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Small Animal Orthopaedics > Elbow > Flashcards

Elbow Flashcards

1
Q

What is he most common cause of a forelimb lameness?

A

Elbow

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2
Q

What are the differentials for a lameness in the elbow?

A

Congenital
Elbow dysplasia - IOHC, FCP, uninvited medial condyle

Traumatic
IOHC - condylar fracture
Proximal ulna / radius fractures
Luxation / collateral ligament ruptures

Degenerative
Flexor enthesiopathy
Osteoarthritis

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3
Q

What is the OCD predilection site in the elbow?

A

Medial condyle of the humerus

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4
Q

What should you evaluate on a craniocaudal view of the elbow?

A 
Collateral ligaments
Coronoid process of the ulna (bottom one)
Medial condyle for OCD
Fissure line between humeral condyles
Enthesiopathy
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5
Q

What 3 sites show changes on a lateromedial view of the elbow in OA?

A

Cranial aspect of the radial head - osteophytes
Dorsal process of the anconeal process - osteophytes
Ulna caudal to the anconeal process - sclerotic

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6
Q

What can synoviocentesis of the elbow be used to diagnose?

A

Inflammatory arthropathy

- increased neutrophils

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7
Q

What is the most sensitive imaging modality for use in elbow disease?

A

Arthroscopy

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8
Q

What breeds are predisposed to elbow dysplasia?

A

Labradors
Rottweilers
Bernese mountain dogs

Though to be genetic

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9
Q

What 4 disease entities result in elbow dysplasia?

A

Fragmented medial Coronoid process
OCD of the medial humeral condyle
Ununited anconeal process
Elbow incongruity = short radius syndrome

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10
Q

What is a common pathogenesis of elbow dysplasia?

A

Elbow incongruency due to a short radius

Overloads the medial Coronoid process - fragments

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11
Q

How can you diagnose medial Coronoid disease?

A

History and clinical signs
Radiography - appears normal, may be mild osteophyte formation as predilection sites
- cranial head of radius
- dorsal anconeal process

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12
Q

What should you consider as a differential in a case of elbow dysplasia?

A

Panosteitis - GSD, other large breeds

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13
Q

What is the best method of diagnosing medial Coronoid disease?

A

Arthroscopy

Can also remove the fragment during this

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14
Q

How can you conservatively manage elbow dysplasia?

A 
Warn owner animal will get OA
Rest 
Lead exercise 5-10 mins per day, gradually increase this 
NSAIDs and paracetamol / codeine 
Weight control 
Omega 3 supplements 
Physio / hydrotherapy
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15
Q

What surgical treatments are available for medial Coronoid disease?

A 
Arthroscopic removal 
Arthrotomy
Proximal ulnar osteotomy 
- fragment removal alone 
- fragment removal + proximal ulnar osteotomy 
- subtotal coronoidectomy 
- biceps ulnar release procedures 
- sliding humeral osteotomy 
- total elbow replacement
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16
Q

How can you diagnose OCD of the medial humeral epicondyle?

A

Radiography
Arthroscopy
Arthrotomy

17
Q

When is surgery indicated in OCD of the medial humeral epicondyle?

A

When there is a fragmented but no secondary changes

18
Q

What surgery should be performed to treat OCD of the medial humeral epicondyle?

A

Arthroscopy / arthrotomy

  • cartilage flap removal
  • curettage the bone
19
Q

What breeds are predisposed to ununited anconeal process?

A

GSD, Bassetts, bernes mountain dog

Should have normally fused by 5 months
10-11 months in Bassett
- will see ununited anconeal process on radiograph

20
Q

How can you treat an ununited anconeal process?

A

Conservative tx - mild lameness in Bassetts

Surgery - cases that fail to respond to conservative management
- lag screw fixation of anconeal process +/- proximal ulnar osteotomy
= 85% then radiographically Unite

Can remove the anconeal process in older dogs

21
Q

What is what is the pathology of elbow incongruency?

A

Radius and ulna do not grow at the same rate due to early closure of the radial physis = short ulna syndrome

Tx: ulna osteotomy / osteotomy

22
Q

What breed is predisposed to incomplete ossification of the humeral condyle?

A

Springer spaniel, cocker spaniels and Labradors

23
Q

How does IOHC present?

A

Chronic, intermittent or continuous thoracic limb lameness
Acute humeral condyle fracture

Dx: Ct or radiography shows a fissure line
Tx: trans-condylar screw

Small Animal Orthopaedics (8 decks)

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