Osteomyelitis and osteosarcoma Flashcards

0
Q

What is the difference between osteomyelitis and osteitis?

A

Osteomyelitis is the inflammation of all layers of the bone

Osteitis is the inflammation of just the cortex of the bone without the involvement of the bone marrow

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1
Q

Using DAMNITV which causes commonly cause disease in bone?

A
Developmental = common, Degenerative = typically joints
Autoimmune = rare, Anomalous = possible
Infectious = common, inflammatory = joints
Metabolic = calcium disorders
Neoplastic = common
Traumatic = common
Vascular = specifically affecting bone is uncommon
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2
Q

How do animals present with acute osteomyelitis?

A

Rapid onset, short duration single limb lameness often with a history of laceration or surgery
On clinical exam heat, pain and swelling on bone palpation are commonly found and joints can be normal and febrile

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3
Q

How do animals present with chronic osteomyelitis?

A

Moderate/intermittent lameness of days/weeks duration often with a history of laceration or surgery
On clinical exam it is possible to find heat, pain and swelling, normal joint structures, discharge and sinus tract formation and possibly a pathological fractre

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4
Q

What is a key diagnostic point for osteomyelitis?

A

Combination of the bone’s pathogenic process and the bone’s reaction results in bone loss and formation

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5
Q

How is osteomyelitis diagnosed?

A

Radiography, culture and sensitivity, biopsy and radionuclide scan

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6
Q

What is the treatment for osteomyelitis?

A

If early then broad spectrum antibiotics
Change on the basis of bacterial cultre
Consider local delivery, surgical debridement, immobilisation, lavage and rehabilitation of the entire limb

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7
Q

How does osteosarcoma present?

A

Typically older dog with unilateral few week long lameness that isn’t responsive to analgesia and rest
Pain on palpation and swelling

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8
Q

How do you investigate a case of osteomyelitis?

A

Clinical exam including LN palpation and degree of disability
Local and thoracic radiography
Swab tracts, culture and sensitivity to rule out osteomyelitis
Biopsy in a number of sites sing a Jamshidi needle
Definitive diagnosis based on biopsy or culture
Stage and evaluation of progression and prognosis

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9
Q

What are the decisions that need to be made in terms of treatment?

A

Analgesia doesn’t work so need to treat primary tumour whilst considering secondary spread as nearly all osteosarcomas have micro-metastases at the lungs at the time of diagnosis

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10
Q

What are the options for treatment of osteosarcoma and their prognoses?

A

Amputation (4 months) with chemo (12-14 months)
Limb sparing and chemo (12-14 months)
Euthanasia
Radiotherapy as a palliative treatment

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