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Eq SX Musc Skel Exam > Osteochondrosis > Flashcards

Osteochondrosis Flashcards

1
Q

Mechanism of increased length of long bones

A

Endochondral Ossification at the level of the physis

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2
Q

Endochondral ossification

A
  1. Osteoblasts migrate from perichondrium into cartilage, cause calcification of cartilage matrix.
  2. Osteoclasts migrate into calcified cartilage via capillaries to resorb tissue, leaving trabecular bone
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3
Q

OC lesions thought to be result of

A

Failure of endochondral ossification resulting in excessively thick epiphyseal cartilage

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4
Q

Radigraphs

A

Areas of lucency or flattening of joint surface

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5
Q

Area of retained cartilage is weaker and subject to

A

injury by normal or abnormal biomechanical forces

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6
Q

OCD

A

Cartilage flap, fragmentation, or abnormal cartilage breaking off and loose in the joint

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7
Q

OC etiology

A
  1. Exercise
  2. Nutrition
  3. Genetics
  4. Trauma
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8
Q

Exercise

A
  • Important for maturation of musculoskeletal tissues

- Some vague association between restricted exercise and OC

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9
Q

Nutrition

A
  1. Rapid growth often a culprit
  2. Low Copper, High zinc-effect on repair?
  3. High phosphorus-sign inc OC lesions
  4. High digestible energy
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10
Q

Genetics

A
  • Complex and Polygenic

- Thoroughbreds, Standardbreds, Warmbloods

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11
Q

Trauma

A

Not been proven, considered an additive factor

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12
Q

Most common joints

A
  1. Femoropatellar
  2. Tarsocrural
  3. Metacarpo/metatarsophalangeal
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13
Q

DDX acute severe lameness

A
  1. OC/OCD
  2. Septic joint
  3. Articular fracture
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14
Q

Common silent lesion

A

Medial malleolus of tibia

-may require arthroscopy

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15
Q

Lesions that won’t resolve spontaneously

A
  1. Tarsocrural joint lesions after 5 months old

2. Femoropatellar lesions after 8 months old

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16
Q

Treatment considerations surgery vs conservative tx

A
  1. Lameness
  2. Free fragments-indicates surgery
  3. Effusion
  4. Sale pressure
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17
Q

Conservative treatment

A
  1. Rest/controlled exercise
  2. NSAIDS
  3. Intra-articular therapies
  4. Systemic joint therapies
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18
Q

Intra-articular therapies

A
  1. Hyaluronic acid
  2. Corticosteroids
  3. IRAP
  4. PRP
  5. Stem cells
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19
Q

Systemic joint therapies

A
  1. PSGAGs
  2. Hyaluronic acid
  3. Neutraceuticals
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20
Q

Surgery

A
  1. Arthroscopic debridement
  2. PDS pins
  3. Grafts (stem cells, PRP, BMAC, etc)
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21
Q

Be cautious in young animals

A

Normal bone is soft in young animals and debridement may result in excess trauma

22
Q

Subchondral bone cysts

A
  1. form beneath articular cartilage at sites of major weight bearing, occasionally in active physis
  2. Osteolysis surrounded by sclerotic rim, lined by myxomatous and fibrous tissue w/variable amount fluid
23
Q

Cause of bone cysts

A
  1. Hydraulic theory-slit in articular cartilage

2. Inflammation theory-fluid within cyst excretes inflammatory stuff

24
Q

Most common location

A

Medial femoral condyle of distal femur

OFTEN BILATERAL

25
Q

Common Breeds

A
  1. Thoroughbreds and quarterhorses

2. Warmbloods have a greater distribution of lesions within phalanges (including navicular bone)

26
Q

Diagnosis

A
  1. Lameness
    - Effusion-single/multiple joints
    - Positive flexion
    - Variable response to joint injections
  2. Radiographs
27
Q

Conservative tx OC

A
  1. Rest
  2. NSAIDs
  3. Intra-articular medication
    - corticosteroids, HA, IRAP, PRP, stem cells
    - Intra-lesional injection steroids (triamcinolone)
28
Q

Surgical tx OC

A
  1. Arthroscopic debridement
  2. Transosseous drilling and debridement
  3. Intralesional corticosteroid injection
  4. Grafting
    - Autologous cancellous bone graft
    - Tricalcium phosphate
29
Q

Femoropatellar joint signs

A
  1. joint distension
  2. variable lameness-bunny hop
  3. often bilateral
30
Q

Femoropatellar joint dx

A
  1. Lateral and caudolateral-craniomedial oblique

2. Lateral trochlear ridge most common

31
Q

Femoropatellar joint tx

A
  1. > 8 months old Surgical arthroscopic debridement if athletic career expected
    - 60-70% return to use
    - if large lesion and on patella OA likely
  2. Small lesion maybe rest and HA injection
    - fair to poor prog
32
Q

Tarsocrural joint signs

A
  1. Bog spavin most common
  2. lameness mild
  3. CS with trochlear ridge lesions
  4. CS rare w/ distal tibia lesions until training
  5. Often bilateral
33
Q

Tarsocrural joint dx

A
  1. rads, or arthroscopy for unresolved cases
34
Q

Tarsocrural joint tx

A
  1. Distal intermediate ridge lesions removed for racing, otherwise NBD
  2. Medial malleolus-debridement or effusion persists
  3. Trochlear ridge lesions need arthroscopic debridement to prevent OA
35
Q

Tarsocrural joint prognosis

A
  1. Arthroscopy-75-80% return to intended use
  2. Trochlear ridges of talus fair to good for racing soundness after sx
  3. Distal intermediate ridge or malleoli of tibia-EXCELLENT
36
Q

Fetlock joint signs

A
  1. Young horses 6-24 months
  2. Fetlock joint capsule distension
  3. Mild-mod lameness if dorsal MCIII or MTIII
  4. Ush very lame ifsubchondral cyst of MCIII
  5. Intra-articular anesth often unecessary
37
Q

Fetlock joint dx

A
  1. Lameness exam
  2. Rads
  3. Sagittal ridge lesions usually bilateral
    - often quadrilateral
38
Q

Fetlock joint tx

A
  1. Sagittal ridge OCD flaps: conservative tx, rest and HA injections
  2. Persistent lameness/swelling: surgical tx via arthroscopy
  3. Subchondral cysts: conservative therapy/arthroscopic debridement
39
Q

Fetlock joint prognosis

A
  1. Arthroscopy-50-60% return to intended use (if distal sagittal ridge)
  2. Guarded to poor w/ conservative tx subchondral cyst MCIII MTIII
40
Q

Shoulder joint signs

A
  1. Stiff stilted gait-shortened cranial phase of stride
  2. Shoulder pain on flexion/manipulation
  3. Cant use detect effusion
  4. Mod-severe lameness
  5. Young horses 4-12 months old, often fast growing horses
  6. Hx of acute onset
41
Q

Shoulder joint dx

A
  1. Confirmed by rads
  2. mid humeral head + glenoid cavity cysts
  3. Intra articular anesthesia used, but variable response
42
Q

Shoulder joint tx

A
  1. Time/HA, sx debridement
  2. may progress to OA
  3. Arthroscopic debridement of OCD slows progression OA, but poor race performance
43
Q

Shoulder joint prognosis

A
  1. Guarded to poor without sx, possible euthanasia

2. 20-45% success with surgery

44
Q

Femorotibial joint signs

A
  1. Medial femorotibial AND femoropatellar joint pouch distension w/subchondral bone cysts
  2. Variable lameness mild-severe
  3. Often bilateral on rads even if unilaterally lame
  4. Horses 6 months to 8 years old
45
Q

Femorotibial joint dx

A
  1. Cranial-caudal rads
  2. Intra-articular anesth inconsistent
  3. Usually medial condyle of femur
46
Q

Femorotibial jont tx

A
  1. Treat cases w/ severe lameness > 2 months
  2. Initially rest and/or joint injection, can continue light work with bute
  3. If lameness persists > 6 months surgery
  4. Arthroscopic curettage of cyst contents, trim articular margins of cyst
  5. Bone graft or osteogenic material
  6. Screw across cyst?
  7. Stem cells?
47
Q

Femorotibial joint prognosis

A
  1. 60% return to soundness with surgery

2. secondary OA or meniscal damage later is common

48
Q

Hip joint

A
  1. Femoral head and acetabular cysts rare sites, difficult to dx
  2. Not ush detected until racing
49
Q

Phalangeal cysts

A
  1. Results in OA of coffin or pastern if cyst enters joint
  2. Arthrodesis of pastern
  3. often bilateral
50
Q

Cervial spine

A
  1. OCD may be inciting cause of cervical vertebral instability
  2. OCD of articular facets is common
  3. Causes spinal cord compression with neuro dz, hindlimbs more severe
  4. tx is cervical fusion.

Eq SX Musc Skel Exam (20 decks)

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