Musculoskeletal Disease

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Musculoskeletal Disease
2013-03-26 20:14:23
Animal Diseases Four

Animal Diseases
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  1. What is the musculoskeletal system used for?
  2. What causes the rigid frame, flexible articulations, and pulleys of the musculoskeletal system?
    • rigid frame:  skeleton
    • flexible articulations:  joints
    • pulleys:  muscles, tendons, ligaments
  3. What are the different problems with the musculoskeletal system?
    • cruciate ligament disease
    • luxating patella
    • OCD
    • panosteitis
    • aseptic femoral head necrosis
    • hip dysplasia
    • osteosarcoma
  4. What are the two types of cruciate ligaments?
    cranial (anterior) and caudal (posterior)
  5. What do the cruciate ligaments do?
    stabilize the stifle joint
  6. What happens if the cruciate ligaments rupture or tear?
    causes instability
  7. What does instability of the stifle joint lead to?
    degenerative changes
  8. What animal does cruciate ligament tears usually happen in?
  9. What is the most common cruciate ligament rupture?
    cranial cruciate rupture
  10. What is the typical signalment for a cruciate ligament rupture?
    • middle aged
    • obese or highly active, athletic
  11. What are the clinical signs of a dog with a cruciate ligament rupture?
    • non-weight bearing lameness
    • appears to be in pain if leg is used
    • "toe touching"
    • stifle swelling (effusion)
    • usually acute onset
  12. How do we diagnose a cruciate ligament rupture?
    • anterior drawer sign - cranial drawer movement
    • tibia slide forward
    • may need to sedate to get the drawer sign due to pain or muscle spasms
    • radiographs
  13. What is the treatment for a ruptured cruciate ligament?
    • surgical stabilization of the stifle joint
    • try to decrease the development of DJD (degenerative joint disease)
    • may need to repair torn menisci - meniscal "click"
  14. How do we educate clients on a cruciate ligament rupture?
    • restrict exercise for 3 - 6 weeks
    • gradually increase to full exercise in about 12 weeks
    • opposite cruciate often ruptures within one year of the first rupture
    • weight reduction is important
    • DJD will occur to some extent even with surgical stabilization
  15. What are the different types of patellar luxation?
    medial and lateral luxation
  16. What does luxation mean?
  17. Which animal is a patellar luxation a frequent problem in?
    • dogs
    • can occasionally happen in cats
  18. Which types of dogs are prone to patellar luxation?
    toy and miniature breeds
  19. What are the different ways an animal gets a patellar luxation?
    • can be congenital
    • induced by trauma
    • anatomic deformities
  20. _____ of patellar luxations are medial.
    70 - 80%
  21. What are the clinical signs of a patellar luxation?
    • intermittent gait abnormalities
    • sudden rear leg lameness
    • skipping or hopping gait
    • leads to DJD
  22. How do we diagnose a patellar luxation?
    • palpation - try to luxate the patella
    • radiographs - may see anatomic abnormalities
  23. How do we treat a patellar luxation?
    surgery is the treatment of choice
  24. What is the goal for treating a patellar luxation?
    • stabilize joint, prevent DJD
    • returen patella to its functional position
  25. How do we educate clients of patellar luxation?
    • limit exercise after surgery
    • NSAIDs as needed for pain
    • physiotherapy/swimming
    • some degree of DJD later in life
  26. What does OCD stand for?
    osteochondrosis dissecans
  27. What is osteochondrosis?
    degeneration or necrosis of bone and cartilage, followed by reossification
  28. What is osteochondrosis dissecans?
    • defect in endochondral ossification - cartilage thickens
    • lower layers of cartilage unable to obtain nutrients and dies
    • dead cartilage pulls away from the bone
    • may pull loose into the joint - joint mice
  29. Which joints is OCD seen in?  Which one is the most common?
    • shoulder, stifle, hock, elbow
    • most commonly seen in the shoulder
  30. Which dogs do we often see OCD in?
    lameness in large breed dogs
  31. What age do we often see OCD?
    3 - 18 months of age
  32. What are the clinical signs of OCD?
    • juvenile bone disease
    • pain during palpation
    • pain during range of motion manipulations
  33. How do we diagnose OCD?
    • radiographs - OCD lesions
    • DJD
    • joint mice
  34. How do we treat OCD?
    • if caught early - rest and weight control
    • if patient is lame - surgical removal of flap, mouse
    • curettage of lesion to stimulate fibrocartilage formation
    • disease is often bilateral
  35. What does ROM stand for?
    range of movement
  36. What are some other names for panosteitis?
    • endosteosis
    • eosinophilic panosteitis
  37. What causes panosteitis?
    • self-limiting
    • idiopathic
    • viral infection?
  38. What age do we often see panosteitis?
    6 - 14 months
  39. What types of dogs do we often see panosteitis?
    young, rapidly growing large or giant breeds
  40. What does panosteitis affect?
    • affects bone marrow and endosteum
    • bone marrow degeneration
    • endosteal thickening
  41. What are the clinical signs of panosteitis?
    • cyclic lameness, shifting leg lameness
    • one or multiple legs
    • usually acute, no history of trauma
  42. Which bones are affected by panosteitis?
    long bones affected:  ulna, humerus, radius, femur, tibia
  43. How do we diagnose panosteitis?
    • palpation of long bones is painful
    • may be lethargic and febrile
    • radiographs - changes in medullary cavity - dense patches
    • radiographic changes may not correlate with clinical signs
  44. How do we treat panosteitis?
    • self-limiting
    • analgesics
    • anti-inflammatory drugs
  45. How do we educate clients on panosteitis?
    • waxes and wanes
    • clinical recovery usually by 18 months of age
    • eventually complete recovery
  46. What are other names for aseptic femoral head necrosis?
    • legg-calve-perthes disease
    • avascular necrosis
  47. Is aseptic femoral head necrosis a congenital disease?
  48. What bones are involved with aseptic femoral head necrosis?
    involves femoral head and neck
  49. Which animals does aspetic femoral head necrosis affect?
    • dogs
    • miniatures, small breeds, terriers
  50. When do dogs get aseptic femoral head necrosis?
    during late phase of growth
  51. What are the clinical signs of aspetic femoral head necrosis?
    • rear limb lameness
    • pain in coxofemoral joint
    • atrophy of thigh muscles
    • irritability and chewing at hip
  52. How do we diagnose aseptic femoral head necrosis?
    radiographs:  decreased bone density in the femoral head and neck, flattened femoral head, osteophyes - bone spurs and bony overgrowths
  53. What is the treatment for aseptic femoral head necrosis?
    • FHO - femoral head and neck ostectomy - is the treatment of choice
    • both limbs may be affected
    • want early use of limb after surgery
    • do not breed affected dogs
  54. What is the most prevalent disorders of the canine hip?
    hip dysplasia
  55. Hip dysplasia is rarely seen in dogs under _____.
    12 kg
  56. What factors contribute to hip dysplasia?
    • genetic
    • environment
    • diet
    • disparity of muscle mass and rapid skeletal growth
  57. What does joint laxity from hip dysplasia lead to?
  58. What are the clinical signs of hip dysplasia?
    • lameness - from barely detectable to non-weight bearing
    • bunny-hopping - advancement of both rear limbs at the same time
    • pain elicited on joint extension
    • joint laxity
    • waddling gait
    • atrophy of thigh muscles
    • difficulty rising and stiffness - will often "warm out" of
    • reluctance to stand or move
  59. How do we diagnose hip dysplasia?
    radiographs:  subluxation, DJD, flattening of femoral head, osteophytes of femoral neck
  60. How do we treat hip dysplasia?
    • conservative:  weight control, exercise, anti-inflammatory drugs, nutraceuticals (Adequan, Cosequin)
    • surgical:  FHO, total hip replacement, triple pelvic osteotomy
  61. How do we educate clients on hip dysplasia?
    • do not breed affected dogs
    • progressive condition
    • puppies born to parents without hip dysplasia may develop hip dysplasia
  62. After we breed a dog, when do we take hip dysplasia radiographs?  What are the different certification groups?
    • radiograph hips at 2 years old
    • OFA certification 
    • PennHIP
  63. What is the most common skeletal neoplasia in dogs and cats?
  64. Which animals are the most affected by osteosarcoma?
    mature large and giant breed dogs about 7 years old
  65. Which bones are the most affected by osteosarcoma?
    • radius
    • humerus
    • femur
    • tibia
  66. What are the clinical signs of osteosarcoma?
    • lameness
    • weight loss
    • pain, swelling in affect limb
    • dyspnea from metastatic lesions
  67. How do we diagnose osteosarcoma?
    • radiographs of limbs
    • biopsy
    • thoracic radiographs to check for metastasis
  68. How do we treat osteosarcoma?
    • limb amputation
    • limb amputation with chemotherapy
    • radiation therapy
    • most treatment survival rates are less than 12 months