Small Ani. Sx- Ortho- OCD

wilsbach's version from 2015-11-28 17:20

hey OCD

Question Answer
what is the Pathophysiology of OCD?It is because of a Failure of endochondral ossification. this happens bc: There is thickening of cartilage (cells mult too fast)--> this leads to malnourished cartilage (too far away from joint to get nourished, but not getting mineralized (mult too fast) so get sick layer of cartilage...too sick to take the load, dies and breaks.)--> malnourishment leads to necrosis--> fissures-->flap--> joint mouse (dissecans)
explain some of the multifactorial causes of OCDGenetic, Rapid growth, Over-nutrition (let large breeds grow slow!!), Trauma, Hormonal factors
explain what is going on here This is pathophys: in 1, there is a ton of cartlage that isnt being ossified bc it is growing too fast (arrow to the dark grey area). In two, that cart is too thick and isnt getting nutrition and the farthest cells from the nutrition necrose and fissue. In 3, the unstable loose cartilage breaks down and forms a flap (joint mouse) (lots of progression bc synovia is very aggressive to bone)
what is the lesion that isn't OCD but is caused by OCD?KISSING LESION- the irregular surface of the OCD wears pathologically on the normal cartilage directly across from it and causes lesions on the normal tissue.
which breeds of dogs are prone to OCD?Large breeds of dogs (golden, lab)
what age of dog is usually affected by OCD?Immature (5-7 months)
what is a pretty good tell tale sign there is OCD?young large breed dog is stiff in the joints after rest
what are some of the many dx methods for OCD?Rads, CT, MRI, Scintigraphy (doesnt determine problem, helps you localize tho), Arthrotomy, Arthroscopy (last two are dx and tx)
what should you keep in mind when using radiographs to dx OCD?YOU CANNOT SEE CART ON RADS! only bone! so looking for related bone defects in subchondral bone.
how soon should you tx OCD?ASAP
how can you use Arthroscopy or Arthrotomy to treat OCD? (sx tx for OCD)use it to do Dissecans removal (remove fragments!), Curettage (scooping), and lavage (flush away inflammatory factors) ----> fibrocartilage (remove fibrous tissue)
is there medical management of OCD?can try GAG, CS (cosequins), NSAIDs (for NSAIDs reduce to effect, cant go full dose for life of pt, not good for them) (aren't really proven to help, but can't hurt)
MOST COMMON area for OCD? what are some other areas?MOST COMMON IS the humeral head (74%). Can also get in the Humerus condyle (medial) > Hock (medial, lateral) (9%), and Femur-condyle (lateral) (4%)
which part of the shoulder gets the OCDs? how severe?caudal head of humerus. Moderate CSs
which part of the elbow gets them OCDs? how severe?medial condyle of the humerus. severe lameness
which part of the hock gets them OCDs? how severe?talus medial. severe lameness
which part of the stifle gets them OCDs? how severe?lateral condyle of the femur. Severe lameness.
what is the only OCD with a good prog?shoulder
how common is shoulder OCD? how bad are the CSs? where in the shoulder is the lesion?MOST common (74%), moderate clinical signs, caudal humeral head
if you have elbow dysplasia, where else should you check for concurrent OCD?SHOULDER
how do you tx shoulder OCD?Arthroscopy or arthrotomy for fragment removal
how do you tx elbow OCD? Prog?Arthrotomy or arthroscopy for OCD removal. Prognosis depending on severity at treatment.....OA progress always :( !
how might a dog stand if they have ankle OCD?hyperextended talus
how do you tx talus OCD?Arthroscopy or arthrotomy, GAG, CS(cosequins), NSAID, ARTHRODESIS!
what is the WORST prog of the locations of OCDs? (is a bigger or smaller lesion a better prog?) why just a bad prog?talus-- Small lesions better prognosis. Most cases remain lame and there is ALWAYS DJD
what other problem can arise with stifle OCD?look at central area of articulation-- prolly torn cruciate. this dz can affect cruciate as well.
how do you tx stifle OCD? whats the prog?TX: Arthroscopy or arthrotomy, GAG, CS(cosequins), NSAID, Arthrodesis. PROG: Bad prognosis :( lameness and DJD
aside from the specific joints mentioned that OCD can affect, what other joints can be affected?Theoretical all joints may be affected... vert. end plates are another place that can be affected specifically
what is a new form of tx which can be used in all areas of OCD?Osteochondral autograft Transfer-- take some cart and subchondral bone from a non-articular surface and put in area of OCD
what's going on with curetteage?scoop out all the OCD lesion, let it fill in with fibrous tissue