Lecture 8: Muscoskeletal Diseases Flashcards
what causes bone fractures
Trauma Nutrient deficiencies Neoplasm Hormonal imbalance Infection
how do you classify bone fractures
Open vs closed
Complete vs incomplete
describe a linear fracture
Linear: incomplete, parallele to bone
describe a greenstick fracture
incomplete, bent
describe a comminuted fracture
multiple bone fragments
describe a compression fracture
collapse of vertebra
describe an avulsion fracture
loss of section of bone due to muscle contraction
how do you diagnose a bone fracture
History, signs: severe lameness, pain, crepitus on palpation
Radiographs
what can bone fractures be associated with
If the result of trauma Can be associated with more severe damage!
Shock, internal organ damage, internal bleeding
how do you initially manage a bone fracture
Initial management: immobilization
Reduces pain
Reduces trauma to soft tissue
Closed fractures (2-4 days), open (8h; 24-48h)
how do you repair a bone fracture
External coaptation: splint or cast
External fixation
Internal fixation: plates, screws, nails, pins, wires
what factors are to be considered when treating a bone fracture
Fracture
Patient
Environment
what is important to remember about a splint or cast repair
Splints need frequent evaluations and changes
complications may result in a longer overall healing period
whereas some fixation methods improve the chance of successful outcomes without demanding post-operative care.
what is panosteitis
Acute, self-limiting condition in quickly growing animals
Pain & inflammation
In long bones
Most common in large and giant dog breeds
what causes panosteitis
Unknown (idiopathic)
Genetic
Stress
Autoimmune factors
what are the clinical signs of panosteitis
Acute lameness in young animals
Often shifting lameness, intermittent
May be associated with muscle atrophy
Fever, anorexia, lethargy
how do you diagnose panosteitis
History, signs, PE
Radiographs (may be NSF if acute)
Rule out more serious causes
how do you treat panosteitis
Palliative
Pain relief
Review diet
Excessive development contributes to this disorder
what is degenerative joint disease
Progressive, long-term deterioration of the joint cartilage, causing damage
Frequent in dogs and cats
what causes degenerative joint disease
Age Infection Trauma Developmental dystrophies Obesity Autoimmune conditions
what are the clinical signs of degenerative joint disease
Lameness Worst with exercise, weather changes, inactivity Muscle atrophy Joint inflammation and crepitus Decrease in activity, gait change
how do you diagnose degenerative joint disease
history and PE
radiographs
describe degenerative joint disease
Narrowed joint space
Bone sclerosis
Osteophytes
Joint effusion
Non-inflammatory
Severity of lesion not indicative of pain
how do you treat degenerative joint disease
Palliative Weight loss Pain management (monitoring) Low impact exercise Specialized diets Physical therapy Surgery Joint replacement or excision
what is hip dysplasia
Very common ☹ Abnormal development of coxofemoral joint Joint laxity Leads to DJD Most common in large breeds
what causes hip dysplasia
Genetic
Extra nutrients in diet
what are the clinical signs of hip dysplasia
Variable
Lameness, bunny hop
Reduced range of motion
Muscle atrophy
how do you diagnose hip dysplasia
History & PE
Subluxation test
Radiographs
Special protocols: OFA, PennHIP
how do you treat hip dysplasia
Medical management Surgical options TPO (triple pelvis osteotomy) THR (total hip replacement) FHO (femoral head osteotomy)
what is osteochondritis dissecans
Results from abnormal bone formation from cartilage precursors.
Leads to retention of excessive cartilage in the joint
Forms flaps and breaks off in joint space
Debris can lead to synovitis and osteoarthritis
what are the most common sites of osteochondritis dissecans
Shoulder Elbow Stifle Tarsal joint Most common in large and giant breeds
what are the clinical signs of osteochondritis dissecans
4-8 mo old
Lameness
Inflammation, joint effusion
Muscle atrophy
how do you diagnose osteochondritis dissecans
Signs and history, PE
Radiographs
Cytology to rule out infectious
Arthroscopy
how do you treat osteochondritis dissecans
Removal of joint debris + curette to stimulate new formation of cartilage
NSAIDS
Weight control
Prognosis depends on joint (+: shoulder, stifle; -: elbow, tarsus) and degree of damage
Likely genetic so stop breeding
what is patellar luxation
Patella no longer stays confined to femoral groove Medial or lateral movement Can be uni or bilateral Can lead to osteoarthritis Toy and small breeds Mostly genetics
what are the clinical signs of patellar luxation
Can develop very early
Skipping lameness
Abnormal leg position: bow legged or knock-kneed
Rarely painful
how do you diagnose patellar luxation
History, Signs, PE
Orthopedic exam
Radiographs to evaluate changes
when do you do surgery for patellar luxation
If animal symptomatic
Considered for grade 2 and over
Reconstruction of soft tissue and groove (mostly)
what is a cranial cruciate ligament rupture
Most common causes of hindlimb lameness
Tear or rupture of stifle stabilisation ligament
what causes CCL
Trauma
Autoimmune disease
Conformational deformity (genetic)
40-60% of dogs that have CCL in one knee will, at some future time, develop a similar problem in the other knee.
what are the clinical signs for CCL
Lameness, non-weight bearing Pain Joint effusion Muscle atrophy Drawer sign: Radiographs
how do you treat CCL
Medical Weight loss, Physical therapy NSAID, analgesics, joint supplements Surgical Best treatment option Done to restore stability, not repair Osteotomy or suture technique
what is intervertebral disk disease
Degeneration and protrusion of the disk located between the vertrebra
Puts pressure on spinal cord, causing CNS signs
which animals are genetically pre-disposed to intervertebral disk disease
Genetic predisposition in chondrodystrophic dogs
Dachshunds, Shih Tzus, Lhasa Apsos, Basset, Corgis, Beagles, Cocker
what are the clinical signs of IVDD
Neck and back pain
Muscle spasm (stiff, round back)
Ataxia, paraplegia, toe knuckling
how do you diagnose IVDD
History, signs and PE
Neurological exam
Radiographs/CT
how do you treat IVDD
Conservative treatment with cage rest, confinement, and pain medications
first episode and the neurologic deficits are mild
Surgery
More severe cases
Loss of deep sensation requires emergency surgery
Prognosis is variable
