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SAS FINAL > Osteoarthritis and osteochrondritis dissecans > Flashcards

Osteoarthritis and osteochrondritis dissecans Flashcards

1
Q

_____ joins bones with a fibrous joint capsule that is continuous with the periosteum of the joined bones

A

synovial joint

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2
Q

_____ permits motion while providing stability for load transfer b/t bones

A

synovial joints

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3
Q

Hips, stifle, elbow and shoulder are examples of _____ joints

A

synovial

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4
Q

Synovial joints are made up of what type of cartilage?

A

hyaline/articular cartilage

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5
Q

T/F: Hyaline/Articular cartilage is highly vascular

A

FALSE: relatively avascular

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6
Q

Where do joints get their nutrients?

A

synovial fluid

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7
Q

Is osteoarthritis inflammatory?

A

No- non inflam degenerative joint disease

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8
Q

What are the three factors of osteoarthritis (non-inflam DJD)?

A

articular cartilage degeneration

marginal bone hypertrophy, aka osteophytosis

synovial membrane changes4

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9
Q

T/F: Dysplasia, DJD, trauma and neoplasia are examples of inflammatory arthropathy

A

FLASE- non inflammatory

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10
Q

Inflammatory causes

A

infectious: bact, viral, rickettsia, fungi, mycoplasms, protozoa, spirochetes

non-infectious: erosive vs nonerosive

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11
Q

Inflammatory non-infectious causes of arthopathy

A

erosive: rheumatoid, feline chronic progressive polyarthritis
nonerosive: immune-mediated polyarthritis, chronic inflam induced polyarthritis, systemic lupus erythematosus

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12
Q

Diagnosis of osteoarthritis

A

history and clinical signs: acute vs chronic, dog vs cat

physical exam: muscular asymmetry, joint enlargement, CREPI

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13
Q

What does CREPI stand for?

A

Crepitus (cracking/crunching when moving joint)

Range of motion

Effusion

Pain

Instability

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14
Q

What are the risk factors for osteoarthritis?

A

Size and growth rate: 45% of OA dogs are large breeds

Breed and genetics: labs & german shepards are predisposed

Advanced age: 50% of OA dogs are 8 to 13 years old

Obesity

Repeated trauma & mechanical stress

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15
Q

Clinical signs of mild osteoarthritis (OA)

A

dogs: stiffness, decreased activity, limping
cats: decreased activity

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16
Q

Clinical signs of moderate OA

A

dogs: pain, muscle atrophy, difficulty rising
cats: reluctance to jump, climb stairs, groom

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17
Q

Clinical signs of severe OA

A

dogs: loss of range of motion, vocalization, creptius, lethary, inappetence
cats: limping, muscle atrophy, inappropriate elimination

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18
Q

OA radiographic changes for inflammatory/infectious

A

subchondral bone may be sclerotic or lytic

+/- periarticular bone formation

+/- joint space narrowing

+/- capsule distension and soft tissue swelling

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19
Q

OA radiographic changes for noninfectious- nonerosive

A

soft tissue swelling and joint capsule w/o bony changes- multiple joints affected

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20
Q

OA radiographic changes for noninfectious- erosive

A

joint space collapse

subchondral bone proliferation

periosteal new bone production

soft tissue swelling

-multiple joints affected

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21
Q

OA radiographic changes in non inflammatory DJD

A

soft tissue swelling & intracapsular distension

diminished joint space

periarticular osteophytosis

subchondral bone plate usually intact but may be sclerotic

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22
Q

OA radiographic changes in non inflammatory- trauma

A

depends on trauma (fracture luxation)

ultimately leads to DJD

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23
Q

OA radiographic changes in non inflammatory- neoplasia

A

soft tissue swelling and intracapsular distension

destruction of the subchondral bone plate (often on both sides of the joint) with aggressive bone proliferation

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24
Q

What testing can we use to diagnose osteoarthritis (OA)?

A

computed tomography (CT) -bony changes

MRI- evaluate soft tissue structure: tendons and ligaments

ultrasound

bone scintigraphy

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25
Q

T/F: bone scintigraphy diagnoses OA

A

FALSE- it localizes OA

(radioactive isotope specific for inflam w/in a joint)

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26
Q

What can differentiate b/t inflammatory Vs non-inflammatory arthropathies?

A

Joint tap/Joint fluid analysis

looking at the cellular content

inflam has neutrophils

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27
Q

List some examples of OA medical management

A

weight management

nutritional supplements

exercise moderation

physical rehabilitation

anti-inflam medications and other pain management

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28
Q

What types of nutritional supplements are good for management of OA?

A

omega 3 fatty acids- anti inflam

chrondroprotectants- glucosamine/chondroitin and ASU (avocado soybean unsaponifiables)

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29
Q

What type of exercise is recommended for P with OA?

A

low impact activity

leash walks, swimming, hill work

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30
Q

Physical therapy options for OA

A

stregth

endurance

range of motion

laser therapy

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31
Q

List some options for pain management of OA

A

NSAIDs- want to spare the kidneys and stomach (COX-1, COX-2, EP4 blockers)

Corticosteroids NOT recommended with DJD

PSGAGs

Acupuncture

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32
Q

Osteochondrosis is a disturbance in _____ that leads to _____

A

endochondral ossification

cartilage retention/thickening

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33
Q

What is the issue with increased cartilage thickness?

A

can result in malnourished, necrotic chondrocytes

34
Q

Osteochondrosis leads to resultant clefts at the junction of ____ and ____

A

calcified and non-calcified tissue

clefts are fissues that develop w/in the cartilage

35
Q

Normal activity with osteochondrosis can create vertical fissures and result in _____

A

cartilage flap (OCD)

36
Q

What does the bottom circle show an example of?

A

osteochondosis- clefts

37
Q

What are some risk factors for osteochondrosis?

A

age, gender, breed (genetics), rapid growth, nutritional excesses (Ca)

38
Q

The cause of osteochondrosis is multifactoral. What are the two factors?

A

genetic and nutritional factors

39
Q

T/F: Females are more likely to develop osteochondrosis

A

FALSE males more likely

40
Q

What breed of dogs are mostly presented with osteochondrosis?

A

large/giant breeds

41
Q

When do we usually see clinical signs of osteochondrosis?

A

usually at 4-8 months but can present later

42
Q

T/F: osteochondrosis usually presents as a bilateral disease

A

FALSE: it is a bilateral disease but presents with unilateral lameness

so make sure to evaluate the other side

43
Q

How can we diagnose osteochondrosis?

A

physical exam findings dependent on location

radiographs

CT/MRI

arthroscopy

44
Q

When examining a dogs shoulder joint, if they have osteochondrosis they will show pain when?

A

hyperextension of the shoulder, flexion of the shoulder

45
Q

Does osteoarthritis have an acute or gradual onset?

A

gradual onset that is worse after exercise

46
Q

Osteochondrosis is usually lameness on what limb?

A

unilateral forelimb lameness

47
Q

Early signs on shoulder osteochondrosis on a lateral radiograph?

A

flattening of the subchondral bone of caudal humeral head

48
Q

Later signs on osteochondrosis on a lateral radiograph?

A

Saucer shaped radiolucent area

49
Q

What is the arrow pointing to?

A

saucer shaped radiolucent area

osteochondrosis

50
Q

What are some way to conservatively manage shoulder OCD?

A

rest

diet

NSAIDs

51
Q

What diet helps in the conservative management of shoulder OCD?

A

control energy, calcium, vitamin D intake

52
Q

Surgery is usually the recommened treatment for shoulder OCD. We try conservative treatment first as long as what 3 indications are true?

A

small defect

minimal to no lameness

very young dog (<6 months)

53
Q

____ is the standard of care for dogs with shoulder OCD treatment

A

surgical treatment

54
Q

What is preffered with surgical tx of shoulder OCD… arthroscopy or arthrotomy?

A

arthroscopy

55
Q

What does surgical treatment of shoulder OCD entail?

A

flap removal and joint lavage

debridement of bone with curette or shaver

defect heals with fibrocartilage

56
Q

Prognosis of shoulder OCD with surgery

A

px much better w/ sx than w/o

near-normal function w/ sx

  • pet dog- good to excellent
  • working dog- fair to good
  • assuming sx is done prior to onset of DJD
57
Q

If surgery is not performed on a OCD shoulder, what can we expect to see?

A

DJD

58
Q

OCD on the distal humerus is the ____ joint

A

elbow

59
Q

How does elbow joint OCD present?

A

unilateral lameness- acute vs chronic, worse after exercise and stiff in the AM

60
Q

When examining the elbow joint on a P with OCD, you will see pain when doing what to the joint?

A

pain on elbow extension and lateral rotation of the forearm

61
Q

What does elbow joint OCD look like on radiographs?

A

radiolucent concavity of distal aspect of medial humeral condyle

62
Q

What does this rad show?

A

OCD of the elbow joint

63
Q

T/F: early intervention for elbow OCD will prevent DJD

A

FALSE

64
Q

What is the best chance for a good prognosis with elbow OCD?

A

early intervention

65
Q

What tx is worse for elbow OCD… arthroscopy or arthrotomy?

A

arthrotomy is worse

66
Q

T/F: short term medical management of elbow OCD has a good prognosis

A

FALSE- expect long term treatment

67
Q

How does stifle joint OCD present?

A

young, large breed dog w/ hindlimb lameness

stifle effusion and crepitus

68
Q

What does stifle joint OCD look like on radiographs?

A

radiolucent concavity on medial aspect of lateral femoral condyle (most comon)

medial condyle can also be affected

69
Q

What does this radiograph show?

A

OCD of the stifle joint

70
Q

Tarsus OCD is seen in what dogs?

A

large breeds- Rotties

71
Q

How does Tarsus OCD present?

A

unilateral hindlimb lameness- acute vs chronic- worse after activity or rest

72
Q

When examining OCD of the tarsus, the P will exhibit pain when?

A

flexing the hock

73
Q

Radiographic signs of an OCD tarsus

A

radiolucent concavity on medial (more frequent)

or lateral trochlear ridge of talus

74
Q

Tarsus OCD prognosis

A

gaurded to poor

75
Q

_____ is ideal for treatment of tarsus OCD

A

arthroscopy

76
Q

T/F: arthrotomy and fragment removal may be no better than medical management for tarsus OCD

A

TRUE

77
Q

T/F: surgery for tarsus OCD will prevent the development of OA

A

FALSE: does not prevent

78
Q

T/F: surgery for tarsus OCD will eliminate the lameness

A

FALSE: does not eliminate the lameness

surgery improves function somewhat

79
Q

End stage OCD is also known as?

A

DJD

80
Q

Prognosis of OCD is dependent on?

A

when diagnosis was made and level of DJD present

81
Q

List the joints in order of best prognosis to least for OCD

A

shoulder

stifle

elbow

tarsus

SAS FINAL (4 decks)

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