Lecture 13 - DDx of forelimb lameness in large dogs Flashcards
is the coronoid process a common site for OC?
no, there was a thoery that fracture of coronoid process was due to OC but this has been proven wrong!
what is the common location for osteochondrosis desicans (OCD)?
humeral head
how to do you differentiate OC from OCD on PE?
the dog will have a weight bearing lameness with OCD. often radiographs will NOT help you to differentiate - but more likely to notice differences on the lateral radiograph
what is the treatment for OCD, which joint has the best response, and what is the approach?
tx for OCD is arthroscopy.
shoulder
craniolateral, caudolateral or caudal approach
what is the prognosis for OCD?
typically excellent for a normal return of limb function following both arthrotomy and arthroscopy
what is the leading cause of forelimb lameness in the dog? especially large breeds?
elbow dysplasia!
elbow dysplasia is really an umbrella term for 3 different conditions - what are they and which one is most common?
- ununited anconeal process (UAP)
- OC/OCD of the medial humeral condyle
- fragmented coronoid process (FCP)
what breed do we see commonly with elbow dysplasia?
rottweilers - they are famous for the supinated stance
what breeds do we commonly see with ununited anconeal process?
GSD and basset hounds
how does the anconeal process normally fuse to the olecranon?
there is a separate center of ossification. at 4 - 5 months of age it fuses to the main body of the olecranon (normal when the animal is young)
by what age is the anocneal process considered to be ununited to the olecranon?
20 weeks of age
describe the proximal diaphyseal ulnar osteotomy
it is a treatment for an ununited anconeal process
if there is incongruity of the proximal raidal head (its too high) –> we raise the ulna by cutting a piece out. this relieves the pressure on the anconeal process.
if you have a 7mo dog with an ununited anconeal process, proximal radial head. what surgical tx should you provide?
proximal diaphyseal ulnar osteotomy.
OCD lesions of the humeral condyle always effects
the trochlea (medial portion) of the condyle
the point that articulates with the ulna
OCD of the humeral condyle occurs most often in what breed?
Labrador retrievers - particularly chocolate labs
see a limping chocolate lab, this should be first on your list
which type of elbow dysplasia is often seen in association with a fragmented cornoid process (FCP)?
OCD of the humeral condyle
OCD of the humeral condyle is best seen from what view in a radiograph?
craniolateral-caudomedial OBLIQUE projection by about 15 degrees
allows you to highlight the medial aspect of the humeral condyle
standard radiographic study of the elbow should include:
- orthogonal views
- flexed lateral view
- craniolateral caudomedial orthogonal view
in what disease do we see diffuse microcracks in subchondral bone that is consistent with FATIGUE micordamage?
fragmented coronoid process - medial aspect
what is the pathophysiology behind the fragmented coronoid process (FCP)? how does it occur?
most likely from a subtle defect in the overall shape of the trochlear notch of the ulna that creates repetitive overloading on the medial coronoid process that eventually results in fragmentation
is arthritis in the dog primary or secondary?
arthritis in the dog is SECONDARY to some underlying cause.
what is panosteitis and what part of the bone does it involve?
it is a cyclic or recurring “shifting” lameness whereby DIAPHYSEAL bone becomes abnormal
(NOT physis or metaphysis - just the DIAPHYSIS)
what are the cause and clinical signs of panosteitis? how is it treated?
cause - idiopathic
CS - “shifting” lameness, lethargy, anorexia, fever
tx - granular medullary radiopacity on radiographs - easy to recognize
was is a common site for OC?
humeral head humeral condyle - specifically the MEDIAL aspect femoral condyles patella trochlear ridges of talus
