B) Septic
C) DJD
D) Inflammatory

A

D) Inflammatory joint condition is described based on the listed synovial fluid characteristics. This can include low-grade sepsis where bacteria is yet to be found

25
Q

A positive culture rate from synovial fluid samples is approximately ___%.

A) 25%
B) 50%
C) 75%
D) 95%

A

B) 50% of synovial fluid samples are positive

26
Q

What are the principles of treating septic joints?

4

A
  1. Systemic broad-spectrum antibiotics
  2. Local joint lovage/debridement
  3. Local antibiotic delivery
  4. Pain management
27
Q

What are the most common organisms isolated from septic physitis in foals?

A

Salmonella and R. Equi

28
Q

If septic arthritis is too advanced in cattle, what is an alternative treatment?

A

Facilitated ankylosis

29
Q

List some factors that influence prognosis in foals with septic arthritis.

A
  1. Systemic condition
  2. Number of joints involved
  3. Localization of joints involved
  4. Severity of the infection
  5. Early versus delayed identification and institution of treatment
  6. Presence of osteomyelitis
  7. Virulence of organisms
30
Q

List some factors associated with NON-survival in foals with septic arthritis.

A
  1. Less than 30 days of age
  2. Critical illness
  3. Multisystem disease
  4. Multiple bone lesions
  5. Lesion of the proximal phalanx
  6. Concurrent septic arthritis
  7. Multiple septic joints
  8. Involvement of the coxofemoral, stifle, hock or navicular bursa
31
Q

Pathogenic Mycoplasma can cause many different conditions. Other than polyarthritis, what might does or kids present with?

A

Does with pathogenic Mycoplasma often have mastitis, pneumonia, as well as lymphadenitis, peritonitis, abortions, pericarditis and keratoconjunctivitis.

Kids will frequently have septicemia, pneumonia and can less commonly have meningitis.

32
Q

What pathogenic species of Mycoplasma is most common in the United States, causing polyarthritis in goats? Does this affect cattle?

A

Mycoplasma mycoides, subspecies mycoides.

M. mycoides subspecies mycoides (small colony) was found in cattle to cause contagious bovine pleuropneumonia. This has since been eradicated (1892) and the species that affects goats cannot be serologically differentiated from the bovine strain. The caprine strain is also known as large colony type.

33
Q

What is important to consider when selecting antibiotics to treat polyarthritis caused by Mycoplasma mycoides submycoides?

A

Mycoplasma bacteria lack a cell wall, therefore drugs that inhibit cell wall synthesis are ineffective. These bacteria are susceptible to antimicrobials that distrust DNA or protein synthesis.

34
Q

What antibiotics is Mycoplasma generally susceptible to?

A

Macrolides, tetracyclines, florfenicol, tylosin

35
Q

What are recognized forms of CAE?

A

CAE can present as leukoencephalomalacia, polysynovitis-arthritis, endurative mastitis and interstitial pneumonia

36
Q

What causes the enlarged joints of animals affected with CAE?

A

Hyperplasia of the synovial tissues causes this problem, more frequently than increased volume of the joint fluid.

37
Q

The AGID is reportedly A)MORE/LESS specific but B)MORE/LESS sensitive than the ELISA for CAE.

What does this mean?

A

A) more
B) less

If the AGID is more specific but less sensitive than the ELISA, than the AGID should be done as a confirmatory test, and positive animals should be considered to have the test. Negative animals may be false negatives.

Positive animals have a lifelong infection.

38
Q

Why should kids that test positive for CAE at ages 8-16 weeks of age be retested when they are older?

A

Kids may be transiently positive due to presence of antibodies from the dam. The kids will typically STILL seroconvert later due to the non-protective nature of maternal Abs.

39
Q

What is stimulating the granulomatous inflammatory pathology in affected tissues of animals with CAE?

A

Non-neutralizing antibodies released by lymphocytes are interacting with virus-infected macrophages, leading to immune complexes that buildup and cause the pathology behind CAE.

40
Q

Which of the following are ways that CAE can be transferred between animals?

A) Through colostrum/milk
B) Direct contact
C) In utero
D) Aerosol

A

A B and C

41
Q

Why should, ideally, animals be tested twice a year for CAE?

A

CAE seroconversion is often preceded by viral shedding, thus, animals that are tested negative may be shedding the virus and another animal acquires the virus, while also testing negative.

42
Q

If an animal with CAE is not to be culled, how far away, at minimum, should they be housed to prevent transmission?

A) 4 feet
B) 6 feet
C) 8 feet
D) 10 feet

A

B) Seropositive animals should be housed at least 6 feet away from zero negative animals.

43
Q

If colostrum is going to be used from an animal with an unknown status of CAE, how should the colostrum be treated to try to lower the risk of CAE transmission?

A

Heat treat at 113*F for 1 hour.

44
Q

What are other names that osteoarthritis is known as?

A

Degenerative joint disease, osteoarthrosis, and secondary joint disease

45
Q

That is the most important basis for development of OA in large animals?

A

Severe injury or low-grade repetitive damage

46
Q

What changes in the joint, characterize OA?

A

Fibrillated and ulcerated cartilage, eburnation and sclerosis of subchondral bone, hyperplasia of the synovial membrane and development of periarticular osteophytes

47
Q

These things may contribute to failure of resident chondrocytes to maintain the extracellular matrix, as seen in OA.

(3)

A
  1. Trauma and then repetitive micro trauma, damaging chondrocytes and physically disrupting the joint surface
  2. Destructive enzymes, released from leukocytes, degrade the cartilage surface
  3. Proteoglycans rapidly depleted from the extracellular matrix
48
Q

How can repetitive cyclic compression during exercise affect subchondral bone and potentially predispose the joint to the development of OA?

A

Repetitive cyclic compression can cause remodeling and subchondral bone sclerosis, leading to trauma to the overlying articular cartilage

49
Q

List some radiographic findings in a joint affected with OA.

A

Marginal osteophyte proliferation, periosteal new bone production at sites of joint capsules and ligamentous attachments (entheseophytes), narrowing or obliteration of the joint space, subchondral bone sclerosis, occasional subchondral lysis

50
Q

Treatment for OA is dependent on the inciting cause of OA, stage of cartilage degradation, joint involved and degree of active inflammation. What treatments are popular for OA?

A

IA corticosteroids, IA and IM polysulfated glycosamioglycans, IA and IV hyaluronan and oral GAGs

51
Q

List some viruses that can cause arthropryposis.

4

A
  1. Schmallenburg
  2. Cache Valley
  3. Akbane
  4. Bluetongue
52
Q

List plants that can cause arthrogryposis.

A
  1. Genera Lupin, Conium, and Nicotiana

2. Grazing on sorghum pastures and ingesting Veracruz californicum

JAS Smith Review (32 decks)

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