OA And OCD Flashcards

1
Q

What makes up hyaline/articular cartilage?

A

Chondrocytes dispersed within an extracellular matrix

Relatively avascular — nutrition from synovial fluid

Proteoglycans (repel each other)— shock absorber

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2
Q

What is osteoarthritis?

A

Non-inflammatory degenerative joint disease (DJD)

— articular cartilage degeneration
—marginal bone hypertrophy AKA osteophytosis
—synovial membrane changes

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3
Q

Inflammatory arthropathy, infectous causes?

A
Bacterial 
Viral 
Rickettsial 
Fungal 
Mycoplasma 
Protozoal 
Spirochete
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4
Q

Inflammatory arthropathy, non-infectious, erosive

What diseases fall under this ?

A

Rheumatoid arthritis

Feline chronic progressive polyarthritis

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5
Q

Inflammatory arthropathy, non-infectous and non-erosive.

What diseases fall under this?

A

Immune-mediated polyarthritis

Chronic inflammatory- induced polyarthritis

Systemic lupus erythematosis

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6
Q

What are the non-inflammatory arthropathy EVS?

A

Dysplasia
DJD
Trauma
Neoplasia

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7
Q

What are risk factors for osteoarthritis?

A

Size and growth rate
Breed and genetics

OBESITY

Advanced age

Repeated trauma and mechanical stress

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8
Q

What radiographic changes do you see in infectious inflammatory arthropathy?

A

Subchondral bone may be sclerotic or lytic

+/-periarticular bone formation
+/-joint space narrowing
+/- joint capsule distention and soft tissue swelling

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9
Q

What radiographic changes do you see in an non-infectious, nonerosive arthropathy?

A

Soft tissue swelling and joint capsule without bony changes

Multiple joints affected

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10
Q

What radiographic changes do you see in a non-infectious, erosive arthropathy?

A

Joint space collapse
Subchondral bone proliferation
Periosteal bone production
Soft tissue swelling

Multiple joints affected

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11
Q

What additional diagnostics to radiographs can be done in joint disease?

A

CT — bony changes
MRI — soft tissue (tendon and ligament)
Ultrasound
Bone Scintigraphy — localized, not diagnostic

Arthrocentesis

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12
Q

Arthrocentesis comes back with phagocytic monocular cells.

Dx?

A

Non-inflammatory joint disease

Eg Degenerative joint disease

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13
Q

Arthrocentesis comes back with non-degenerative neutrophils?

A

Non-infectious inflammatory diseases

Eg SLE, rheumatoid arthritis, infectious arthritis, immune mediated polyarthritis

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14
Q

Arthrocentesis comes back with degenerative neutrophils

Dx?

A

Infectious inflammatory arthropathy

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15
Q

How do you medically manage joint diseases?

A

Weight management***
Nutritional supplements
-omega 3 fatty acids (anti-inflammatory)
-chondroprotectants; glucosamine/chrondroitin and ASU
Exercise moderation
Physical therapy

Anti-inflammatories and other pain management

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16
Q

What pain management options can you use in OA?

A

NSAIDS

  • COX1 or 2 inhibitors
  • EP4 receptor blocker — galiprant

NOT- corticosteroids (depress chondrocyte functin)

Polysulfated gycosaminioglycans (PSGAGs)

Acupuncture?

17
Q

What is osteochrondrosis?

A

Disturbance of endochondrial ossification that leads to cartilage retention/thickening

Increased thickens —> malnourished and necrotic chondrocytes causing clefts of calcified and non calcified tissue

Fissures and cartilage flaps (OCD)

18
Q

What is the etiology of osteochrondrosis ?

A

Genetic and nutritional factors

19
Q

Signalment associated with osteochrondrosis?

A

Large/giant breeds

Male>females

Clinical signs present at 4-8moths but can be later

Bilateral disease but present with unilateral lameness

20
Q

How can you diagnose osteochondrosis?

A

PE
Radiographs
CT/MRI
Arthroscopy

21
Q

PE findings in a dog with shoulder joint OCD?

A

Pain on hyperextension and flexion of shoulder

22
Q

Radiographic findings of a shoulder with OCD?

A

Flattening of the subchondral bone of caudal humeral head

Saucer shaped radiolucent area

23
Q

How do you conservatively treat shoulder OCD? When is this treatment method indicated

A

Rest
Diet: control energy, Ca, and Vit D intake
NSAIDS

Small defects
Minimal to no lameness
Very young dog (<6months)

24
Q

What is the surgical treatment for OCD?

A

Flap removal and joint lavage

Debridement of bone with curette or shaver (promote bleeding and some healing)

Defects heals with fibrocartilage

Arthroscopy&raquo_space; arthrotomy

25
What is the prognosis for a shoulder with OCD that has been surgically treated? What would you expect without surgery?
Near normal function Pet dog— good to excellent Working dog— fair to good DJD is expected without surgery
26
In the elbow joint, where does OCD develop?
Distal humerus on the medial humeral condyle
27
What do you see on PE of a dog with OCD of the elbow joint?
Pain on elbow extension and lateral rotation of the forearm
28
What is the prognosis for elbow OCD?
Early intervention gives best change but does not prevent DJD Arthroscopy >> arthrotomy Medical management long term
29
Where does OCD develop in the stifle joint?
Lateral femoral condyle (most commonly) Medial can also be affected
30
Where does OCD develop in the tarsal joint?
Medial >> lateral trachear ridge of talus
31
What is the prognosis for OCD of tarsus?
Guarded to poor Surgical intervention Arthroscopy is ideal Arthrotomy may not be any better than medical managment Doesn’t prevent OA
32
How are end stage OCD cases managed?
Medically or total joint replacement Prognosis is dependent on level of DJD present Shoulder>stifle>elbow>tarsus