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CVSOH BVSc4 > Lame - SA joint problems > Flashcards

Lame - SA joint problems Flashcards

1
Q

What is degenerative joint disease also known as?

A

Osteoarthritis

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2
Q

What are the different classifications of joint disease?

A

Osteoarthritis
Septic arthritis
Immune mediated arthritis

Osteochondrosis
Neoplastic
Trauma

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3
Q

What is articular cartilage also known as?

A

Hyaline cartilage

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4
Q

What is osteoarthritis?

A

Degenerative disease of synovial joints

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5
Q

What is a simplified explanation of what happens in osteoarthritis?

A

Deterioration of articular cartilage and the formation of new bone at joint margins (osteophytes)

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6
Q

What are some secondary causes of osteoarthritis?

A

Congenital eg. achondroplasia (dwarfism)
Developmental eg. hip dysplasia
Acquired eg. after fractures

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7
Q

What is the pathogenesis of osteoarthritis?

A

Loss of cartilage matrix constituents and chondrocytes
Flaking and fibrillation - less smooth
Osteophytes
Synovial membrane thickening and fibrosis

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8
Q

What makes up the cartilage matrix?

A

Collagen
Glycosaminoglycans
Chondrocytes

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9
Q

What is the onset of osteoarthritis?

A

Insidious, chronic, slowly progressive
Can be acute lameness if done lots of exercise

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10
Q

How do you confirm the diagnosis of osteoarthritis on radiograph?

A

Osteophyte formation
Soft tissue swelling
Joint effusion
Subchondral sclerosis
Synoviocentesis

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11
Q

What changes occur to the synovial fluid in osteoarthritis?

A

Increase in volume, decrease in viscosity

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12
Q

How do you treat/manage osteoarthritis?

A

Exercise modulation
Weight loss
Physical therapy/hydrotherapy
Drugs - end stage OA
Surgical options
Environmental modification

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13
Q

What exercise should animals with osteoarthritis do? Why?

A

Little and often, not vigorous
Avoid inactivity - strengthen ligaments, prevent fibrosis, maintain muscle tone

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14
Q

Why is massage good for osteoarthritis?

A

Stimulates circulation

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15
Q

How does hydrotherapy improve osteoarthritis?

A

Improves range of motion
Muscle strength improves
Fitness
No high impact

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16
Q

What drugs can you give for end stage osteoarthritis, or if management isnt working?

A

NSAIDs
Corticosteroids - last resort

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17
Q

How do NSAIDs help osteoarthritis?

A

Analgesic
Catabolic - increases proteoglycan synthesis
Has GI side effects though

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18
Q

What are some nutraceutical drugs/chondroprotectives?

A

Pentosan polysulphate
Glycosaminoglycans

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19
Q

What benefits do nutraceutical drugs/chondroprotectives have?

A

Claim to stop or moderate the degenerative processes in the cartilage
Improve joint fluid
Improve healing

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20
Q

What are some surgical options for osteoarthritis?

A

Correct inciting cause to delay progression of osteoarthritis
eg. TPLO for cranial cruciate ligament rupture
Hip dysplasia - TPO (triple pelvic osteotomy)
Patella luxation

Salvage procedures

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20
Q

What are some salvage procedures done for osteoarthritis?

A

Joint replacement
Joint fusion eg. carpus
Joint removal eg. remove femoral head

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21
Q

How can you modify the environment for osteoarthritis?

A

Soft beds
Ramps or steps
Low litter tray
Feed on the floor for cats

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22
Q

What is the pathogenesis of septic joint disease?

A

Bacteria rapidly proliferate in the joint
Acute inflammatory response
Cytokine release
Cartilage loss
Erosions

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23
Q

What is the signalment for septic/infectious joint disease?

A

Cats - bites
Dogs - young large breed males but can affect all

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24
Q

What are the clinical signs of septic joint disease?

A

Acute or chronic
Painful
Effusion/swollen
Severe lameness
Single joint

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25
Q

How can you diagnose septic joint disease?

A

Radiography
Arthrocentesis

26
Q

How does synovial fluid present in septic joint disease?

A

Less viscous
Increased volume
Darker in colour
High numbers of cells - neutrophils

27
Q

How do you treat septic joint disease?

A

Remove infected fluid
Lavage
Antibiotics - culture
Surgical debridement

28
Q

What is the prognosis of septic joint disease?

A

Good in acute cases with appropriate therapy
Poor in chronic cases with cartilage loss

29
Q

What are the two different categories of immune mediated inflammatory joint disease?

A

Erosive and non erosive

30
Q

What is the most common immune mediated inflammatory joint disease?

A

Idiopathic immune mediated polyarthritis

31
Q

What does it mean to be an erosive immune mediated inflammatory joint disease?

A

Can see bone erosion on imaging

32
Q

What is the main erosive immune mediated inflammatory joint disease?

A

Rheumatoid arthritis

33
Q

What are some non erosive immune mediated inflammatory joint diseases?

A

Idiopathic immune mediated polyarthritis
Polyarthritis/polymyositis
Polyarthritis/meningitis
Vaccine/drug reactions

34
Q

What is rheumatoid arthritis usually seen in? Is it common?

A

Small breed dogs - rare

35
Q

What occurs in rheumatoid arthritis?

A

Erosive joint disease
Joint collapse
Crepitus and instability
Pain variable

36
Q

What is idiopathic immune mediated polyarthritis?

A

Type III hypersensitivity reaction - immune complex deposition that affects multiple small distal limb joints
Causes stiffness and lameness in young dogs

37
Q

What are the different types of idiopathic immune mediated polyarthritis?

A

Type I - uncomplicated
Type II - associated with remote infection eg. pyometra
Type III - Associated with GI tract disease
Type IV - associated with neoplasia

38
Q

What are the clinical signs of idiopathic immune mediated polyarthritis?

A

Lameness of distal small joints
Pyrexia
Can migrate from joint to joint

39
Q

What does idiopathic immune mediated polyarthritis look like on radiograph?

A

Soft tissue swelling

40
Q

How do you diagnose idiopathic immune mediated polyarthritis?

A

Arthrocentesis of 6 joints
Increase in volume, change in colour
Lots of neutrophils - not as active as in septic arthritis though
No bacteria

41
Q

How do you treat idiopathic immune mediated polyarthritis?

A

Treat any underlying cause
Immunosuppressive drugs - prednisolone
Azathioprine, cyclophosphamide if these dont work
Then taper down

42
Q

What is the prognosis for idiopathic immune mediated polyarthritis?

A

Type I - cure in 50% of cases
Other half need continued medication or euthanasia

43
Q

What are some examples of tumours than invade the joints?

A

Synovial sarcoma
Fibrosarcoma
Haemangiosarcoma

44
Q

How can you tell if a tumour in the joint is an osteosarcoma or not?

A

Osteosarcomas dont tend to cross joints - not in multiple bones

45
Q

What is the treatment for joint neoplasia?

A

Amputation

46
Q

What predisposes dogs to osteochondrosis?

A

Hereditary disease - dont breed affected dogs
Multifactorial - high calorie diet
Exercise

47
Q

What is the pathogenesis of osteochondrosis?

A

Failure of endochondral ossification resulting in a thickened area of cartilage (cartilage doesnt turn to bone)

48
Q

What is osteochondritis dissecans?

A

When the flap of cartilage separates from the bone into the joint

49
Q

What is the signalment of osteochondrosis?

A

Age - 4-8 months
Large/giant breeds
Cats - very rare
More in males

50
Q

What are the clinical signs of osteochondrosis?

A

Insidious onset lameness
Chronic
Deteriorates after rest or excessive exercise
Bilateral
Reduced range of motion in the joint
Pain on manipulation
Effusions/swelling of the joint

51
Q

How do you diagnose osteochondrosis?

A

Radiography/CT
Saucer shaped defect in the bone
Joint mice - balls of cartilage next to joint
Osteophytes
Mineralised flaps

52
Q

What conservative treatment can you use to treat osteochondrosis?

A

Rest, NSAIDs, diet

53
Q

What surgical treatment can you use to treat osteochondrosis?

A

Surgery - arthrotomy, arthroscopy for cartilage flap removal
Chondrectomy - remove cartilage

54
Q

What are the complications of osteochondrosis surgery?

A

Seroma formation
Failure to remove all cartilage flap causing chronic lameness

55
Q

What is the prognosis for osteochondrosis?

A

Better for stifle and shoulder (loose joints)
Better for smaller lesions
Worse for tighter joints eg. hock and elbow
Worse for large lesions or chronic problem

56
Q

What will all dogs develop with osteochondrosis?

A

Osteoarthritis

57
Q

Where does osteochondrosis occur in the shoulder?

A

Caudomedial humeral head (OCD)

58
Q

Where does osteochondrosis occur in the elbow?

A

Medial humeral condyle (OCD)
Anconeal and coronoid process on ulna

59
Q

Where does osteochondrosis occur in the carpus?

A

Retained cartilaginous cores on the ulna

60
Q

Where does osteochondrosis occur in the stifle?

A

Lateral condyle of the femur

61
Q

Where does osteochondrosis occur in the hock?

A

Medial talar ridge on the talus

62
Q

What is the most common to least common joints to get osteochondrosis in in the dog?

A

Elbow - most common
Shoulder
Hock
Stifle - least common

CVSOH BVSc4 (86 decks)

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