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Musculoskeletal > Miscellaneous orthopedic conditions > Flashcards

Miscellaneous orthopedic conditions Flashcards

1
Q

What are potential causes of retarded growth/dwarfism?

A

Proportionate: Metabolic disease, endocrinopathy, polysystemic diseases.

Disproportionate: Osteochondrodysplasia, nutritional disease

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2
Q

What is an osteochondrodysplasia?

A

A heritable disease that is characterized by abnormal endochondral or intramembranous ossification

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3
Q

How is a presumptive diagnosis of osteochondrodysplasia made?

A

Clinical signs, history/family history, evidence of abnormal endochondral +/- intramembranous ossification of rads

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4
Q

What are dystoses?

A

Group of bone dysmorphologies characterized by abnormal development of individual bones or parts of bones

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5
Q

What are the different classifications of dystoses?

A

Amelia: complete absence of limb

Hemimelia: absence or partial absence of bone

Dimelia: duplicated limb

Ectrodactyly: congenital digital cleft extending between metacarpal bones

Polydactyly: additional digits

Syndactyly: fused digits

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6
Q

What are the different classifications of amelia?

A

Thoracic limb: Monobrachia (one limb), abrachia (both limbs)
Pelvic limb: Monopodia, apodia

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7
Q

In which breed might amelia be heritable in?

A

Beagles

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8
Q

What are the classifications of hemimelia?

A
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9
Q

What are some examples of hereditary hemimelia?

A

Bilateral terminal preaxial thoracic limb hemimelia in Chihuahuas, radial hemimelia in DSH and Siamese cats.

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10
Q

What are signs associated with radial hemimelia?

A

Marked varus and flexural deformity of the elbow and carpus

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11
Q

What are treatment options for hemimelia?

A

Young patient (<4-6 months): external coaptation.
Older patient: conservative therapies or surgery (declawing, reconstruction or amputation [can consider ectoprostheses after amputation])

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12
Q

Is ectrodactyly inherited in dogs and cats?

A

Possibly in cats, not in dogs

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13
Q

Between which bones is ectrodactyly most frequent reported?

A

First and second metacarpals

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14
Q

What are treatment options for ectrodactyly?

A

Young patient (<4-6months): splinting as for hemimelia.
Older patient: conservative or surgical (amputation or reconstruction) treatment

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15
Q

What conditions are often seen in conjunction with ectrodactyly?

A

Elbow joint incongruity and luxation, syndactyly, digital contractures, missing carpal bones, short ulna

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16
Q

Is polydactyly considered an inherited trait?

A

Yes for preaxial polydactyly in dogs. Considered autosomal dominant in cats.

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17
Q

What are the classifications of syndactyly?

A

Simple: interconnection between digits only consists of skin and fibrous tissue.
Complex: both soft tissues and bone are fused (further subclassified into complicated when other defects are involved, or uncomplicated)

Complete: digits are connected along their entire length
Incomplete: digits are only partially connected

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18
Q

What is the most likely signalment for a patient with HOD?

A

Large or giant breed breed, young (2-6 months), male dog (2.3 times more likely than females)

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19
Q

Which bones are most frequently affected by HOD?

A

Distal radius and ulna, tibia

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20
Q

What are some proposed causes of HOD?

A

Vitamin C deficiency, overnutrition (both largely refuted), inherited (particularly Weimeraners), infectious, inflammation, vaccinations.

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21
Q

What are some systemic clinical signs associated with HOD?

A

Lethargy, depression, diarrhea, inappetence/anorexia, hyperthermia.

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22
Q

Are corticosteroids or NSAIDs thought to be more effective in treating non-bacteremic, systemically affected Weimeraners with HOD?

A

Corticosteroids associated with better response

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23
Q

What is the typical signalment for dogs affected by panosteitis?

A

Large to giant breed, young (5-12 months), male dogs (4:1 male to female ratio)

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24
Q

Which bones are most frequently affected by panosteitis?

A

Ulna (42%), radius (25%), humerus (14%), femur (11%), and tibia (8%)

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25
Q

What is the pathogenesis of panosteitis?

A

Vascular proliferation and bone formation around the nutrient foramen result in increases in intramedullary pressures. This causes further local bone formation and enlargement of the haversian system. These eventually coalesce, joining the endosteum and being remodelled resulting in reformation of the medullary canal and bone marrow.

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26
Q

What is the treatment for panosteitis?

A

Rest and analgesia (self limiting)

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27
Q

What are the typical radiographic findings associated with panosteitis?

A

Increased medullary opacity with granular pattern or loss of the normal trabecular pattern.

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28
Q

Which breeds of dogs are at highest risk for craniomandibular osteopathy?

A

West highland whites, cairn terriers, scottish terriers (generally less than 6 months of age)

29
Q

Is craniomandibular osteopathy suspected to be inherited?

A

Yes - strong breed predisposition suggests this

30
Q

What characterizes craniomandibular osteopathy?

A

Unilateral or bilateral symmetric irregular osseous proliferations of mostly the mandibles and/or tympanic bullae

31
Q

When does craniomandibular osteopathy typically become self limiting by?

A

11-13 months of age

32
Q

What is the treatment for craniomandibular osteopathy?

A

Supportive care

33
Q

What is the expected signalment for a patient with a retained ulnar cartilaginous core?

A

Large or giant breed dog, young.

34
Q

What is the cause of a retained ulnar cartilaginous core?

A

Failure of hypertrophic chondrocytes to convert into metaphyseal bone. Can result in similar limb deformities as are seen with premature closure of the distal ulnar physis.

35
Q

What is the most likely signalment for a patient with Legg-Calve-Perthes disease (avascular necrosis of the femoral head)?

A

Toy breed or small breed dog, 4-11 months of age, no sex predisposition

36
Q

What is the pathogenesis of avascular necrosis of the femoral head?

A

Necrosis of the trabeculae of the femoral head followed by fragmentation and collapse of the epiphyseal subchondral bone during loading and cleft formation on the articular surface. Trabecular thickening and necrosis may also be found in the metaphyseal region resulting in fracture. Remodelling results in partial or complete malformation of the femoral head.

37
Q

What are radiographic signs associated with avascular necrosis of the femoral head?

A

Flattening and mottling of the femoral head, collapse and thickening of the femoral neck, potential femoral neck fractures.

38
Q

Is surgical or conservative management recommended in the treatment of avascular necrosis of the femoral head?

A

Surgical (FHO or THR). Conservative treatment associated with only 25% success rate

39
Q

What is the normal signalment for a patient suffering from a slipped capital femoral epiphysis?

A

Male, neutered, overweight cats (normal age 4.5-42 months)

40
Q

What differentiates slipped capital femoral epiphysis from a Salter Harris fracture?

A

Slipped capital femoral epiphysis is the slow progressive displacement of the proximal femoral metaphysis from the epiphysis through the growth plate. Often bilateral. Salter Harris fractures are traumatically induced.

41
Q

What is the proposed pathogenesis of slipped capital femoral epiphysis?

A

Unclear but might be related to delayed closure of the growth plate following gonadectomy and hypotestosteronism

42
Q

What is the treatment for slipped capital femoral epiphysis?

A

FHO typically. If the femoral neck remains intact can consider THR

43
Q

What are the primary differences between multiple cartilaginous exostoses in dogs as compared to cats?

A

In dogs normally they only form during growth and stop once endochondral ossification ceases. In cats they are normally found after skeletal maturity.

44
Q

What are multiple cartilaginous exostoses?

A

Cartilage capped bony protuberances that arise from the surfaces of any bone formed by endochondral ossification

45
Q

Can multiple cartilaginous exostoses undergo malignant transformation?

A

Yes - to osteosarcomas or chondrosarcomas

46
Q

What bones do multiple cartilaginous exostoses most frequently affect?

A

Vertebra, ribs and long bones

47
Q

What is the treatment for multiple cartilaginous exostoses?

A

Can be excised if solitary or impeding function, otherwise monitoring with serial radiography is recommended

48
Q

What is the treatment for Swimmer syndrome?

A

Hobbles and physical rehabilitation

49
Q

What are the two forms of puppy carpal laxity syndrome?

A

Hypoextension: less than 180 degrees
Hyperextension: greater than 180-190 degrees

50
Q

What are the treatments for puppy carpal laxity syndrome?

A

Typically exercise, splinting and change in diet is adequate for most patients. If severe hyperextension may require carpal arthrodesis. Severe hypoextension can perform tenotomy but rarely indicated.

51
Q

What is the typically signalment for a patient with puppy carpal laxity syndrome?

A

Large breed dogs between 6-16 weeks of age

52
Q

Where is hypertrophic osteopathy most frequently seen?

A

Distal extremities and long bones

53
Q

What is the proposed pathogenesis of hypertrophic osteopathy?

A

Increased peripheral blood flow due to a neurally mediated increase in peripheral blood flow. This is thought to occur secondary to a primary lesion (neoplasia) causing irritation to afferent nerves. The increase in blood flow results in vascular congestion in the periosteum.

54
Q

What is the most common site of neoplasia in cases of hypertrophic osteopathy?

A

Pulmonary or metastatic neoplasia most common

55
Q

In what direction is new bone often deposited in relation to the long axis of the bone in cases of hypertrophic osteopathy?

A

Perpendicular (pallisade formation)

56
Q

Which breed is predisposed to disseminated idiopathic skeletal hyperostosis?

A

Boxers (large and giant breed dogs most commonly affected)

57
Q

What structure does disseminated idiopathic skeletal hyperostosis most frequently affect?

A

Ventral longitudinal ligament of the vertebrae

58
Q

What is the most common differential for disseminated idiopathic skeletal hyperostosis?

A

Spondylosis deformans

59
Q

The presence of 4/5 of which criteria is sufficient for a diagnosis of disseminated idiopathic skeletal hyperostosis?

A

(1) Continuous or “flowing” calcification and ossification of at least three contiguous vertebral bodies

(2) relative preservation of intervertebral disc width

(3) periarticular osteophytes surrounding the zygapophyseal joints

(4) formation of pseudoarthrosis between the bases of spinous processes

(5) periarticular osteophytes and calcification and ossification of soft tissue attachments (enthesophytes) in both axial and peripheral skeleton

60
Q

What are the classifications of bone cysts?

A

Simple, aneurysmal and subchondral. Simple most commonly reported in dogs and cats

61
Q

Which breed is predisposed to polyostotic bone cysts?

A

Dobermans

62
Q

What are surgical treatment options for bone cysts?

A

Surgical drainage, curettage, placement of cancellous bone graft, radiation, total excision and amputation.

63
Q

Which breeds are most frequently affected by acute caudal myopathy?

A

Labrador retrievers and pointers

64
Q

What is the treatment for acute caudal myopathy?

A

Nothing, most dogs spontaneously recover

65
Q

What is the iliopsoas muscle maneuver?

A

Simultaneous internal rotation and extension of the hip joint

66
Q

What surgical treatment can be performed in instances of iliopsoas muscle injury?

A

Tenomyectomy

67
Q

In a study by Roberston 2023 in JSAP, were male or female dogs more likely to be affected by hypertrophic osteodystrophy? What were the 4 most common clinical signs? How many patients suffered relapses prior to skeletal maturity?

A

Male dogs were more frequently affected.

The most common clinical signs were pyrexia, lethargy, pain and non-ambulatory.

8/25 cases suffered relapse prior to skeletal maturity.

Median hospitalization was 5 days. 4/25 cases developed future autoimmune disease.

68
Q

In a study by Pilot 2022 in JFMS, what was an occasional concurrent finding in cats with PADS (patellar fracture and dental anomaly syndrome)? What treatment was frequently required?

A

Chronic paronychia was identified in some cats with PADS. This is inflammation of the folds of tissue surrounding the nail. Often affected multiple digits.

Medical management was only successful in 17% of cases, with the remaining 83% requiring digital amputation.

Musculoskeletal (36 decks)

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