Test 2: 23: case discussion Flashcards
2 year old dog with history of lameness over the past year what should be at top of differential
young= developmental disease
chronic and progressive= ortho> soft tissue
dog with pain on right stifle extension and effusion can be —
Cranial cruciate ligament disease (CCL)
Osteoarthritis (primary or secondary)
Osteochondritis dissecans (OCD)
Hypertrophic osteodystrophy
Septic arthritis
Trauma/fracture
what is wrong
effusion (fat pad displaced-triangle moved)
big chunk is missing
OCD
dog with stifle pain what is wrong
big chunk missing
osteophytes
OCD
disturbance in endochondral ossification
Osteochondrosis
clinical manifestation of osteochondrosis
Osteochondritis-
— must accompany radiographic evidence for OCD diagnosis
clinical signs- limping, swollen joints
most common locations of OCD for dog and horse
DOG:
Shoulder → caudal humeral head (good)
Elbow → humeral trochlea (poor)
Stifle → lateral femoral condyle (poor)
Tarsus → medial trochlear ridge of the talus (poor)
HORSE:
Shoulder→caudal humeral head, glenoid (poor)
cervical (poor)
Stifle→ Lateral and medial trochlea ridge of femur, patella (good)
tarsus→ DIRT, medial malleolus of tibia, medial and lateral trochlear ridge of talus (excellent)
fetlock→ (poor)
treatment for OCD
Surgical removal of loose osteo-chondral flap (arthrotomy or arthroscopy)
Debridement to bleeding bone - tries to form scar tissue to protect itself
Osteochondral or synthetic grafts
medial patella luxation
- Coxa —
- Femoral — and — varum
- — trochlear groove with poorly developed trochlear ridge(s)
- Hypoplasia of the — femoral condyle
- Coxa vara
- Femoral varus and genu varum
- Shallow trochlear groove with poorly developed trochlear ridge(s)
- Hypoplasia of the medial femoral condyle
- Medial displacement of tibial tuberosity and/or internal rotation of tibia relative to femur
- Proximal tibial varus
- Internal rotation of the foot
medial patella luxation
5. — displacement of tibial tuberosity and/or — rotation of tibia relative to femur
6. Proximal tibial —
7. — rotation of the foot
- Coxa vara
- Femoral varus and genu varum
- Shallow trochlear groove with poorly developed trochlear ridge(s)
- Hypoplasia of the medial femoral condyle
- Medial displacement of tibial tuberosity and/or internal rotation of tibia relative to femur
- Proximal tibial varus
- Internal rotation of the foot
bow legged
dog with OCD repair now presents with non weight bearing lameness what probably happened
ligaments are cut to get into joint to fix OCD,
sutured back together, can snap and now traumatic grade 3 luxation of the patella
if lateral approach fails → medial luxation of patella
if lateral OCD approach fails what way will patella luxate
medially
2 weeks post op OCD and patella lux reapir: worsening lameness, pain, effusion, swelling, high temp
what is wrong
post op infection
how to test for infection in joint
arthrocentesis
in normal joint what is the most common cell type
mononuclear
a septic joint will have ↑↑ amount of neutrophils
septic arthritis will have what cell type
neutrophils
— are most common cause of septic arthritis in a dog
staph and strep
how to treat septic arthritis
antibiotics
flush joint
how long to continue antibiotics for septic arthritis
2 weeks beyond resolution of all clinical signs
if healed in 4 need to go to 6 weeks
what joint does well after OCD repair
shoulder
elbow, tarsus, stifle have poor prognosis and will usually form OA
conservative treatement of OA
NSAIDs
intra-articular injections
decreased exercise/ rehab
weight loss
4 surgical treatments of OA
Remove osteochondral fragments
Resurfacing of cartilage defects
Total joint replacement- hip, elbow stifle tarsus
Arthrodesis- fuse joint
1 yo rotti
occasional LH lameness for 3 months
positive cranial drawer test
what is wrong
CCL tear
