PART 3 Chapter 7 LEGGCALVEPERTHES DISEASE aka AVASCULAR NECROSIS of the FEMORAL HEAD YOUNG SMALL BREEED DOGS LEGGCALVEPERTHES DISEASE Considered a developmental disorder but could also occur due to trauma ID: 774593
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Slide1
Slide2DISEASES OF THE MUSCULOSKELETAL SYSTEM
PART 3
Chapter 7
Slide3LEGG-CALVE-PERTHES DISEASEaka AVASCULAR NECROSIS of the FEMORAL HEAD
YOUNG, SMALL BREEED DOGS
Slide4LEGG-CALVE-PERTHES DISEASE
Considered a developmental disorder but could also occur due to trauma
Slide5LEGG-CALVE-PERTHES DISEASE
Clinical signs
Pain in the hip
Atrophy of the muscles of the affected limb
Gradual onset of lameness
Chewing at the hip and flank area
Usually young dogs 5-8months
Treatment consist of surgery!
Slide6LEGG-CALVE-PERTHES DISEASE: TREATMENT
FEMORAL HEAD AND NECK EXCISION (FHNE) aka FEMORAL HEAD OSTECTOMY (FHO)
Slide7LEGG-CALVE-PERTHES DISEASE: TREATMENT
CLIENT INFO
Post-operative treatment requires early and active use of the limb as soon as 2 weeks after surgery
Exercise and passive range-of-motion exercises should be done daily
Animals may have both hips involved – surgeon is likely to separate procedures by 8-10 weeks
https://www.youtube.com/watch?v=uBz3YLl_QYo
Therapy for patients: hydrotherapy
Slide8DEGENERATIVE DISORDERS: OSTEOCHONDROSIS DISSECANS
OCD
Slide9OSTEOCHONDROSIS DISSECANS
FAILURE OF THE LOWER LAYERS OF ARTICULAR CARTILAGE TO MATURE INTO
BONE RESULTS IN THICKENED CARTILAGE THAT IS PRONE TO INJURY
Slide10OSTEOCHONDROSIS DISSECANS
Failure of the articular cartilage to become cemented to underlying bone, together with constant trauma during exercise, results in formation of a non-healing flap or
joint mouse
This disorder can occur in several joints
Shoulder
Stifle
Hock
Elbow
CLINICAL SIGNS
Lameness in young, large breed dogs
Slide11OSTEOCHONDROSIS DISSECANS
CARTILAGE FLAP OF THE SCAPULOHUMERAL
JOINT WHICH IS THE MOST COMMON LOCATION
Slide12DIAGNOSIS
Slide13OSTEOCHONDRITIS DISSECANS
JOINT MOUSE IN THE STIFLE JOINT
Slide14OSTEOCHONDROSIS DISSECANS: TREATMENT
TREATMENT
SURGICAL REMOVAL OF THE FLAP OR JOINT MOUSE via ARTHROSCOPY
ALMOST IMMEDIATE RETURN TO NORMAL FUNCTION
https://youtu.be/KNEGnyM39uc
The surgery to remove the flap or joint mouse
Slide15INFLAMMATORY CONDITIONS: PANOSTEITIS
LARGE, MEDIUM BREEDS AT A YOUNG AGE 6-8 MONTHS
CAUSE: UNKNOWN, BUT THERE ARE MANY SUSPECTED CONTRIBUTORS
Slide16PANOSTEITIS
PELVIS
LESIONS OF PANOSTEITISFEMUR
INFLAMMATION IN THE MARROW
CAVITIES OF LONG BONES THAT LEADS
TO PAIN, INTERMIITENT LAMENESS, AND FEVER
Anorexia
Wt. loss
Reluctant to move
Slide17PANOSTEITIS
INCREASED MEDULLARY OPACITY
Slide18PANOSTEITIS
TREATMENT OF PANOSTEITIS INCLUDES NSAIDS AND CAGE REST
THIS DISEASE IS SELF-LIMITING AND HAS A GOOD PROGNOSIS!
Slide19TRAUMA: LUXATIONS
HX OF TRAUMA, ACUTE LAMENESS, NON WEIGHT BEARING, POSSIBLE
SWELLING OVER THE AFFECTED JOINT
Slide20COXOFEMORAL LUXATIONS
CRANIODORSAL
LUXATION IS THE
MOST COMMON TYPE
Slide21LUXATIONS
TREATMENT
Closed reduction: femoral head is replaced back into the acetabulum under anesthesia
Open reduction: femoral head is surgically replaced into the acetabulum and the soft tissue structures are used to secure the reduction.
Slide22STABILIZING REDUCED LUXATIONS
THE
EHMER SLING
IS USED AFTER CLOSED AND OPENED REDUCTION OF THE LUXATED
HIP JOINT; THE DOG SHOULD BE CONFINED FOR 7-10 DAYS
Slide23ELBOW LUXATION
IT IS CRITICAL TO ALWAYS PERFORM 2 RADIOGRAPHS THAT ARE AT 90
∘
TO EACH OTHER
THESE ARE CALLED
ORTHOGONAL
VIEWS
THIS IS TRUE FOR ALL RADIOGRAPHS & NOT ONLY ORTHOPEDICS
Slide24STABILIZING REDUCED LUXATIONS
THIS
VELPEAU SLING
IS USED TO PREVENT WEIGHT BEARING ON THE FORELIMB
Slide25NEOPLASIA OF THE BONE
MOST COMMON IN LARGE BREED
MALE DOGS OLDER THAN 7 YRS OF
AGE
Slide26NEOPLASIA
85%-90% OF BONE CANCER IN DOGS IS OSTEOSARCOMA
THE DISTAL RADIUS IS THE MOST COMMON LOCATION
Slide27NEOPLASIA: DIAGNOSIS
RADIOGRAPHS AND BIOPSY SHOULD BE PERFORMED TO
CONFIRM DIAGNOSIS
OSTEOLYSIS
PROLIFERATION
OF BONE
PERIOSTEAL REACTION
Slide28NEOPLASIA
METASTASIS OF OSTEOSARCOMA TO THE LUNGS; THERE IS USUALLY ALREADY
SOME MICROSCOPIC SPREAD OF TUMOR BY THE TIME IT IS DIAGNOSED
Slide29NEOPLASIA
AMPUTATION OF THE AFFECTED LIMB ALONG WITH CHEMOTHERAPY IS A COMMON TREATMENT PLAN
SURVIVAL TIME IS ~12 MONTHS EVEN WITH AGGRESSIVE THERAPY
Slide30MYOPATHIES
MYOPATHIES
are diseases that affect the muscle
Inflammatory (bacterial, protozoal)
Immune-mediated
Acquired (secondary to other diseases)
Diagnosis is usually made by
muscle biopsy
and treatment directed toward the primary cause
Slide31IMMUNE-MEDIATED MYOPATHIES: MASTICATORY MUSCLE MYOSITIS (aka atrophic myositis, eosinophilic myositis)
CLINICAL SIGNS INCLUDE:
ELEVATED 3
RD
EYELIDS, ATROPHY OF THE JAW
MUSCLES, AND INABILITY TO OPEN THE MOUTH (TRISMUS)
Slide32IMMUNE-MEDIATED MYOPATHIES: MASTICATORY MUSCLE MYOSITIS (aka atrophic myositis, eosinophilic myositis)
The muscles of mastication contain a special type of fiber
(2M)
that has antigenic properties possibly shared with bacteria.
The treatment of choice
is glucocorticoids (steroids).
Slide33ACQUIRED MYOPATHIES: FELINE POLYMYOPATHY
HYPOKALEMIA:
CERVICAL VENTROFLEXION OF THE NECK, PERIODIC WEAKNESS, AND MUSCLE PAIN
TREATMENT:
Potassium supplementation, diet change