test 2: 19 developmental orthopedic disease

Question 1

Any orthopedic disorder related to abnormal growth, maturation or structural development of bone, cartilage, tendon or ligament

Answer 1

DOD
developmental orthopedic disease

Question 2

OCD vs OC

Answer 2

osteochondritis
* manifestation of osteochondrosis

Osteochondritis dissecans (OCD)
* Dissecting flaps of abnormal cartilage at articular surface

Question 3

— is failure of endochondral ossification

Answer 3

Osteochondrosis

usually at secondary physis (ephiphyseal)

Question 4

what happens during osteochondrosis

Answer 4

failure of endochondral ossification

bone failed to form at ephiphyseal (secondary physis)

retained cartilage core are weak and can cause necrosis, fissues/flaps

Question 5

what can cause OCD

Answer 5

rapid growth
nutrition: over fed, abnormal glucose levels, mineral imblances
genetics
biomechanical: joint built wrong

Question 6

what are the predilection sites for OCD in large animals

Answer 6

stifle
tarsus
fetflock
shoulder
cervical articular process joints

Question 7

clinical signs of OCD

Answer 7

+/- Joint effusion
+/- Lameness

often bilateral

Question 8

in the stifle where is OCD common

Answer 8

• Lateral trochlea ridge (LTR) of the femur
• Medial trochlea ridge (MTR) of the femur
• Patella

Question 9

where is OCD common in the tarsus

Answer 9

• Distal intermediate ridge of the tibia (DIRT)
• Lateral trochlear ridge (LTR) of talus
• Medial trochlear ridge (MTR) of talus
• Medial malleolus of tibia

Question 10

conservative treatment of OCD

Answer 10

time: may heal over time in first year (bone becomes ossified)
rest
dietary restrictions: prevent fast growth
NSAIDS if needed for lameness

Question 11

when to do surgery on OCD

Answer 11

after year 1
want to remove loose or free fragments to prevent further injurt/OA down the line

Question 12

prognosis of OCD after treatment in stifle and tarsus

Answer 12

stifle: good
tarsus: excellent

Question 13

prognosis of OCD after treatment in fetlock, shoulder and cervical articular process joints

Answer 13

fetlock: respond to conservative treatment, but if extensive lesion: poor
shoulder: poor
cervical articular process joints: can lead to OA and type II CVSM

Question 14

what causes subchondral cyst-like lesions

Answer 14

Likely due to trauma to articular cartilage + subchondral bone leading to progressive cyst formation

Question 15

predilection sites of subchondral cyst-like lesions

Answer 15

Medial femoral condyle
phalanges
proximal radius
MC3/MT3

Question 16

how to treat subchondral cyst-like lesions

Answer 16

Stimulate bony filling of cyst to restore biomechanical integrity to joint surface
* Arthroscopic cyst debridement +/- filling cavity
* Translesional screw placement
* Intra-lesional corticosteroid or orthobiologic injection

Question 17

Abnormal endochondral ossification in metaphyseal
physis

Answer 17

physitis

Question 18

physitis causes

Answer 18

metaphyseal flaring causing visible, painful enlargment

often affects multiple long bones

need to differentiate septic and non-septic

Question 19

how to treat physitis

Answer 19

Conservative management
Dietary restriction to limit growth
Exercise restriction
NSAIDs for pain

Question 20

what can cause angular limb deformity

Answer 20

Physeal asymmetry

Incomplete ossification of cuboidal bones

Question 21

valgus

Answer 21

later deviation

physeal asymmetry that leads to angular limb deformity

Question 22

varsus

Answer 22

medial deviation

physeal asymmetry that leads to angular limb deformity

Question 23

predilection sites for angular limb deformities

Answer 23

carpus (valgus- lateral)
fetlock (varus- medial)
tarsus (valgus- lateral)

Question 24

conservative treatment of angular limb deformity

Answer 24

trimming or shoeing

increase hoof on side you want hoof to grow toward

exercise restriction

Question 25

surgical treatment of angular limb deformities

Answer 25

Growth Acceleration
* Periosteal transection (stripping)
* Little evidence of efficacy

Growth Retardation
* Transphyseal bridge
* Transphyseal screw
* Corrective osteotomy / ostectomy
* Try to avoid due to increased difficulty compared to small animals

Question 26

Shoeing: Place extension on — side from which hoof is deviating

Answer 26

opposite

Ex. turned out = apply medial extensio

Question 27

Trimming: — the wall toward which hoof is deviating

Answer 27

Lower

Ex. turned out = lower outside wall

Create hoof with more hoof on side you want hoof to grow towards

Question 28

flexural limb deformities causes persistent —

Answer 28

hyperflexion
tendons too short for bone

can be congenital or acquired

Question 29

prediliction sites of flexural limb deformities

Answer 29

coffin: clubbed foot

Question 30

conservative treatment for flexural limb deformities

Answer 30

Dietary changes to slow growth Controlled exercise
Encourage stretching without making foal too painful
Toe extension shoes
Oxytetracycline
NSAIDs

Question 31

surgical treatment of flexure limb deformities

Answer 31

increase length of ligament

inferior check ligament desmotomy: increase DDFT (coffin joint)

superior check ligament desmotomy: increase SDFT (fetlock, carpus)

Question 32

— is wobblers syndrome

Answer 32

Cervical Vertebral Stenotic Myelopathy

compression of spinal cord that leads to compression and ataxia

Question 33

conservative treatment for wobblers

Answer 33

conservative: exercise restrictions, NSAIDs, dietary restriction

Cervical Vertebral Stenotic Myelopathy : compression of spinal cord

Question 34

surgical treatment of wobbler’s

Answer 34

cervical ventral stabilization

Cervical Vertebral Stenotic Myelopathy : compression of spinal cord