Small Animal Orthopedics Flashcards
What are the principles of small animal fracture imaging
1) At least 2 orthogonal view
2) Joint above and below (for long bone fracture)
With fractures, how many orthogonal views do you need to have
at least 2
The fracture line is best seen when the x-ray beam is
parallel with the fracture
a radiographic image taken at a 90° angle to another image.
orthogonal
How might one fracture have multiple projected fracture lines
if the fracture is irregular it has multiple parts where the x-ray beam is parallel with the fracture
What might cause a lucent line that makes you think something is a fracture
1) Nutrient foramen
2) Physis
3) Superimposition
4) Sesamoids
5) Separate center of ossification
6) Chronic joint disease
What is a nutrient foramen
a channel that allows vessels to enter bone
wide smooth white line
-consistent locations, variable appearance
-present at all ages
-may be surrounded by sclerosis
lucent line during bone growth
consistent locations
disappear at varying ages
physis
What should you do if you are unsure you are looking at a physis
radiograph opposite limb
look at normal same-age patient
look at a reference textbook
a lucency seen at the edge of superimposed bones
can be confused with a fracture
superimposition
present around joints
typical locations but some are variably present
smooth/round or flatedges
can be confused with a fracture
sesamoid bones
appears in the ends of long bones after the primary ossification center has formed.
can be confused with a fracture
separate center of ossification
joint associated osseous bodies that create small mineral structures that can confused with fracture fragments
chronic joint disease
a type of broken bone where the bone is broken into more than two fragments, often into three or more
comminuted fracture
a fracture where there are at least 2 full separated fragments
complete
What is a greenstick fracture
a type of bone fracture where the bone cracks but doesn’t break completely into multiple pieces. It’s named for the way it looks, similar to how a young, green twig bends and cracks instead of snapping cleanly apart
How might greenstick fractures occur
young animals- they have bendy bones
sometimes one side bends and the other side breaks
an incomplete fracture that originates at the site of a complete fracture
fissure fracture
What might be challenging in repairing a complete fracture with an incomplete fissure fracture
the fissure may further break when attempting to fix the fracture
a simple transverse fracture
a fracture that is single perpendicular to the long axis of the bone
a simple fracture that is diagnonal at an angle less than 45 degrees
Short oblique
a simple fracture that is diagonal at an angle more than 45 degree
Long oblique
a simple fracture that twist around the cortex then cuts back to the starting point
spiral fracture
How do you describe the location of a fracture
-Long bones:
a) diaphysis: which portion
b) metaphysis/epiphysis: proximal or distal one
-Non-long bones (carpal bones, vertebrae)
a) Describe general anatomic location
b) Describe orientation in general terms
*Must meniton articular involvement
If juvenile with open physes, must mention physeal involvement (give salter-harris classification)
When talking about the location of a fracture, why must you mention articular involvement
because if it heals improperly, it can lead to severe osteoarthritis
also tells prognosis
When talking about the location of a fracture, why must you mention physeal involvement in a juvenile patient
Damage to the physis usually means premature physeal closure, angular limb deformity
Give Salter Harris classification
When a fracture occurs at the metaphysis, what must you include in your description
if its the proximal or distal one
What classification is used to descrube damage to the physis
Salter-Harris Classification
a fracture that is exposed to air
may be a fragment poking through skin
may be SQ gas bubbles
open fracture
What will you see with open fractures
gas bubbles
Salter-harris classification:
when the fracture line extends through the physis or within the growth plate
Salter I (Slipped)
Salter-harris classification:
when the fracture extends through both the physis and metaphysis. These are most common and occur away from the joint space.
Salter II (Above)
Salter-harris classification:
an intra-articular fracture extending from the physis into the epiphysis
Salter III (lower)
Salter-harris classification:
an intra-articular fracture, in which the fracture passes through the epiphysis, physis, and metaphysis
Salter IV (Thru and Thru)
Salter-harris classification:
due to a crush or compression injury of the growth plate
Salter V: Rammed /Ruined
How should you describe displacement of a fracture
most distal fragment relative to the most proximal fragment
T/F: displacement is described based on the most proximal fragment relative to the most distal fragment
False: most distal fragment relative to the most proximal fragment
T/F: Displacement is described based on the most distal fragment relative to the most proximal fragment
True !
a fracture that has 2 or more complete fracture fragments
comminuted
What should you do if there is no recognizable main fracture
just describe it as comminuted
what is a segmental fracture
a fracture where theres two complete fractures with a fracture segment in the middle
a fracture where theres two complete fractures with a fracture segment in the middle
segmental fracture
a special comminuted fracture that has a triangle fragment made by two oblique fractures
sometimes said for a middle fragment only involving one side of the cortex
butterfly fragment
What are the characteristics of acute fractures in small animals
-sharp fracture fragment
-sort tissue swelling
What are the characteristic of chronic fractures in small animals
1) Rounded margins
2) Less swelling
3) Some early callus/ periosteal proliferation
4) May have muscle atrophy from favoring that leg
What are the 6 things you must include when describing a fracture *
-Simple or comminutd
-Orientation (if simple)
-Complete or incomplete
-Open or closed
-Location
-Displacement
What do pathologic fractures look like
often acute fracture (sharp edges and swelling) with less bone in the area that there should be
what do traumatic fractures look like
adjacent bone is normal
acute: well-defined fracture margins
chronic: less defined
a fracture where the adjacent bone is normal
traumatic fracture
a fracture that is due to any lesion weakening bone, either aggressive or nonaggressive (but typically agressive)
pathologic fracture
humeral condyle fractures typically occur in
dogs and pot-bellied pigs
What kind of breeds get incomplete ossification of the humeral condyle
spaniel breeds and french bulldogs
congenital defect where there is incomplete ossification of the humeral condyle leading to condylar fractures
commonly bilateral
seen in spaniel breeds and french bulldogs
incomplete ossification of the humeral condyle -> humeral condyle fracture
T/F: incomplete ossification of the humeral condyle is commonly bilateral
True- check contralateral limb
When should fusion across the humeral condyle occur
by 3 months
dogs with incomplete ossification of the humeral condyle have lack of fusion across the condyle and are predisposed to fractures
T/F: all humeral condyle fractures are articular
true
What is an avulsion fracture
a fracture that occurs at a bone due to the attachment of tendon/ligament there
tibial tiberosity avulsion fragments
growth plate of the apophysis is weak in a juvenile animal
contralateral limb radiographs are helpful
this causes the tibial tuberosity to become ripped off due to its attachment of the patellar ligament
capital physeal fractures are common in
young male neutered cats, especially if obese
-delayed closure of the pelvis (should be closed before 1 year of age)
When should the pelvis be closed
by 1 year of age. if this doesnt occur then this can lead to capital physeal fractures
What Salter-Harris classification are capital physeal fractures typically
type 1 fracture
What causes capital physeal fractures
delayed closure of the physis
-common in young male neutered cats (especially if obese)
T/F: capital physeal fractures are traumatic fractures
False- can be spontaneous or with little trauma
What is the most useful view for diagnosis capital physeal fractures
frog leg VD
Primary cortical bone healing
rarely happens to complete fractures
nondisplaced fracture, no motion, direct bridging of bone
no external callus, internal opaque callus
gradual disappearance of fracture line
Secondary cortical bone healing
ideal way of healing
1) Edges of fracture sharp (1-7 days)
2) Edges of fracture fragments Rounded (3-10 days) and widening as demineralization of fragment
3) early osseous callus formation (7-14 days): fracture gap begins to decrease
4) External bridging osseous clalus (4-6 weeks): fracture lines gradually disappear, external callus increases in opacity and remodels
5) Secondary callus and remodeling- several months: continued remodeling of external callus, trabecular pattern develops and cortical margins become visible as medullary cavity re-established
What factors affect bone healing
age
blood supply
stability (fracture type, fixation method)
nutritional/metabolic conditions
infection
neoplasia
What is the rule of thumb to tell that a fracture is healed
when at least 3/4 of the sides of the crotex are bridged by callus
-sometimes these edges are hidden by impants
How might some fractures radiographically never look healed
if they are healed by fibrous union
What are complications with fracture healing
-Osteomyelitis (acute/chronic)
-Sequestrum
-Implant failure (plate/pin breaks, screws come out)
-Malunion
-Delayed union
-Non-union (vital and non-vital)
What are the radiographic findings of osteomyelitis after fracture
1) irregular callus- not smooth
2)lucency, lysis of bone around implants
*keep in mind that radiographic signs occur 7-10 days after infection
What might be the source of osteomyelitis
hematogneous, trauma, implant and/or sequestrum
What is the Uberschwinger artifact
an image processing artifact
-symmetric, small faint lucent halo around implants
an image processing artifact
-symmetric, small faint lucent halo around implants
Uberschwinger artifact
dense fragment of dead bone that is usually infected
sequestrum
new bone around a sequestrum
appears as a lucent pocket
involucrum
opening in the involucrum that pus comes out of
not usually seen radiographically
cloaca
where bones are healed in abnormal alignment
malunion
when fracture healing takes longer than usual after accounting for healing factors (age, type, etc)
delayed union
delayed union may increase the risk of
implant breaking before the bone is healed
worse than delayed union where there is no progress towards healing
Non-union
hypertrophic non-union
lots of proliferation adjacent to the fracture but no bridging bone between the fracture segments
oligotrophic non-union
little to no proliferation, no bony bridge between segments
atrophic non-union
where the bone is resorbing at the edges the the fracture segments
a type of non-union where the segment is necrotic
sequestrum
defect non-union
large piece of bone missing and its too far for the bone to bridge the gap
5 Types of non-nion
1) hypertrophic
2) oligotrophic
3) atrophic
4) necrotic
5) defect
What can hypertrophic non-union lead to
pseudoarthrosis- happens under chronic motion where the soft tissues form a false joint that is still vital
would need surgery to stabilize so it can heal
a non-union where there is no active bony callus
fragments tapering, resorbing at the fracture site
usually in small dogs
probably avital
atrophic non-union
aggressive bone lesions can either be caused by
osteomyelitis (bacterial, fungal, or parasite)
OR
Neoplasia (primary bone tumor, metastatic, multicenteric, soft tissue mass invading bone (joint centered, digit associated, others)
What are the 3 criteria that aggressive lesions are likely to have *
1) ill-defined margin (long zone of transition)
2) cortical lysis
3) irregular periosteal proliferation
otherwise the lesion is usually nonaggessive
With aggressive lesions, why might it be difficult ro assess early
because there isnt formation of a lesion yet. recheck with more radiographs to catch aggressive lesions with rapid rate of change
T/F: smooth periosteal proliferation means that that the lesion is non-aggresive
False- it is typically nonaggressive but this may happen with aggresive lesions
because it only takes one of the criteria to be aggresive
1) ill-defined margin (long zone of transition)
2) cortical lysis
3) irregular periosteal proliferation
What are the different types of irregular periosteal proliferation
1) Columnar
2) Spiculated
when the periosteum becomes lifted by a rapidly growing lesion, especially neoplasia, leaving a triangle of smooth bone under the periosteum
Codman triangle
What is codman triangle
when the periosteum becomes lifted by a rapidly growing lesion, especially neoplasia, leaving a triangle of smooth bone under the periosteum
typically with primary bone tumors
What two terms imply a long zone of transition (aggressive)
1) Moth eaten
2) permeative
Is geographic bone lysis aggressive or nonaggressive
it can be either
well defined region of bone lysis
geographic bone lysis (can be aggressive or nonaggressive)
medium to small patches of bone lysis
moth-eaten bone lysis (sign of aggressive)
small of pinpoint foci of lysis
permeative (sign of aggressive)
85% of primary bone tumors in dogs is
osteosarcoma
primary bone tumors primarily affect what kind of dog
mostly old dogs, especially large breeds. (small additional peak in incidence around 2 years of age)
what part of the long bone do primary bone tumors (ie osteosarc) typically occur
almost always metaphysis
What joint are primary bone tumors (ie osteosarc) typically not at
Elbow
primary bone tumors (ie osteosarcoma) are usually monostotic, what does that mean?
it only affects one region on one bone
-doesnt often extend into nearby bones
-but can metastasize to other bones
How might primary bone tumors look on radiographs
can be both osteolytic and osteoproductive
almost always metaphysis of long bone
usually monostotic and very rarely occurs near the elbow
where does metastatic neoplasia of the bones typically occur
can occur anywhere, diaphyseal, or less commonly the metaphyseal
usually lytic, rarely sclerotic
metastatic neoplasia of the bones are typically _____ and rarely _____
typically lytic, rarely sclerotic a
Common multicentric neoplasia of bone
Multiple myeloma
-multifocal regions of bone lysis (looks like swiss cheese)
-patchy or irregular shape
What does multiple myeloma look like on radiographs
Multifocal regions of bone lysis
patchy or irregular shape
What might you confuse with multiple myeloma due to its multifocal regions
Osteopenia in older patients
-Distinguish because osteopenia will have small well defined lucencies in typical locations (C2 spinous process)
What is the typical site to see osteopenia of older patients
C2 spinous process and other cervical v
How do you differentiate multiple myeloma from osteopenia
Osteopenia: small well defined lucencies in typical locations (commonly C2 spinous process and )
Multiple myeloma: multiple regions of lysis, patchy or irregular shape
What are hints that support a soft tissue neoplasia invading bone instead of a primary bone tumor
1) Larger soft tissue mass
2) multiple bones involved with one lesion *
3) Joint space crossed *
4) Lysis from “outside” bone
5) More lysis than periosteal reaction
joint centered neoplasia
soft tissue neoplasia that invades bone
soft tissue mass of the joint
aggressive bone lysis on both sides of the joint
(in contrast primary bone tumore are usually monostotic)
What do you see with joint centered neoplasias?
aggressive bone lysis on both sides of the joint - this is a type of soft tissue neoplasia.
In contrast, primary bone tumors are usually monostatic
What is the origin of digit neoplasia
1) Soft Tissue: squamous cell carcinoma
melanoma
mast cell tumor
2) Osteosarcoma
3) Lung digit syndrome (feline)- metastasis from lung
What is lung digit syndrome
cats get mastastasis from lung to the digits
is bacterial osteomyelitis more common in young animals or older animals
young animals
What is bacterial osteomyelitis associated with
trauma, surgery
-occasionally hematogenous
-typically younger animals
What does fungal osteomyelitis look like
can look like bone neoplasia
How is fungal osteomyelitis typically spread
hematogenous
What are possible causes of an aggressive lesion around an implant
1) Osteomyelitis
2) Osteosarcoma
What are the causes of fungal osteomyelitis
1) Coccidioidomycosis (SW)
2) Blastomycosis (SE/Midwest)
3) Histoplasmosis (SE/Midwest)
4) Aspergillosis
What do you see on radiographs with fungal osteomyelitis
Animal that is systemically ill, histroy of traveling
1) Diaphysis or or sometimes metaphysis
2) Lysis or irregular periosteal reactions +/- smooth periosteal reactions
3) Can see multiple lesions
4) often polyostotic, sometimes monostotic
How do you tell neoplasia from fungal osteomyelitis
Raising probably of primary tumor:
-Old animal
-Metaphyseal
-Large amount of tumoral bone production (not periosteal)
Raising probability of fungal:
-young to middle aged animal
-travel history
-other sites of infection or systemic illnesses: lymph nodes, lungs, skin, eyes
-Diaphysis
-Multiple bones
often you can be sure radiographically
What factors might increase your probabilty of fungal osteomyeltitis as suppose to neoplasia
-young to middle aged animal
-travel history
-other sites of infection or systemic illnesses: lymph nodes, lungs, skin, eyes
-Diaphysis
-Multiple bones
What factors might increase your probabilty of neoplasia as suppose to fungal osteomyelitis
-Old animal
-Metaphyseal
-Large amount of tumoral bone production (not periosteal)
What are your differentials for an aggression lesion centered at the diaphysis
fungal osteomyelitis
What are your differentials for an aggression lesion centered at the metaphysis
primary bone tumor
-metastatic neoplasia and fungal osteomyelitis uncommon
often your cant differentiate fungal osteomyelitis from neoplasia on radiographs. What else can you do?
1) Lesion sampling: best for lesions with cortical lysis or extra-osseous soft tissue component
-Ultrasound guided FNA
-Bone biopsy
2) Fungal titers or antigen testing
3) Chest radiographs:
-Lung nodules for neoplasia or fungal disease
-Lymph node enlargement for fungal disease (and some types of neoplasia)
How might you sample lesions for differentiating between fungal osteomyelitis
-Ultrasound guided FNA
-Bone biopsy
best for cortical lysis, or extra-osseous soft tissue component
hypertrophic osteopathy results in
swollen limbs, lameness, sometimes fever
hypertrophic osteopathy starts _______ and progresses ________
starts distal and progresses proximal
What does hypertrophic osteopathy look like on radiograph?
irregular periosteal proliferation of all limbs
-sometimes smooth or only very slightly irregular
-often see columnar
T/F: you should sample hypertrophic osteopathy cases
False- often unrewarding
*Instead take thoracic radiographs, due to mass in the lung or other places
What causes hypertrophic osteopathy
mass elsewhere in body
-commonly lung
bone cysts (small animals)
-rare
-thin cortex (from marked expansion)
-well defined margins
What are the 7 radiographic signs of osteoarthrosis in small animals *
1) joint capsule swelling (effusion, joint capsule thickening)
2) narrowed joint space
3) subchondral bone sclerosis
4) subchondral bone erosion
5) ostephytes
6) periarticular enthesophytes
7) changes in joint margins/shape
why might you not see joint capsule swelling with osteoarthrosis in small animals
if there are other extracapsular soft tissue swelling that can occur in region of joint, obscuring it
cant tell if there is swelling
what causes joint capsule swelling seen with osteoarthrosis
effusion
joint capsule thickening
osseous proloferation at the edge of articular cartilage, sign of osteoarthrosis
osteophytes
flexor enthesopathy
enthesophyte on the distal caudal humerus
in dogs can be primary disease
or secondary to other joint disease
T/F: joint space narrowing is a reliable sign of osteoarthrosis in small animals
false- hard to tell in small animals because they are not standing
usually artifactual in small animals bebecause we dont take weight bearing animals
what might cause subchondral bone erosion
1) Osteoarthrosis - damage from improper cushioning
2) lysis from septic joint
what is an example of changes in the joint margins/shape associated with osteoarthosis
flattening of femoral head and thickening of neck
developmental defect in cartilage and sunchondral bone
osteochondrosis
a developmental defect in cartilage and subchondral bone but also a flap of cartilage dissects away either partially or completely causing inflammation in the joint
osteochondrosis dissecans
what are the radiographic findings of osteochondrosis
1) flat subchondral bone or concave lucent defect
2) commonly bilateral
3) surrounding bone sclerosis
is OCD commonly unilateral or bilateral
bilateral - look at other limb, might have earlier subclinical lesion
synovial osteochondral fragment
“joint mouse” a joint associated ooseous body
hard to probe the OCD is the cause
what are common sites of OCD in small animals
Shoulder- caudal aspect of humeral head
Elbow- medial aspect of humeral condyle
Stifle- femoral condyles
Tarsus- trochlear ridges of talus
where in the shoulder is a common site for OCD
caudal aspect of humeral head
where in the elbow is a common site for OCD
medial aspect of humeral condyle
where in the stifle is a common site for OCD
femoral condyles
where in the tarsus is a common site for OCD
trochlear ridges of talus
what might help demonstrate joint instability on radiographs
stress views - apply pressure or rotation to the joint
You should only do stress views in
heavy sedated or anesthetized patients only
what might cause joint instability leading to carpal hyperextension
1) fall from really high
2) chronic joint disease
3) congenital
complete loss of contact between articular margins
luxation
displacement, contact of articular margins that normally do not
or excessive stretching of joint capsule
or abnromal shape of joint surface, and articular margins cannot make normal contact
subluxation
abnormal shape of joint surface, and articular margins cannot make normal contact
subluxation
What are the three definitions of subluxation
1) displacement, contact of articular margins that normally do not
2) excessive stretching of joint capsule
or abnromal shape of joint surface
3) articular margins cannot make normal contact
displacement, contact of articular margins that normally do not
subluxation
excessive stretching of joint capsule
or abnromal shape of joint surface
subluxation
dyplasia of what joints is common in dogs
hip and elbow
in dogs, significant bilateral osteoarthritis at these sites is oftne assumed to be from
dysplasia- especially when early onset
hip dysplasia in dogs is almost aways (unilateral or bilateral)
bilateral
what causes hip dysplasia in dogs
increased laxity of hip joints
-position dependent: decreased coverage of the dorsal acetabulum and/or lateral displacement of the femoral head
normally the femoral head should by covered _____ by the dorsal acetabular rim
> 50%
Normal hip joints
femoral head: normal shape, >50% coverage of femoral head by dorsal acetabular rim
acetabulum: deep
what are the 3 effects of hip dysplasia in dogs
1) flattened femoral head
2) shallow acetabulum
3) secondary osteoarthrosis
is elbow dysplasia unilateral or bilateral
bilateral- need to consider imaging contralateral elbow
what might cause elbow dysplasia in a dog
1) Ununited anconeal process
2) Elbow incongruity
3) Medial coronoid process disease +/- fragmentation
When does ununited anconeal process (UAP) typically occur in dogs
separation after 5 months of age
-lucent area that is wide and irregular
-seen better with a flexed lateral view
What does ununited anconeal process (UAP) look like on radiograph
flexed lateral view
-wide and irregular area of lucency
What is the best view to see ununited anconeal process (UAP)
flexed lateral view
What are the joints that can be associated with elbow joint incongruity
1) Humeroulnar
2) Humeroradial
3) Radioulnar
where the humerus articular margin doesnt match with the ulna leading to subluxation
humeroulnar incongruity
what are the radiographic findings of medial coronoid process disease
indistinct medial coronoid disease
+/- visible fragment (hard to see on radiograph)
secondary osteoarthritis as a result
what are the changes seen with canine septic arthritis
1) one or sometimes multiple joints
2) soft tissue swelling (intracapsular +/- extracapsular)
3) +/- subchondral bone lysis depending on duration
4) +/- adjacent sclerosis and periosteal reaction
5) +/- wide joint space
6) +/- secondary osteoarthrosis
What is seen radiographically in non erosive immune mediated polyarthritis
multiple usually symmetric joints
joint capsule swelling
+/- osteoarthrosis
How does IMPA progress
starts off with: mild subchondral bone lysis, joint capsule swelling +/- osteoarthrosis
chronic becomes more severe subchondral bone lysis, becomes severe osteoarthrosis, narrowed joint spaces, joint instability, and collapse of cuboidal bones
T/F: immune mediated polyarthritis typically occurs in multiple, usually symmetric joints
true
how might you tell the difference between septic arthritis and erosive IMPA as they both include
1) Soft tissue swelling
2) subchondral bone lysis
3) adjacent periosteal reaction and bone sclerosis
4) Can be polyarticular
Joint tap
What is seen with erosive IMPA
1) Soft tissue swelling
2) subchondral bone lysis
3) adjacent periosteal reaction and bone sclerosis
4) polarticular
What breeds of dog is panosteitis common in
german shepherd dogs and other large breed dogs
what bones does panosteitis typically affect
the long bones
What kind of dogs does panosteitis typically affect
german shepherds and other large breeds dogs
typically 5-18 months (occasionally up to 7 years in german shepherds)
What kind of bones does panosteitis typically affect
the long bones
-ill or well defined patches of variably faint sclerosis in the medullary cavity
-random distribution
-may see smooth periosteal proliferation in severe cases
-No lysis
-Eventually gets remodeled away
T/F: panosteitis is usually self-limiting
true- no lysis and eventually becomes remodeled away
typically occurs at 5-18 months of the dog’s age
ill or well defined patches of variably faint sclerosis in the medullary cavity of longbones
no lysis
panosteitis
what kind of dogs does hypertrophic osteodystrophy typically affect
large breeds, fast growing dogs 2-7 months of age
become febrile and lame in more than 1 limb
hypertrophic osteodystrophy commonly affects which part
distal ulna and radius more common
usually bilateral
irregular lucent line in the metaphysis parallel to normal physeal line
what has an irregular lucent line in the metaphysis parallel to normal physeal line
hypertrophic osteodystrophy
What are the radiographic changes seen with hypertrophic osteodystrophy
1) irregular lucent line in the metaphysis parallel to normal physeal line
2) +/- adjacent sclerosis
3) Regional soft tissue swelling
4) can see some mild periosteal proliferation (become moderate to severe)
can see premature physeal closure leading to angular defomritiess
what is the most common site for a retained cartilage core in dogs
distal ulna
retained cartilage core is most common in what kind of dogs
large to giant breeds
What are the radiographic changes seen with retained cartilage core
lucent, conical cartilage core in medullary region of ulnar metaphysis
often bilateral
retained cartilage core is often (unilateral or bilateral)
bilateral
lucent, conical cartilage core in medullary region of ulnar metaphysis
retained cartilage core
What are the most common developmental bone diseases in small animals
1) Panosteitis
2) Hypertrophic osteodystrophy
3) Retained cartilaginous core
disorders that result in osteopenia
1) hyperparathyroidism
2) Disuse osteopenia
also (humoral hypercalcemia of malignancy, hypovitaminosis D, osteogenesis imperfecta)
What disorders result in too much bone mineral
1) Poloyostotic hyperostosis
hypervitaminosis A
osteopetrosis
a
Polyostotic hyperostosis results in osteopenia or too much bone mineral?
too much bone mineral
hyperparathyroidism can be
primary (adenona, carcinoma, or hyperplasia)
secondary- nutritional or renal
nutritional secondary hyperparathyroidism is most often sen in
young patient - leading to +/- folding fractures, +/- angular limb deformities
common in exotics like lizards
What species is nutritional secondary hyperparathyroidism most commonly seen in
Lizards - reptiles need IV lights and vitamin D supplementation
with renal secondary hyperparathyroidism where is the loss of bone density seen?
early- lamina dura around the teeth
late- fibrous osteodystrohphy
with renal secondary hyperparathyroidism where is the loss of bone density worst
in the skill
What has increased contrast with renal secondary hyperparathyroidism
the teeth
lack of stress of the bone resulting in overall decreased opacity +/- coarse trabecular pattern in medulla (more conspicious lacy mineral)
disuse osteopenia
What is seen with disuse osteopenia
1) decreased opacity +/- coarse trabecular pattern in medulla (more conspicious lacy mineral)
what is polyostotic hyperostosis
a condition that causes bones to appear denser and more opaque, and is often observed in birds
a condition that causes bones to appear denser and more opaque, and is often observed in birds
polyostotic hyperostosis
