Osteochondritis Dissecans

Question 1

What is Osteochondritis Dissecans?

Answer 1

Failure of endochondral ossification cartilage has flapped off

Question 2

What is the pathogenesis of Osteochondritis dissecans?

Answer 2

1) vascular necrosis leads to ischemic damage of the cartilage & cartilage will not mineralize

2) Retained core of unmineralized cartilage

3) Unmineralized cartilage is susceptible to traumatic damage & it will flap off

Question 3

What are the risk factors of Osteochondritis dissecans?

Answer 3

Fast growing dogs
Age 4-8 months
Large/giant breeds
Nutrient excess
Microtrauma
No vascular invasion in cartilage
traumatic injury

Question 4

What are the clinical signs/ presentation of osteochondritis dissecans?

Answer 4

Starts at 4-8 months old
Gradual onset that improves with rest but worsens with exercise
Unilateral or bilateral
Joint effusion
Pain on palpation

Question 5

What are the common locations for osteochondritis dissecans to manifest?

Answer 5

Shoulder: caudal humoral head
Elbow: medial portion of the condyle
Stifle: lateral condyle
Tarsus: medial trochlear ridge

Question 6

What diagnostics would you want for ruling in or out osteochondritis dissecans?

Answer 6

Radiographs

Question 7

What would the radiographs show with osteochondritis dissecans?

Answer 7

Distribution of subchondral bone
flattening or concavity of normal contour
sclerotic margins

Question 8

What are the normal conservative treatments for osteochondritis dissecans?

Answer 8

NSAIDs
Exercise restrictions
caloric restrictions & balanced diet
Weight control

Question 9

What are the normal surgical treatments for osteochondritis dissecans?

Answer 9

Gold standard of treatment
Flap removal
debride to bleeding subchondral bone
make edges perpendicular

Question 10

What are the prognosis of surgical treatment for the different areas that can be affected by osteochondritis dissecans?

Answer 10

Shoulder: good to excellent
Elbow: guarded to fair
Stifle: guarded to fair
Tarsus: guarded