OA And OCD Flashcards
What makes up hyaline/articular cartilage?
Chondrocytes dispersed within an extracellular matrix
Relatively avascular — nutrition from synovial fluid
Proteoglycans (repel each other)— shock absorber
What is osteoarthritis?
Non-inflammatory degenerative joint disease (DJD)
— articular cartilage degeneration
—marginal bone hypertrophy AKA osteophytosis
—synovial membrane changes
Inflammatory arthropathy, infectous causes?
Bacterial Viral Rickettsial Fungal Mycoplasma Protozoal Spirochete
Inflammatory arthropathy, non-infectious, erosive
What diseases fall under this ?
Rheumatoid arthritis
Feline chronic progressive polyarthritis
Inflammatory arthropathy, non-infectous and non-erosive.
What diseases fall under this?
Immune-mediated polyarthritis
Chronic inflammatory- induced polyarthritis
Systemic lupus erythematosis
What are the non-inflammatory arthropathy EVS?
Dysplasia
DJD
Trauma
Neoplasia
What are risk factors for osteoarthritis?
Size and growth rate
Breed and genetics
OBESITY
Advanced age
Repeated trauma and mechanical stress
What radiographic changes do you see in infectious inflammatory arthropathy?
Subchondral bone may be sclerotic or lytic
+/-periarticular bone formation
+/-joint space narrowing
+/- joint capsule distention and soft tissue swelling
What radiographic changes do you see in an non-infectious, nonerosive arthropathy?
Soft tissue swelling and joint capsule without bony changes
Multiple joints affected
What radiographic changes do you see in a non-infectious, erosive arthropathy?
Joint space collapse
Subchondral bone proliferation
Periosteal bone production
Soft tissue swelling
Multiple joints affected
What additional diagnostics to radiographs can be done in joint disease?
CT — bony changes
MRI — soft tissue (tendon and ligament)
Ultrasound
Bone Scintigraphy — localized, not diagnostic
Arthrocentesis
Arthrocentesis comes back with phagocytic monocular cells.
Dx?
Non-inflammatory joint disease
Eg Degenerative joint disease
Arthrocentesis comes back with non-degenerative neutrophils?
Non-infectious inflammatory diseases
Eg SLE, rheumatoid arthritis, infectious arthritis, immune mediated polyarthritis
Arthrocentesis comes back with degenerative neutrophils
Dx?
Infectious inflammatory arthropathy
How do you medically manage joint diseases?
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
What pain management options can you use in OA?
NSAIDS
- COX1 or 2 inhibitors
- EP4 receptor blocker — galiprant
NOT- corticosteroids (depress chondrocyte functin)
Polysulfated gycosaminioglycans (PSGAGs)
Acupuncture?
What is osteochrondrosis?
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)
What is the etiology of osteochrondrosis ?
Genetic and nutritional factors
Signalment associated with osteochrondrosis?
Large/giant breeds
Male>females
Clinical signs present at 4-8moths but can be later
Bilateral disease but present with unilateral lameness
How can you diagnose osteochondrosis?
PE
Radiographs
CT/MRI
Arthroscopy
PE findings in a dog with shoulder joint OCD?
Pain on hyperextension and flexion of shoulder
Radiographic findings of a shoulder with OCD?
Flattening of the subchondral bone of caudal humeral head
Saucer shaped radiolucent area
How do you conservatively treat shoulder OCD? When is this treatment method indicated
Rest
Diet: control energy, Ca, and Vit D intake
NSAIDS
Small defects
Minimal to no lameness
Very young dog (<6months)
What is the surgical treatment for OCD?
Flap removal and joint lavage
Debridement of bone with curette or shaver (promote bleeding and some healing)
Defects heals with fibrocartilage
Arthroscopy»_space; arthrotomy
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
In the elbow joint, where does OCD develop?
Distal humerus on the medial humeral condyle
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
What is the prognosis for elbow OCD?
Early intervention gives best change but does not prevent DJD
Arthroscopy»_space; arthrotomy
Medical management long term
Where does OCD develop in the stifle joint?
Lateral femoral condyle (most commonly)
Medial can also be affected
Where does OCD develop in the tarsal joint?
Medial»_space; lateral trachear ridge of talus
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
How are end stage OCD cases managed?
Medically or total joint replacement
Prognosis is dependent on level of DJD present
Shoulder>stifle>elbow>tarsus
