Small animal orthopaedic conditions Flashcards
What is bicipital tenosynovitis?
inflammation of the biceps brachii tendon
What is the aetiology of bicipital tenosynovitis??
repetitive strain?? Associated with shoulder arthritis??
What history is considered for bicipital tenosynovitis?
medium → large breed active dogs
What are the clinical signs of bicipital tenosynovitis?
ranges from acute → insidious onset lameness, affects biceps tendon of origin in intertubercular groove of humerus (also joint capsule)
Pain on palpation of tendon and ROM (shoulder flexion)
What are the treatment options for bicipital tenosynovitis?
Conservative; strict rest for 4 – 6 weeks on NSAIDs or peritendinous/ intra-articular corticosteroids
Surgical:
tenodesis (anchor tendon to bone) or tenotomy (transection of tendon)
Describe post-surigcal management for bicipital tenosynovitis
Restricted lead exercise and room rest for around 6 weeks
Then gradual progressive return to normal exercise
What are the three major types of elbow dysplasia?
Un-united anconeal process (UAP)
Fragmentation of the medial coronoid process (FCP)
Osteochondritis dissecans (OCD) of the medial portion of the humeral condyle
Describe the un-united anconeal process
Aetiology; anconeal process normally develops as part of the ulnar diaphysis;
in some breeds i.e. GSD get a separate centre of ossification;
In other breeds i.e. Basset Hound; separation is secondary to non-traumatic premature closure of the distal ulnar growth plate
a form of OCD?
All cases eventually develop osteoarthritis
What are the clinical signs of the un-united anconeal process?
Clinical signs: may be uni- or bilateral; progressive limb lameness developing at 4 – 5 months of age.
Commonest in GSD and other large breeds
Gait affected (lame) and at stance tends to abduct elbow. ↓ ROM; crepitus & thickened joint capsule
What are the treatment options for the un-united anconeal process?
Treatment; usually surgical
Removal of the anconeal process (chronic cases)
Osteotomy of the proximal ulna
Combination of internal fixation of anconeal process (k-wires / lag screw) & osteotomy.
Most develop arthritis and have continued impaired limb function
Post surgery lame for quite a long time (especially ulnar osteotomy).
Require 4 – 8 weeks rest and pain relief
Describe fragmentation of the medial coronoid process
Fragmentation of the medial coronoid process
Aetiolgy; OCD?? Radioulnar / humeroulnar incongruity; abnormal load bearing (microfractures??)
Signs; Young rapidly growing large / giant breeds; Rottweiler, Labrador, Bernese Mountain Dog, GSD, Golden Retriever, St. Bernard, Newfoundland
Uni- and bilateral
Usually lameness noted at 4 – 5 months age; usually subtle onset and progresses.
Elbow tends to be adducted
Lameness usually worse after rest and heavy exercise
Osteoarthritis often present
Severity of elbow dysplasia can be assessed by level of cartilage destruction (Modified Outterbridge Scale)
Describe treatment for fragmentation of the medial coronoid process
Surgical treatment required
Fragment removal
Ulnar osteotomy (cranial and distal)
Post surgical management as per UAP
Describe screening for elbow dysplasia
BVA/KC Elbow dysplasia scheme
Minimum 1 year age, can only present once
Elbows graded 0 – 3 (0 = normal, 3 + severe); the highest grade of the two elbows is the grade awarded
Breeders encouraged to breed only from scores 0
Describe humeral osteochrondritis dessicans
Medial epicondyle of humerus affected
Particularly Labrador and Golden retriever
Often bilateral
May occur with FCP
Surgical treatment
Arthroscopy & curettage of articular surface
Describe elbow incongruencies
Distal ulnar / radial growth plate damage
Often post trauma to growth plates (fall from a height)
Premature plate closure
Subluxation of elbow / carpus
Often treated by osteotomy of shorter bone
