Juvenile Orthopedic Diseases Flashcards
osteochondrosis / OCD
disruption/failure of normal endochondral ossification at the growth cartilage at the epiphysis of the femur, humerus, and tarsus
likely caused by ischemia
clinical signs of OC/OCD
lameness
pain on palpation
joint effusion
OC/OCD treatment
surgical tx ONLY
palliative: remove flap and allow fibrocartilage formation
prognosis depend on location:
- shoulder: good
- stifle, elbow tarsus: relieves pain but likely to still have lameness
OC/OCD signalment
young (4-5 months)
large breeds
males
**highly heritable
panosteitis
protein retention leading to increased intraosseous pressure –> fat necrosis –> vascular proliferation –> bone formation –> bone remodelling –> replacement with fat
OC/OCD on radiographs
subchondral bone defect (concave lucency in subchondral bone) with surrounding sclerosis
OCD: cartilage flap fragment within joint (only visible if mineralized)
clinical signs of panosteitis
shifting limb lameness
NO systemic illness
painful long bones
panosteitis treatment
none; self-limiting
prognosis is good
panosteitis signalment
young (5-12 months)
large breed (GSD, rotties, labs, great danes)
males
panosteitis on radiographs
increased intramedullary opacity (“wispy” sclerosis/smoke in the chimney)
periosteal productive response
**can have a radiographic lag compared to onset of clinical signs
hypertrophic osteodystrophy
zone of abnormal trabecular bone in the metaphysis –> hemorrhage, inflammation, necrosis, and fibrosis –> reactive bone formation
most common in the distal radius, ulna, tibia, and fibula
clinical signs of HOD
systemic illness
swelling of distal metaphysis
secondary angular limb deformities
HOD treatment
supportive care
- self-limiting
fluids, NSAIDs, opioids
prognosis is good in mild cases, poor in severe cases
HOD signalment
young (3-8 months)
large and giant breeds
HOD on radiographs
lucent line in the metaphysis that is parallel to the physis
later stage: becomes productive causing widening of the metaphysis + periosteal reaction (flare/collar of bone)
hip dysplasia
malformation of the hip joint
major predisposition to DJD
hip dysplasia on radiographs - VD w/ hip extension
- joint conformation: <50% coverage of the femoral head by the acetabulum
- joint incongruity: non-parallel margins of the subchondral bone of the acetabulum and femoral head
- joint instability: subluxation on static rads or DI on pennhip
secondary DJD: enthesiophytes (morgan’s line), femoral neck thickening, osteophytes
hip dysplasia on radiographs - penn hip
series of stress radiographs that allow measurement of distraction index
large DI = significant instability
elbow dysplasia
malformation of the elbow joint caused by:
1. OCD of medial humeral condyle
2. medial coronoid process disease
3. ununited anconeal process
4. joint incongruity
OCD of humeral condyle/trochlea on radiographs
OC lesion (concave lucency) on the medial aspect of the humeral condyles
*best viewed on CT
medial coronoid process disease
fractures or malformations of the coronoid process of the ulna
MCPD on radiographs
loss of the medial coronoid process margin (cannot trace the MCP)
surrounding sclerosis
osteophytes at the anconeal process
ununited anconeal process
anconeal process fails to fuse to the ulna by 6 months old
can NOT diagnose until 6-7 months old
UAP on radiographs
view: flexed lateral
large, triangular fragment of the anconeal process
surrounding sclerosis
elbow joint incongruity
any deformity that causes the components of the elbow joint to not be lined up properly
retained ulnar cartilage core
cores or cones of growth plate cartilage projecting from the distal ulna growth plate into the distal metaphysis
clinical signs of RUCC
thoracic limb lameness
angular limb deformities
RUCC treatment
none vs osteotomy
depends on if angular limb deformity occurs
RUCC signalment
young (3-4 months)
giant breeds
RUCC on radiographs
“flame” shaped lucency in the distal ulnar physis extending into the metaphysis
+/- sclerosis of the ulnar metaphysis
