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VETM 522 > ortho > Flashcards

ortho Flashcards

1
Q

how common in osteoarthritis?
what causes it (dogs/cats)?

A

20% of dogs, 60% of cats
dogs- intiating trauma, laxity
cats- primary or idiopathic

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2
Q

factors causing OA

A

obesity, genetics, gender

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3
Q

OA pathogenesis

A

cartilage- decreased stiffness-> increased proliferation-> loss of tissue when chondrocytes can’t keep up

leads to osteophyte formation, inflammation, fibrosis

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4
Q

hx and C/S of OA (dogs and cats)

A

dogs: reluctant to exercise, lameness, inability to jump up, influenced by weather, worsens.
C/S- bunny hopping, muscle atrophy, joint swelling, pain

cats:more hidden, cant jump
C/S- cannot do performance tests (jumping), responds to discomfort

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5
Q

radiographic features of OA

A

osteophytes, effusion
**NWB images-> cannot assess cartilage
MRI- ligaments, menisci, tendons
CT- good for bony changes
arthroscopy- **evaluates cartilage

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6
Q

OA management

A

weight loss, controlled exercise
NSAIDs, solensia for cats
omega3s

sx- joint debridement, replacement

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7
Q

OCD definition and stages

A

disorder of endochondral ossification
latens- early
manifesta- subclinical rads, clinically present
dessicans- flaps

happens in fast growing breeds, poor limb conformation

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8
Q

common sites for OCD in dogs

A

humeral head, medial humeral condyle, femoral condyles
trochlear ridges of talus

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9
Q

pathogenesis of OCD

A

avascular necrosis of developing cartilage

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10
Q

OCD presentation, C/S

A

young lg breed dogs, lameness, exercise intolerance, often bilateral

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11
Q

OCD dx

A

survey rads-> defect in subchondral bone, flaps

arthroscopy

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12
Q

OCD tx

A

non surgical: sm lesions, dogs w OA where flap removal is not helpful

NSAIDs, exercise restriction, dietary supplements, weight control
shoulder OCD in young dogs-> exercise

surgical:arthroscopy-> flap removal, palliative (curettage, microfx) or restorative (transplant, autograft, resurfacing)

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13
Q

OCD prognosis

A

stifle- guarded to fair
shoulder- excellent w sx
medial humeral condyle- good if sx before OA
talus- guarded to poor, conservative tx

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14
Q

avascular necrosis of femoral head signalment, C/S, dx, tx

A

acute HL lameness, sm breeds
noninflammatory necrosis 4-11m
dx- apple core on rads
tx- femoral head/neck excision, THR

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15
Q

slipped capital femoral epiphysis signalment, C/S, dx, tx

A

young cats (male, overweight), not traumatic
lameness, cant jump, pain
often bilateral
dx- frogleg rads
tx- FHNE, maybe THR

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16
Q

hypertrophic osteodystrophy signalment, C/S, dx, tx

A

young fast growing dogs, lg breed males.
fever, anorexia, pain, cant walk, swelling on distal radius/ulna, tibia
dx- double physis line on rads
tx- symptomatic

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17
Q

hypertrophic osteopathy

A

periosteal rxn of distal limbs
associated w primary and metastatic neoplasia
progressive lameness, firm swelling

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18
Q

panosteitis dx, tx

A

self limiting inflammatory disease in BM, 5-12 dogs
dx- patchy opacity on rads
tx- rest, pain meds

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19
Q

multiple cartilagenous exostosis signalment, dx, tx

A

young growing dogs, before skeleton matures (danes, bernards, hounds)
cats- feLV associated, after skeleton matures
dx- rads (thin cortex bony masses)
histo definitive
tx- rest, NSAIDs
sx- single.lg mass compressing spinal cord

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20
Q

dysostoses dx, tx

A

ectrodactyly (split hand)- dominant in cats
polydacytyl- dominant in dogs/cats
preaxial/medial polydactyl (extra thumb)- recessive in dogs
dx- rads, MRI for axial
tx- medical: rehab, splinting, NSAIDs
sx- palliative (amputation),
reconstructive- realignment/arthrodesis

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21
Q

swimmers syndrome

A

1-3wks old, sm breeds, devon rex.
dx- PE (cant paddle), lateral splaying
tx- rehab, splinting, correct sternum w sx if needed
prognosis good if caught early, guarded of chronic

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22
Q

puppy carpal laxity

A

6-16wks, lg breeds
dx- ortho exam, palmarograde stance w normal rads
tx- exercise, splint 2wks if cannot be extended
sx if severe-> tenotomy, arthrodesis

23
Q

retained cartilage cores

A

lg breed, 5m
torsion angulation deformity, retarded growth of distal ulna
dx- rads, radiolucent cartilage cores
tx- monitor for angular deformity
distal ulnar ostectomy, radial osteotomy

24
Q

CCL insufficiency C/S, dx, tx

A

degenerative condition
loss of muscle mass, fails sit test, medial buttress, effusion, pain, +ve drawer/thrust
dx- rads r/o other causes

tx- weight loss, exercise modification, NSAIDs

25
Q

CCLR sx

A

extracapsular- lateral fabellotibial suture, tightrope, fibular head transposition (create fibrosis)-> dogs <15kg
osteotomies, osteotomies-> dynamic stability (TPLO, TTA, CCW)

26
Q

patellar luxation C/S

A

sit test failure, skipping gait, effusion, drawer positive in flexion (medial)

developmental- medial in sm breeds, lateral in lg breeds
can be traumatic

27
Q

factors creating malignment of extensors

A
  1. coxa vara
  2. distal femoral varus
  3. shallow trochlear groove
  4. hypoplastic medial femoral condyle
  5. medial torsion of tibial tuberosity
  6. proximal tibial valgus
  7. internal torsion of foot
28
Q

patellar luxation grades

A

grade I: stays in, can be luxated but goes back
grade II: stays in, can be luxated and put back
grade III: stays out, can reduce but in goes back out
grade IV: stays out, cannot reduce

29
Q

patellar luxation tx

A

soft tissue procedures- release contracted tissues, desmotomy, quad release

groove reconstruction- sulcoplasty, chondroplasty, wedge resection, block recession

limb alignment- fabello tibial anti-rotational suture, tibial tuberosity transposition, distal femoral osteotomy (vaurs >15 degrees)

30
Q

hip dysplasia causes

A

genetic susceptibility, environment-> hip laxity (excessive joint fluid, low pelvic muscle, hormones, nutritional excess, increased BW)

31
Q

pathophysiology of hip dysplasia

A

forces crossing the joint increase, and are put on less contact area (instead of being spread evenly across the acetabulum)-> cartilage damage, joint inflammation, OA

32
Q

progression of hip dysplasia w time

A

normal at birth-> earliest changes at 30d-> rad signs at 7wks-> pain and disability (OA) w age

**palpable/rad changes appear before degeneration

33
Q

signalment C/S for hip dysplasia

A

lg breeds, not sight hounds
juvenile 5-12m: sudden onset lameness, bunny hopping, difficulty rising, laxity
chronic: pain from DJD, stiff pelvic limbs, exercise intolerance

34
Q

PE for hip dysplasia

A

localize to hip joint, r/o CCLR, back pain, neoplasia, ortolani test

35
Q

hip rads

A

OFA- extended hip rads, results variable in young animals
pennhip (neutral position)- needs GA/certification, rated from 0-1 (tx >0.7)

36
Q

hip dysplasia tx

A

medical- palliative, pain meds, nutritional, modified exercise
surgical: prophylactic- no OA-> prevent
juvenile pubic symphysiodesis 12-20wks, palpable laxity
pelvic osteotomy 10m-1y

salvage- >1y w OA-> eliminate pain
FHO, THR (restores function)

37
Q

hip luxation causes

A

usually trauma, hip dysplasia

38
Q

most hip luxations are

A

craniodorsal, ventral less common

39
Q

hip luxation C/S

A

craniodorsal- pain, lameness, external rotation, adduction, shortened limb
ventral- pain, lameness, internal rotation, longer limb

40
Q

hip luxation dx, tx

A

rads (Vd and lateral)-> check for fx, hip dysplasia

tx- reduction within 3d
closed for CD-> elmer sling ventral-> hobbles

open reduction for fx, or if chronic: capsulorrhaphy, prosthetic capsule, FHNE/FHO, THR-> OA

41
Q

which hip luxation has better prognosis w closed reduction?

A

ventral

42
Q

factors in elbow dysplasia

A

medial compartment disease
ununited anconeal process
OCD
incongruity

43
Q

ununited anconeal process (UAP), dx

A

lg breed, males, 5-12m, bilateral
caused by incongruity, genetics, etc (unclear)
dx- PE, rads-> gradual onset NWB, effusion, pain on palpation and extension

44
Q

UAP tx

A

early intervention (prevent DJD)
anconeal process removal, reattachment
ulnar osteotomy, ostectomy

45
Q

medial compartment disease
fragmented medial coronoid incongruity, signalment

A

young lg breeds (goldens, labs, GSD) 6-18m presentation. biphasic <3y >7y

46
Q

medial coronoid disease?

A

complex polygenic trait-> delay in endochondral ossification-> incongruence, instability

47
Q

lesions on medial humeral condyle from MCD

A

kissing lesion from FCP, graded w MOS scale
1- swelling, dull
2- partial thickness
3- down to subchondral bone
4- full thickness cartilage erosion
5- bone eburnation

48
Q

elbow dysplasia C/S

A

lameness, pain on manipulation, bilateral-> lameness hard to see
elbows abducted, paw externally rotated
effusion, fibrosis (enlarged joint)
decreased ROM if chronic

49
Q

elbow dysplasia dx

A

rads- good for osteophytes, lacks Se for medial coronoid disease
CT- gold standard for medial coronoid, evaluation of subchondral bone, cannot see cartilage
arthroscopy- needs GA, can see joint surfaces, minimally invasive tx

50
Q

elbow dysplasia tx

A

arthrotomy, arthroscopy
fragment removal, subtotal coronoid osteotomy
biceps ulnar release procedure
ulnar osteotomy/ostectomy
humeral osteotomy-> sliding, external rotational

NSAIDS, weight loss, exercise/rehab, injections, radiation

51
Q

factors to consider with elbow dysplasia tx

A

severity of OA
patient age
expected activity level

52
Q

best prognosis for elbow dysplasia is in:

A

early surgical tx in young dogs, mild OA
postop rehab

53
Q
A

VETM 522 (22 decks)

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