Pre-midterm highlights

4 types of mineralization throughout body

• metastatic

• dystrophic

• idiopathic

• neoplastic 

what are the timelines for

• lytic changes

• productive changes

• lytic - 5-7 days to see on rads

• productive - 10-14 days to see on rads

what percent of bone loss present to see on rads

30-60%

6 criterial for eval non-agg vs agg lesion

• location of # of lesion

• pattern lysis

• pattern new bone

• cortical disruption

• transition zone

• change in appearance over time

osteoporosis

loss of bone mass

osteomalacia

loss of mineralization of bone matrix (quality of bone bad)

what tumors affect axial vs appendicular skeleton

• primary bone tumors - appendicular

• mets - axial (ribs and vertebrae)

what conditions can be seen epiphysis, metaphysis, diaphysis of bone

• epiphysis - juvenile bacterial osteomyelitis

• diaphyseal - metastatic tumor

• metaphyseal - juvenile bacterial osteomyelitis, mets, primary bone tumors, fungal osteomyelitis

what types of lysis are benign vs agg

• benign - geographical

• agg - moth eaten, permeative

periosteal rxn in order from least to most agg

• smooth - callus

• lamellated - onion skin

• columnar - palisading

• spiculated/sunburst

• amorphous -disorganized spikey

active vs inactive lesion

• active = fuzzy

• inactive = more sharp

how do we assess duration of lesion

opacity of rxn

• immature - dull and bone like

• mature - bright

which transition zone is agg vs benign

• short transition - benign

• long transition - agg

4 OCD lesion locations in the dog

• cd humerus

• medial humeral condyle (elbow)

• lateral femoral condyle (knee)

• medial trochlear ridge (ankle) - worst prognosis 

which OCD lesions are these in the dog

• A = cd humerus

• B = medial humeral condyle (elbow)

• C = medial trochlear ridge (ankle)

• D =lateral femoral condyle (knee)

Dog OCD signalment

young giant breed (6-9 mo age)

FCP signalment

young (5-12 mo) medium large breed, male

FCP

• blunted wedge of medial coronoid

• little bite taken out of condyle on cr/cd view

UAP signalment

• GSD, large breeds, basset hound

• 5-12 mo age

UAP - would see this better on a flexed view

UME signalment

• Labradors, GSD, english setters

• 6 - 12 mo age

UME

• look for thing off to the side of medial epicondyle

panosteitis signalment

• 5-18 mo → 7 yrs

• large giant breeds - GSD, doberman, Retriever, basset hounds

• shifting leg lameness and pain palpating long bones

• NO lysis

• cigarette smoke

panosteitis

panosteitis

Metaphyseal osteopathy signalment

• 2-7 mo age

• large giant breeds

• systemically ill

• bilateral/all 4 limbs

• double physeal sign ± cuff

Metaphyseal osteopathy

Metaphyseal osteopathy

retained cartilaginous core signalment

• 6-12 mo age

• large giant breeds, saint bernards

• OC of distal ulnar metaphysis/physis

• often bilateral and incidental

retained cartilaginous core

• 2 parallel lines with Lucent in the middle going towards the ulna

hip dysplasia signalment

• large breed dogs

• bilateral - inherited

• flattened acetabulum, bad femoral head coverage, osteophytes along rim, morgans line

hip dysplasia

morgans line - early sign of DJD

what are the 3 views PennHip wants for hip dysplasia

• extended leg VD

• compression VD

• distraction VD

calve legg perthes signalment

• immature toy/small dogs

• unilateral

• increased joint space, irregular femoral head

calve legg perthes

calve legg perthes

medial patellar luxation signalment

• young small breed dogs

• lateral is a large dog thing

• congenital mostly from bow leg (coxa vara)

• shallow trochlear groove

medial patellar lux

do luxating patellas contribute to DJD in the future

nope, happens outside the joint capsule

hypertrophic osteopathy signalment

• middle to older dog

• secondary to thoracic or abdominal dz/mass

• spares small bones of carpus and tarsus

• starts from MC/MT bones and goes up the leg symmetrically and bilateral

• NO lysis but LOTs of periosteal rxn

• AGG lesion

Hypertrophic Osteopathy

Hypertrophic Osteopathy

Hypertrophic Osteopathy

signalment for fungal osteomyelitis

• systemically ill

• young to middle age

• large working/sporting breeds

• polyostotic 

• lysis and production

• metaphysis

• AGG lesion

fungal osteomyelitis 

fungal osteomyelitis 

bacterial osteomyelitis signalment

• hx of bite wound or soft tissue injury

• adult animal

• diaphysis

• polyostotic

• lysis and periosteal rxn

• can be surrounding implant

• AGG lesion

bacterial osteomyelitis

bacterial osteomyelitis

primary bone tumor signalment

• large/giant dogs

• bimodal age distribution

• males

• lung mets

• monostotic - no cross joint

• OSA - away from elbow, towards knee, distal tibia

• AGG lesion

primary bone tumor

primary bone tumor

Salter harris fx classification

S - same

A - across

L - low

T - through

R - rammed/compressed

premature distal ulnar physis closure roentgen signs

• gap - ulna and humerus, and gap at the bottom of ulna and carpus

• cranial bowing of radius

premature distal radius physis closure roentgen signs

• gap - radius and humerus, radius and carpus

• no real ALD

which physis closed early

ulna

which physis closed early

radius

malunion

• just looks wonky

14 wks later

delayed union

• taking longer than 12 wks

non-union

• never got back together

hypertrophic non-union

• its trying but failing to close the gap

oligotrophic non-union

• gave up closing the gap

hallmark signs of DJD in dogs

• intracapsular swelling

• NON-aggressive changes

• osteophytes

• small joint space on weight bearing views

DJD

DJD

CCL rupture signalment

• females

• young athletic dogs and middle age overweight dogs

• acute, non-wt bearing lameness or insidious onset

• tibia displaced cr. , intracapsular swelling

• displace fat pad

CCL rupture

septic arthritis signalment

• systemic infected/ill or hx of direct injury

• AGG lesion

• soft tissue swelling

• lysis with periosteal rxn

• central on joint

• multiple joint surfaces

septic arthritis

septic arthritis

erosive polyarthritis/rheumatoid arthritis signalment

• AGG lesion

• small breeds -shetland sheepdog and poodle

• greyhounds

• cats get a proliferative polyarthropathy

• swelling, cyst like lucencies, destroyed joint surface

• ± multiple bones

erosive polyarthritis

non-erosive polyarthritis signalment/lupus

• just soft tissue swelling

• multiple joints involved

• NO lysis

non-erosive polyarthritis

joint tumor signalment

• AGG lesion

• middle/large breed dog

• stifle and elbow joints

• cross the joint

joint associated tumor

pedal osteitis

• solar margin demineralizes

• widening of vasc channels

septic osteitis

• associated with solar abscesses and penetrating wounds

• margin defect ± sequestrum

• demineralized solar margin

what are 3 measurements for laminitis

• palmar displacement of P3 - rotation/tipping

• hoof wall: P3 ratio

• coronary bad to extensor distance - sinking

laminitis

DJD low ring bone signs

• osteophytes P2-P3

• NON-AGG lesion

• incongruity of joint space on wt bearing rads

low ringbone DJD

P3 fx

I.Non-articular fx of palmar/plantar processes

II. Larger fx of palmar/plantar processes extending into body

III.Split P3 into 2 pts of equal size

IV.Fx of extensor process

V.Comminuted fx of solar margin

VI.Marginal fx

VII.Non-articular fx of palmar/plantar process in foals -3-32 wks of age

Ossification of lateral cartilages signalment

• side bones

• draft horses

• separate centers of ossification → look like horns

Ossification of lateral cartilages

navicular degeneration signs

• synovial invaginations on distal border

• abnormal margins

• cyst like lesions

• sclerotic

• erosion of flexor surface

navicular degeneration

navicular osteomyelitis signs

• penetrating wound 

• fistulography with draining tract

• toe touching lame that is resolved with nerve block

• lysis and sclerosis of flexor surface

navicular osteomyelitis

Multipartite navicular bones signs

• bilateral and symmetric

• genetic 

• no lameness

Multipartite navicular bones

high ring bone DJD

• osteophytes and narrow joint space at P1

high ring bone DJD

P1 fx

type III salter harris fx P1

• physis close at 12 mo

fetlock DJD

• P1

• MC/MT III

• sesamoid bones

what are these fetlock fx’s

red = dorsopalmar

blue = type I prox P1 between saggital groove

green = type II wing of prox phalanx

orange = type III -basilar fx of sesamoid bones

sesamoid fx’s

red = apical

light blue = mid body split

green = basilar

dark blue = abaxial - susp lig here

pink = sagittal

Fx of MC/MT III condyle

• lateral > medial