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Equine Medicine and Surgery > Lecture 13: Osteochondrosis and Subchondral Cystic Lesions > Flashcards

Lecture 13: Osteochondrosis and Subchondral Cystic Lesions Flashcards

1
Q

what lesions can be considered Developmental Orthopedic Disease (DOD)

A

OCD, angular limb deformities, SCB cysts, physitis, flexural deformities, cuboidal bone deformity, vertebral malformation

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2
Q

What is Osteochondrosis

A

Failure of endochondral ossification in articular-epiphyseal complex (growth plate)

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3
Q

What is Osteochondritis dissecans (OCD)

A

Clinical condition of synovitis due to disrupted joint surface due to DOD

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4
Q

What are Subchondral bone cysts (SCB)

A

Invaginations into the bone just below the articular cartilage filled with debris and lined with fibrous tissue

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5
Q

What is juvenile osteochodnral conditions

A

Specific to disturbance of chondral ossification of the AE complex

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6
Q

Describe endochondral ossification

A

Starts as cartilage and as cartilage expands it ossifies from center to outward

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7
Q

Where are the locations for endochondral ossification

A
  1. Epiphysis, joint surface, metaphysical growth plate
  2. Secondary ossification center s- carpal and tarsal bones, apophyses
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8
Q

Failure of endochondral ossification results in __which in legs causes ___ and in neck causes ___

A

Osteochondrosis
Leg- lameness
Neck- neurological signs (wobblers)

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9
Q

What is the zone of hypertrophy

A

Chondrocytes are fatter and expanding as cartilage and then ossify behind

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10
Q

What is the blue arrow pointing at

A

zone of hypertrophy

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11
Q

Lesions of Osteochondrosis are a result of persisting ___

A

Chondrocytes in the zone of hypertrophy— cartilage becomes thicker but doesn’t ossify

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12
Q

What can cause chondrocytes to persist in zone of hypertrophy

A
  1. Failure of vascular invasion
  2. Failure of ossification
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13
Q

what does this show

A

Failure of Osteochondrosis, cartilage becomes thicker, not strong

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14
Q

What does this show

A

left: Osteochondrosis (not dissecans because hasn’t broken off yet)
Right: healing but still cartilage, bone has just formed around

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15
Q

What does this show

A

OCD on trochlear ridge

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16
Q

What does this show

A

Subchondral bone cyst

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17
Q

What happens in the formation of Subchondral bone cyst

A

Articular defect allows synovial fluid pressure into Subchondral bone causing bone resorption

Enlarges until pressure equilibrates

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18
Q

OCD vs SBC, which forms from weight bearing

A

SBC

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19
Q

OCD vs SBC: which occurs from shear forces on gliding surfaces

A

OCD

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20
Q

OCD vs SCB: which forms from compressive forces on loaded areas

A

SCB

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21
Q

What is wrong here

A

Subchondral post cyst

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22
Q

What are some possible factors of OC

A
  1. Growth rate
  2. Diet
  3. Heritability
  4. Trauma (normal trauma on defective cartilage and excessive trauma on healthy cartilage)
  5. Exercise
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23
Q

Excess ___in diet is strongly implicated in OC

A

Energy- excess phosphorous and calcium

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24
Q

Deficiency in what trace mineral is linked to OC

A

Copper

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25
Q

Excess of what mineral leads to OC

A

Zinc

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26
Q

What does a deficiency in cooper cause to result in OC

A

Failure of hydroxylysine cross link in collagen (loss -of “grass in adobe”)

Lysyl oxidase requires Copper

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27
Q

What is the heritable cause for OC

A

Propensity for rapid growth (not a particular gene)

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28
Q

What are some clinical signs of OC

A
  1. Joint effusion
  2. Lameness
  3. DJD
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29
Q

OC can be asymptomatic if fragment is stable, you may need to ___if for sale

A

Treat the radiographs

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30
Q

What is the synovial fluid analysis like for OC

A

Normal

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31
Q

__% bilateral for OC

A

50%

32
Q

What is wrong here

A

OCD at distal intermediate ridge of tibia

33
Q

What does the treatment of OCD depend on

A
  1. Joint involved- accessibility, expected success
  2. Age of horse- give time for <1
34
Q

What is the surgical treatment for OCD

A

Arthroscopy- remove fragment and loose cartilage, debridement parent bone to healthy bone with firm margins so fibrocartilage can fill in

35
Q

How do you medically manage OC

A
  1. Relieve synovitis, prevent DJD- give Adequan IM and hyaluronic Acid IA
  2. Steroids (avoid in foals)
36
Q

What is wrong here

A

SBC on medial femoral condyle

37
Q

What are some signs for SBC

A
  1. Joint inflammation
  2. Effusion (likely fetlock only)
  3. Lameness
38
Q

What is the conservation approach to OC for young horses

A
  1. Confine
  2. Minimize synovitis with IA hyalartin, adequan, cosequin
  3. Balance diet
  4. Minimize weight gain
39
Q

What is the medical therapy for SBC

A
  1. Triamcinolone injection of cyst/lining
40
Q

What are some surgical treatments for SBC

A
  1. Enucleate the cavity- remove fibrous lining and sclerotic bony margin
  2. Transcondylar bone screw
  3. Debridement and grafting
41
Q

What does this show

A

Transconylar bone screw treating SBC

42
Q

What is chondrocytes grafting

A

Put chondrocytes into joint with fibrin glue

43
Q

Coffin joint primarily gets OCD or SBC

A

SBC

44
Q

What does the lameness exam look like for SBC

A
  1. No swelling or effusion
  2. Digital flexion positive
45
Q

What is wrong

A

SBC in coffin bone/ p3

46
Q

What is the only site in the coffin joint where you can operate for OCD arthroscopically

A

Extensor process

47
Q

What wrong

A

OCD of extensor process

48
Q

How does the lameness exam look for SBC in pastern joint

A

Positive flexion
IA block test- abaxial with ring

49
Q

What is wrong here

A

SBC at pastern joint

50
Q

What does lameness exam look like for fetlock with OCD

A
  1. Lameness variable because multiple joints
  2. Fetlock effusion
  3. IA block
51
Q

What is the most common fetlock OCD site- name and number

A

Sagittal- #1

52
Q

What is wrong here

A

Sagittal ridge OCD- fetlock

53
Q

what wrong here

A

SBC in fetlock

54
Q

What is wrong here

A

SBC in radial carpal bone

55
Q

Where are SBC common in elbow joint

A

Medial proximal radial condyle

56
Q

T or F: elbow joint SCB are arthroscopically accessible

A

False, subarticular approach

57
Q

What is wrong here

A

SBC in elbow/ humerus

58
Q

Where is OCD generally in elbow

A

Distal numeral condyle

59
Q

Is shoulder joint/ numeral OCD common

A

Yes

60
Q

How do you dx shoulder joint/ numeral OCD

A
  1. IA blocks
  2. Scintigraphy
  3. Quality rads may require Anesthesia
61
Q

What is wrong here

A

Shoulder/humeral OCD

62
Q

Which is more common OCD or SBC on tibiotarsal joint

A

OCD

63
Q

What does lameness show in tibiotarsal joint OCD

A
  1. Effusion- obvious bog spavin
  2. Minimal lameness- may require flexion
64
Q

What is wrong here and likely cause

A

Tibiotarsal joint effusion/ bog spavin- OCD

65
Q

What are the tarsal sites of predilection of OCD

A
  1. Distal intermediate ridge of tibia
  2. Medial malleolus of tibia
  3. Distal lateral trochlear ridge of tibial tarsal bone
66
Q

What wrong here

A

OCD of distal intermediate ridge of tibia

67
Q

What is wrong here

A

Lateral trochlear ridge OCD

68
Q

What wrong here

A

Medial malleolar OCD

69
Q

SBC or OCD more common in femorotibial joints

A

SBC (very common)

70
Q

Where is SBC usually located in femorotibial joints

A

Medial femorotibial joint

71
Q

What is wrong here

A

Medial femoral joint SBC

72
Q

OCD or SBC: more common in femoropatellar joints

A

OCD

73
Q

What is wrong here and likely cause

A

Femoropatellar joint effusion- OCD

74
Q

What is wrong here

A

lateral trochlear ridge OCD

75
Q

What wrong here

A

lateral trochlear ridge OCD

76
Q

What does a lameness exam look like for coxofemoral joint for SBC

A

Positive flexion
IA anesthesia

77
Q

Where are coxofemoral joint SBC located

A

Femoral head

Equine Medicine and Surgery (27 decks)

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