Miscellaneous Orthopaedic Conditions Flashcards
Panosteitis
Young, large / giant breed dogs - GSD
6-18 months
More common in males
CP: acute onset, shifting lameness
More commonly found in the forelimb
- ulna (most common), radius, humerus
Dx: patchy area of increased radiodensity in the medullary cavity
(around the nutrient foramens)
periosteal new bone formation
Tx: analgesia and controlled exercise, self-resolving
Metaphyseal Osteopathy
Young, rapidly growing medium to large breed dogs
2-6 months old
Causes Unknown - immunodeficiency in weimaramers
CP: mild to very severe lameness and collapse
Pain, Pyrexia and lethargy
Swollen metaphysis
Dx: widened physis
Increased radiodensity adjacent to the physis
Radiolucent line in the metaphysis adjacent to the physis
Tx - self-limiting, supportive care and analgesia
May result in angular limb deformities
Some are euthanised due to the pain
Craniomandibular osteopathy
Non-neoplastic, non-inflammatory proliferative disease
WHWT, cairn, Scottie - autosomal recessive
4-10 months
CP: mandibular swelling and thickening
Pain when eating and difficulty pre hending
Salivation
Anorexia
Dx: radiography
- palisading proliferation on the mandible and bullae
- temporal, frontal and maxillary bones
Tx: self-limiting, analgesics, corticosteroids
Px: self limiting at 11-13 months
Legg-calve-perthes
= avascular necrosis of the femoral head
4-11 month old WHWT, miniature poodle and terriers
CP: mild cases can be sub clinical
Variable from mild lameness to non-weight bearing
Pelvic limb muscle atrophy
Pain and crepitus on manipulation of the joint
= focal area of bone lysis
Dx: femoral head has an apple core appearance on VD
Tx: conservative, FHNE, THR
Tx:
Slipped capital femoral epiphysis
= delayed closure of the capital physeal growth plate due to early neutering
Overweight, neutered male cats
Under 2yo
Siamese
CP: pain, crepitus on manipulation
Mild - acutely severe non-weight bearing lameness
Unable to jump up
Dx: resorption and sclerosis of femoral neck
Displacement of the proximal femoral metaphysis
Tx: FHNE, THR
Hypertrophic osteodystrophy
Older dogs and cats - mean age 9 years
Paraneoplastic - secondary to intra-thoracic/abdominal mass
Or neural mediated - increased blood flow to the periosteum
CP: lameness develops over several months
Firm painful welling over the bone
Hyperthermia, weight loss and depression
Dx: radiography shows periosteal proliferation
+ thoracic and abdominal imaging
Tx: symptomatic, remove primary cause
Bone cysts
Simple - fluid filled cavity line by fibrous tissue
Aneurysmal bone cyst - containing blood sinuses
Subchondral bone cyst - adjacent to the synovial membrane
CP: may be asymptomatic
Lameness, painful swelling, acute lameness (pathological fracture)
Dx: radiograph - expansive, locally aggressive, well demarcated lesion, cortical thinning
Tx: surgical drainage, curretate, cancellous bone grafting
Amputation
Can develop into an osteosarcoma!!!
Infraspinatus muscle contracture
Medium sized / working athletic dogs
Not painful
Shoulder adduction, elbow adduction, lower limb abduction, external rotation
Spinatus muscle atrophy
Reduced ROM in flexion
Tx: infraspinatus tendinectomy
Gracillis / semitendinosus muscle contracture
GSD
3-7 years old
CP: non-painful, weight bearing gait abnormality
Affected limb raised jerkily, hyperflexion of tarsus and internal rotation
No treatment required
Quadriceps muscle contracture
Young, fast growing dogs predisposed
Secondary to femoral fracture - poor limb use / immobilisation
Adhesions between muscle and bone
Peri-articular joint fibrosis and ankylosis
CP: extension of stifle and tarsus, pain over femur
Tx: amputation
Prev: fix fractures well
Reversible contracture of the flexor carpi ulnaris?
Young dogs, 6-8w
CP: flexed carpus that cannot be extended, tendon on the flexor carpi ulnaris is taught on palpation
Tx: resolves after 2-3 weeks, carpal supports, FCU tendinectomy in rare cases
How long does it take for a tendon regain enough strength post-surgery to withstand gentle exercise?
6 weeks post-op
What should you do to stabilise a tendon after repair?
Dressings and splints
External fixates
Calcaneal tibial screw
How should you treat severed flexor tendons?
Manage wounds initially and apply support dressings
Identify all tendon ends - 4x superficial, 4x deep
Small K wire through tendon ends
Perform anastomoses
Apply a flexion bandages for 3 weeks
Nutritional Secondary Hyperparathyroidism
Normal bone production, excessive bone resorption = osteopenia
Seen in animals on meat based diets with not enough calcium (phosphate: calcium 1:2 in dogs)
Cs: lameness, skeletal pain, swollen metaphysis, pathological fracture
Dx: decreased bone density and thinned cortices
Mushroom shaped physis
Pathological fracture
Tx: rest, diet correction, oral calcium, NSAIDs
