Lecture 19: Osteochondrosis/Osteochondritis Dessicans (Exam 3) Flashcards
Definition:
A process where growth cartilage in epiphyses and growth plates is gradually turned into bone through a sequence of matrix mineralization, chondrocyte death, vascularization, and ossification.
Endochondral ossification
Definition:
a failure in the normal process of endochondral ossification
osteochondrosis
osteochondrosis commonly occurs in shoulder elbow stifle and hocks of what type of breed dogs
large and giant
What is the clinical manifestation of osetochondrosis
osteochondritis
Osteochondrosis involvement of epiphyseal physis results in chondro-osseous flaps
osteochondritis dissecans
What is this showing
osteochondrosis(focal area of delayed ossification)
In order to diagnose osteochondritis dissecans radiographic appearance must be accompanied by what
clinical sings (referable to the joint involved (OCD)
What is affecting this patient?
osteochondrosis
What is affecting the left? What about the right?
- Left: osteochondritis dissecans
- Right: osteochondrosis
Osteochondrosis leas to what at deep portion of the thickened cartilage
necrosis (susceptible to trauma)
Can you breed osteochondrosis dogs?
You can but you shouldn’t (genetic predisposition)
What can be a contributing factor to flap formation
microtrauma (location of biomechanical stress seen predisposed by repeat microtrauma)
Diets high in what two things may predispose patients to osteochondrosis in GREAT DANES? What can this diet cause
- calcium and vitamin D3
- in all breeds - increased growth rates, increased muscle mass and BW
Large and giant breeds with rapid what are predisposed to osteochondrosis
growth (overfeeding energy increases growth hormones)
What breed types are mainly affected by osteochondrosis of the humerus? What gender? What age?
- large and giant breed dogs
- males more than females
- 4-8 months old)
What diagnostic tools do you need for diagnosis of osteochondrosis
- routine radiographs
- ALWAYS RADIOGRAPGH BOTH JOINTS (BILATERAL USUALLY)
- can use CT and MRI but really not needed
What will you primarily see on radiography that indicated osteochondrosis
- irregularity in the subchondral bone contour on caudal aspect of humeral head
- may see calcified flap
What is the diagnosis of this patient?
osteochondrosis (sudden flattening and faint line on caudal aspect of femoral head indicating a flap)
Should medical management or sugery be used?
- Pain & lameness on presentation
- Typically indicates OCD vs. OC
- Greater than 8 months of age
- Joint mouse present(free fragments)
- Large lesions
Surgery
Should medical management or sugery be used?
- <6.5 months of age
- Small lesions on radiographs w/ no free fragments
- No lameness or clinical pain on palpation
Medical management
What is the goal of surgical repair of osteochondritis dissecans
- removal of osteo-chondral flap
- debridement of exposed subchondral bed
What is seen here on this arthroscopic image
osteochondritis dissecans
What is affecting this patient
osteochondrosis of the elbow (Irregularity in normal subchondral bone contour on medial aspect of the humeral condyle)
Will you get a cranial drawer on a patient with osteochondrosis?
- slight possible
- Patients are young and OCD can cause space in the joint allowing it to move more
OCD lesions in the stifle are present where?
medial aspect of the lateral femoral condyle
What would you diagnose this patient with?
Osteochondrosis of the stifle
What procedure can you preform in the stifle that is different than other areas of osteochondrosis
Osteochondral plug transfer (OATS- osteochondral autograft transfer system)
What does OATs do
transfers cartilage from away from the joint surface to the joint surface
What breed of dogs are most commonly affected by osteochondritis of the tarsus
rottweilers
Of the OCD lesions what is the poorest diagnosis
tarsal OCD
What symptom might you see in tarsal osteochondrosis that would help differentiate from stifle
- hyperextended hocks
- may be unable to flex hocks
What is the most common area of tarsal osteochondrosis
medial trochlear ridge
What would you diagnose this patient with
Osteochondrosis of the tarsus
Why will many surgeons not consider surgery with tarsal osteochondrosis
destabilization of tarsus (poor prognosis - medical management isnt much better)
What medical management techniques can be used for tarsus osteochondrosis with small lesions in nonclinical patients
- NSAID and DMOA (diseased modified osteoarthritic lesions)
- cage rest
- diet modifications
in osteochondrosis surgery you should debride until when
subchondral bone bleeds
OCD prognosis:
caudal aspect of humeral head?
good to excellent
OCD prognosis:
fragmented medial coronoid process of the ulna?
fair to good (medial humeral condyle varies)
OCD prognosis:
OCD prognosis:
lateral > medial femoral condyle?
guarded to fair
OCD lesion prognosis:
medial trochlear ridge of the talus
fair to poor
