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Ortho > Osteochondritis dissecans > Flashcards

Osteochondritis dissecans Flashcards

1
Q

Who gets OCD?

A
  • Skeletally immature dogs
  • Not cats
  • Larger breed juvenile dogs: labrador retrievers, golden retrievers, pointers, Great Dane, Saint Bernard, over-represented; M > F
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2
Q

Age of onset of OCD

A
  • 5-7 months of age (7-9 months of age)
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3
Q

Risk factors for OCD

A
  • Genetic inheritance (ethically they should not be breeding)
  • Nutritional (supplement calcium volume relative to calcium-phosphorus)
  • Activity? Overloading?
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4
Q

Is OCD usually unilateral or bilateral?

A
  • Bilateral normally
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5
Q

What is the primary defect with OCD?

A
  • Endochondral ossification defect
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6
Q

Which joints are most often affected with OCD?

A
  • Shoulder (humeral head - most common form)
  • Elbow: medial side of the humeral condyle
  • Stifle: lateral aspect of the medial femoral condyle or medial aspect of the lateral femoral condyle
  • Tarsus: Medial trochlear ridge of the talus (or lateral ridge in Rottweilers)
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7
Q

History of OCD

A
  • Acute or insidious onset of lameness
  • Weight bearing lameness
  • Worsens with activity*
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8
Q

Physical examination findings for shoulder OCD

A
  • Unilateral weight-bearing lameness
  • mild muscle atrophy over the shoulder and scapular region
  • Pain/discomfort on flexion or extension of the shoulder
  • Bilateral findings
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9
Q

Elbow OCD findings

A
  • Similar to Medial compartment disease and medial coronoid process disease
  • Elbow pain - flexion with medial collateral ligament pressure
  • Effusion/synovial popping
  • Joint thickening/resistance to flexion/extension
  • Externally rotated paw
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10
Q

Stifle OCD findings

A
  • Stifle pain on flexion and extension
  • Effusion
  • Thickening
  • Looks virtually identically to cranial cruciate rupture
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11
Q

Tarsal OCD findings

A
  • Tarsal pain on flexion and extension
  • Hyperextended when standing
  • Marked effusion/thickening medial side of the joint
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12
Q

Shoulder OCD radiographs - which views?

A
  • Mediolateral view (slight extension, slight traction)

- +/- craniocaudal view

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13
Q

Shoulder OCD radiographs - what findings?

A
  • Osteophytes (caudal humeral head, caudal glenoid cavity)
  • Focal, subchondral bone flattening - caudal humeral head
  • +/- mineralized OCD flap
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14
Q

Elbow OCD radiograph views

A
  • Craniocaudal
  • Mediolateral
  • Flexed mediolateral
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15
Q

Elbow OCD radiograph findings

A
  • Osteophytes

- Focal subchondral defect on the medial side of the humeral condyle (weight bearing aspect)

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16
Q

Stifle OCD radiograph views

A
  • Craniocaudal and mediolateral views
17
Q

Stifle OCD radiographic findings

A
  • Osteophytes

- Focal subchondral defect: lateral side of the medial femoral condyle or the medial side of the lateral femoral condyle

18
Q

Hock OCD radiographic views

A
  • Dorsoplantar
  • Mediolateral
  • DLPM
  • 45 degree views that are skyline or flexed views
19
Q

Hock OCD Radiographic findings

A
  • Osteophytes
  • Subchondral defect on the medial trochlear ridge of the talus (lateral in Rottweilers)
  • It’s a huge osteochondral fragment
  • Lots of joint effusion visible too, and a flattened area on the medial side of the trochlear ridge of the talus
20
Q

Surgical for OCD

A
  • Arthrotomy or arthroscopy to remove the OCD flap (allows for fibrocartilage to form)
  • +/- curettage
21
Q

Other treatment possible for OCD

A
  • In the shoulder only: if no mineralization present and in a patient <6 months of age, you can do conservative management
  • Non-weight bearing flexion bandage for 2 weeks and restrict activity for 4 weeks and spontaneously recover
  • He’s only had this happen with Great Danes
22
Q

Post-op treatment for OCD surgery (arthrotomy, arthroscopy)

A
  • Restrict to leash walks only for 4 weeks
  • NSAID analgesia for 5-7 days
  • Ice incision for 2-3 days after surgery
  • Likely would want to consider mult-modal OA
23
Q

Prognosis for lame free function in shoulder OCD

A
  • Very good to excellent
24
Q

Prognosis for lame free function in elbow or stifle OCD

A
  • Fair to good
25
Q

Prognosis for lame free function in the tarsus

A
  • Poor to fair

- May require future arthrodesis

Ortho (10 decks)

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