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General Osteology 2

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britt611's version from 2017-01-21 04:02

Section 1

Question Answer
Generalized bone loss is usually due to?Metabolic disease, nutritional disease, disuse
how much bone loss is required before radiographic changes are noted?30-60%
What is the radiographic term for generalized bone lossosteopenia
What are the roentgen signs of osteopenia?diminished bone opacity, cortical thinning, coarse trabeculation, bone deformity / pathologic fracture, loss of lamina dura (hyperparathyroidsim)
what can cause loss of lamina dura?hyperparathyroidism
What is localized bone loss usually due to?trauma, infection, tumor
is focal or generalized bone easier to detect?focal
In localized bone, what determines its aggressiveness?zone of transition, the less distinct the margins of the lesion the more aggressive the process
what are signs in the cortex that suggest a more aggressive localized bone lossprocesses that destroy the cortex are usually more aggressive than lesions that allow the cortex to remodel or conform to a enlarging mass
What are some terms that describe bone loss (lysis)geographic lysis, moth-eaten lysis, permeative lysis
Define geographic lysis>10mm area, well defined margins which may displace cortex , usually affects the medullary cavity
Define moth eaten lysismultiple discrete areas +/- cortical involvement , less well defined margins, areas may be confluent
define Permeative lysis multiple ill defined pinpoint areas of osteolysis, poorly defined with spread out distribution in periphery (margins are indistinct and fade gradually into normal bone)
expansile vs aggressive geographic lysis expansile = can deform cortex, aggressive = if destroys cortex
What does expansion of the cortex around an enlarging mass indicatie?a less aggressive, slow growing mass
Which is more aggressive: moth-eaten lysis or geographic osteolysis?moth-eaten lysis is more aggressive
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Section 2

Question Answer
What are 7 characteristics of non-aggressive lesions?1. well demarcated, 2. short zone of transition, 3. absent or geographic osteolysis, 4. cortex may be displaced/remodeled and thin but not broken, 5. solid/smooth periosteal reaction, 6. +/- surrounding sclerosis, 7. static or slow rate of change
What are 7 characteristics of aggressive lesions?1. poorly demarcated, 2. long zone of transition, 3. poorly marginated osteolysis, 4. cortex interrupted, 5. interrupted irregular periosteal reaction, 6. no surrounding sclerosis, 7. rapid rate of change
What are differentials based on?aggressiveness of lesion - must assess signalment, history, location and additional tests
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Section 3

Question Answer
What are 2 forms of degenerative joint disease primary and secondary
what are causes of primary DJD?idiopathic, conformation, wear&tear
What are causes of secondary DJD?species/breed specific, joint specific, single vs multiple joint, symmetric vs asymmetric
What are 3 causes of joint disease?1. DJD, 2. inflammatory joint disease (infectious vs immune mediated) 3. neoplasia
What are 8 signs of DJD?1. increased capsular thickeness or effusion, 2. perichondral (marginal) osteophytes, 3. ethesophytes, 4. subchondral erosions, 5. mineralized joint bodies, 6. subchondral bone opacity, 7. subchondral cysts, 8. joint space narrowing
What are some characteristics of inflammatory joint disease?early joint effusion without bone change, joint space narrowing with cartilage destruction (cant identify synovial fluid), secondary bone destruction from osteomyelitis or perichondral osteolysis, joint instability, periarticualr periosteal reaction or enthesophytes formation (reactive bone)
Define enthesophyte formation reactive bone
What is an example of inflammatory joint diseasefoal septic arthritis
What are some characteristics of neoplastic joint disease primary or metastatic, soft tissue origin, soft tissue swelling/mass, ragged erosion involving more than one bone compromising the joint, variable periosteal reaction and/or soft tissue mineralization, early stage must differentiate from septic arthritis
What do early stages of neoplastic joint disease but be differentiated from?septic arthritis
What are the occurrences of primary bone tumor?large breeds, mean age 7 years but also see a 6mo of age, slightly more common in MALES, may be associated with previous fracture or metallic implant
What are the clinical features of primary bone tumor?swelling at the site of lesion, pain and lameness is seen but not untill extensive chagnes, lesion usually solitary, more common in long bones
which bones in primary bone tumor more common in?long bones
What are the roentgen signs of primary bone tumors?radiographic appearance is variable, lytic or productive changes are aggressive in nature, usually monostotic, located typically in the metaphyseal region of long bones, do NOT cross joint (usually)
what are the variable radio graphic appearances of primary bone tumor lesions may be primary osteoblastic, osteolytic or a combination of both
What are the occurrences of DJD that may be primary?storage disease- cats with lysosomal - mucopolysachardiosis - they walk down on their legs
what are the occrrences seen with secondary DJDluxation/subluxation, articular fracture, developmental disease (hip, elbow dysplaisa), infection
Why do you see intracapsular swelling in DJDseen as a result of joint effusion and/or synovial proliferation - leading to displacement of fat pad
What joint space alteration do you see with DJDdecreased size of joint space due to destruction of articular cartilage of the articualr cartilage, increased size of joint space may be seen in actue injury with severe synovial effusion,
what view is best for accessing joint spacing in DJD?weight bearing view
in DJD what do the periarticular osteophytes result form?articular cartilage proliferating in the non weight bearing areas of the joint
in DJD what happens when the excessive cartilage proliferation outgrows its nutrient supply?the cartilage dies, it invaded by vessels and replaced with bone that is seen radiographyically
What are the perichondral osteophytes in DJDtheya re fibrocartilage elements that may form at the chondrosynovial junction to form a collar of new bone at the joint capsular attachment
in DJD what does subchondral osteosclerosis result form?bone formation and hypertrophy of the trabecular adjacent to the joint
what is subchondral osteoscleoris also called?slcerosis or eburnation
What causes subchondral osteolysis in DJD?caused by necrosis of the bone following loss of articular cartilage
What are subchondral bone cysts formed by in DJD?formed by proliferation of synovium invading subchondral bone
What are joint mice?theya re peices of articular cartilage that have become detached and are within the joint
define Enthesisstie of attachment of muscle tendon or ligament to bone
define enthesopathyproliferation of bone at enthesis due to pulling of ataachment--- another form of periosteal reaction
how does enthesopathy contrast with osteophytes?an osseous outgrwoth at the perichondral margins of joint surfaces (including the inter-vertebral joints)
define enthesiopathynormal interoseous ligament
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Section 4

Question Answer
What age and breed of animal do fungal osteomyelitis occure?young to middle age dogs, may be seen in any breed but working breeds are more common
What are the typical clinical features associated with fungal osteomyelitis?localized swelling in the metaphyeseal regions of long bones, lesions may have draining tract leading to lameness. there may be other other systemic signs of illness
what are some other systemic signs of illness seen with fungal osteomyelitis?pneumonia, lymphadenopathy, ocular disease
How are funal osteomyelitis usually presented and how do they spread?enter through the respiratory tract and spread hematogenously
what are 4 etiologic agents of fungal osteomyelitis?1. blastomycoes dermatitidis 2. coccidioides immitis 3. histoplasma capsulatum, 4. cryptococcus neoformans and aspergillosis
where are blastomyces usually foundsouthern states, mid western and south west
where are coccidoides usually found?western states
where are histoplasma usually found?mid western states
cryptococcus is found where?throughout the US
What are the roentgen signs of fungal osteomyelitis?lysis or productive changes, semiaggressive periosteal reaction, bone lysis may exten though cortex, sclerosis is see adjacent in medullary region, lesions are seen in the metaphysis, extensive destructive changes if infected, polyostotic, localized lesions
Describe the radiogrphic appearance in fungal osteomyelitis?both lysis and productive changes seen
what type of periosteal reaction do you see in fungal osteomyelitis?semiaggressive
How does the bony lysis effect the cortex in fungal osteomyelitis?extend through the cortex
Is there sclerosis associated with fungal osteomyelitis?yes! often in the adjacent medullary region
where in the bone do you normally see fungal osteomyelitis?methaphysis
how are the joints affected in fungal osteomyelitis?extensive destructive changes in the joints that are infected
is fungal osteomyelitis mono or polyostoic?polyostotic
are lesions generalized or localized in fungal osteomyelitis?localized
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Section 5

Question Answer
which sex is more effected by bacterial osteomyelitis?no sex predilection
what is bacterial osteomyelitis usually secondary to?penetrating wound (bite), previous surgery, open fracture, gunshot wound, septicemia in young animals or immunocompromised animals
what are the clinical features of bacterial osteomyelitisare is hot, swollen, very painful, leukocytosis is seen, draining tracts develop in chronic cases
___% of bone infections are polymicrobial40%
___% may be anaerobic infections15%
What are the roentgen signs of bacterial osteomyelitis?earliest stage: only soft tissue swelling, may take 10-14 days before periosteal reaction is seen, also the periosteal reaction is sold, extended along the shaft of the diaphysis which may extend beyond the limits of the fracture or surgical site, and are seen circumferentially on all cortices, rarely extends to adjacent joints
what doe early stages of bacterial osteomyelitis look like?no bony abnormalitis, just soft tissue swelling
how long do you see periosteal reaction in bacterial osteomyelitis10-14 days
where on the bone is periosteal reaction seen in bacterial osteomyelitis they are typically solid and extend along the shaft of the diaphysis
describe the periosteal reaction of bacterial osteomyelitis in regards to a fracture or surgical siteextending beyond those points and seen circumferentially on all cortices
how are the joints affect in bacterial osteomyelitisrarely extends into adjacent joints
What are the roentgen signs in septic arthritis?bony lysis is often seen in early stages leading to rough or irregular atricular margins, multiple surfaces are involved, degree of subchondral erosion is more severe compared to DJD, chronic cases= periosteal reaction and osteophytes can be seen, early infections may show only soft tissue swelling, once you see bony changes you can see the degree of damage is significant
when is bony lysis seen and what does it lead to in septic arthritisoften seen early in disease process, resulting in rough or irregular articular margins
How are the joints involved in septic arthritis?multiple joints are usually involved
what is the degree of subchondral erosion in septic arthritis comapred to DJDmore severe in septic arthritis
what can be seen in chronic cases of septic arthritis?periosteal reactions and ostephyties
what is only seen in early infections of septic arthritissoft tissue swelling
when bony changes become apparent on septic arthritis what does that mean?the degree of damage is significant
if gas is present in tissue when there is no open wound or previous surgery injection what must be considered?infection! bacteria produce gas
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Section 6

Question Answer
What are the etiologies of non erosive polyarthritis idiopathic polyarthritis, systemic lupus erythematosus, chronic infection arthritis, polyarthritis/polymyositis syndrome, plasmocytic- lymphocytic synovities
What are the roentgen signs of non-erosive polyarthritis joints are normal except for signs of joint effuison. if multiple joints are involved you see swelling
What are common sites of swelling in non erosive polyarthritiscarpus, tarsus and stifle joints
describe the rontgen signs of cr. cruciate rupture tibia may be displaced cranially and intracapsular soft tissue swelling
what is the result of secondary osteoarthritis due to cr. cruciate rupture?osteophyte formation on the patella, adjacent to the trochlear groove of the femur, margins of the tibial plateau, and fabellae
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