Presentation about bone affections

1. BONE AFFECTIONS

2. Outline
Anatomy of bone
1
Bone fracture
2
Fracture management
3
Bone healing
4
Developmental Bone Disorders
5

3. Developmental Bone Disorders

4. Osteochondrosis
Introduction
 Bones have a smooth area of cartilage covers their surfaces.
 This acts as a cushion and protects the underlying bone.
 If anything disrupts this smooth cartilage surface, movement of
the joint becomes painful.

5. Osteochondrosis
Introduction
 In OCD, this cartilage is damaged or grows abnormally.
 Instead of being attached to the bone it covers, it separates or
cracks.
 A loose flap of cartilage may form, or an entire piece may
break loose. These are known as joint mice/mouse.

6. Osteochondrosis
Introduction

7. Osteochondrosis
Introduction
 OC results from a focal area of dysfunction of endochondral
ossification (bone that forms from a cartilage matrix) and
occurs in both the articular-epiphyseal cartilage complex and
the growth plate.

8. Osteochondrosis
Introduction
 The articular cartilage becomes thickened and appears
radiographically as a defect in the articular surface.
 Areas of the thickened cartilage may undergo necrosis

9. Osteochondrosis
Introduction
 Repeated concussion from daily
stress and strain may result in fissure
formation that will eventually forms a
cartilage flap.
 This flap may mineralize and then
can be seen radiographically.

10. Osteochondrosis
Introduction
 When a flap or joint
mice/mouse (osteochondral
fragment) is present, the
condition is known as
osteochondritis dissecans
(OCD).

11. Osteochondrosis
Causes
 Multifactorial, It is thought that there are
 Genetics,
 Trauma to the joint,
 Rapid growth,
 Hormone imbalances, and
 Nutrition.

12. Osteochondrosis
Clinical signs
 Most common in dogs and horses that are under 1 year of
age, and of larger, rapidly growing breeds.
 The most common site for OCD lesions is the head of the
humerus, but the elbow, and stifle (knee) can all be involved.

13. Osteochondrosis
Clinical signs
 The clinical signs for these conditions include
 Lameness which often becomes worse with exercise, and improves after
rest
 Pain upon joint manipulation
 Swelling of the joint
 Atrophy (shrinking) of muscles in the area due to disuse.

14. Osteochondrosis
Diagnosis
 History,
 Physical examination
 X-rays.

15. Osteochondrosis
Treatment
 Conservative medical treatment
 Surgical removal of the lesion.

16. Osteochondrosis
Treatment
 Conservative medical treatment
 Indicated for animals that have early mild symptoms of OCD
 Strict rest for 4 to 8 weeks.
 Walking is permitted but no running or playing is allowed.
 Anti-inflammatories and pain-killers may be indicated.
 If the symptoms do not improve, surgery is indicated.

17. Osteochondrosis
Treatment
 Conservative medical treatment
 Surgical removal of the lesion.
 Indicated in animals that show severe symptoms, in cases where large
lesions are identified on radiographs or when conservative treatments
fail.
 The surgery is very straight forward. The affected joint is opened and the
offending flap, defect, or joint mouse is removed.

18. Osteochondrosis
Treatment
 Conservative medical treatment
 Surgical removal of the lesion.
 Curette (scrape) the surface of the defect to stimulate healing.
 Strict rest, confinement and passive exercise for about 4 weeks after
surgery will be needed.
 The prognosis is generally good

19. Panosteitis
Introduction
 Panosteitis is an Self-limiting inflammatory disease of the long
bones of large and giant breed dogs that usually occurs in
dogs under one year of age.
 The cause of this condition is unknown but stress, allergies
and hormonal conditions may all contribute to the cause.

20. Panosteitis
Introduction
 The disease will typically go away without treatment but
lameness may persist for months.

21. Panosteitis
Clinical signs
 Involve one or more legs.
 Lameness that comes and goes
 Patients often present with shifting leg lameness
 Pain on deep palpation of affected long bones.

22. Panosteitis
Diagnosis
 Is based on history, clinical exam and x-rays
of the affected bones (patchy nodular
opacities).
 Blood counts and related tests will reveal
little.

23. Panosteitis
Traetment
 This disease will usually go away without specific treatment,
 But Meloxicam and other NSAIDs can all be given to alleviate
pain.
 Restricted exercise is advised and patience is needed as
several months may pass before the animal is back to 100%.

24. Osteoporosis
Introduction
 The mineral density of the bone is usually not altered but the
amount of matrix is reduced.
 The bone becomes porous, light and fragile and is prone to
fracture.

25. Osteoporosis
Introduction
 Generalized osteoporosis
 Localized osteoporosis (Disused osteoporosis):

26. Osteoporosis
Introduction
 Generalized osteoporosis:
 Seen in postmenopausal women
 Osteoporosis is seen in animals occasionally with under nutrition rather
than actual deficiencies of calcium, phosphorus, or vitamin D.
 It is seen in copper deficiency and chronic lead poisoning in lambs.

27. Osteoporosis
Introduction
 Generalized osteoporosis:
 Localized osteoporosis (Disused osteoporosis):
 Common, especially in horses with cast (external immobilization) on their
limbs.
 Immobilization of the affected bone reduced the normal muscular activity
around the bone, which in turn diminishes the flow of blood through the
bone

28. Neoplasia of Bone

29. Neoplasia of Bone
Primary Bone Neoplasia
 Clinical features:
 Osteosarcoma is the most common primary bone tumor
 Aggressive lesion originating in the metaphysis of the long bones
 Common sites:
 Distal radius and proximal humerus ,
 Distal femur and proximal tibia,
 Front limbs are affected twice as often as rear limbs

30. Neoplasia of Bone
Primary Bone Neoplasia
 Radiographic findings::
 Lytic to proliferative or most commonly a combination of both
 Lysis is generally aggressive (mouth-eaten) and also generally involves the
cortex
 Soft tissue extension and swelling may be present

31. Neoplasia of Bone
Metastatic Bone Neoplasia
 Clinical features:
 Can occur with any tumor type
 Common sites: vertebrae, pelvis, femur, humerus, and ribs.
 Often a polyostotic aggressive lesion originating in the diaphysis of the
bone (near the nutrient foramen), but metaphyseal location also common

32. Neoplasia of Bone
Metastatic Bone Neoplasia
 Radiographic findings:
 Variable findings of aggressive lysis, proliferation or combination
 In long bones, either diaphyseal or metaphyseal location
 Generally polyostotic

33. Neoplasia of Bone
Treatment Bone Neoplasia
 Amputation to remove the primary tumor, combined with
chemotherapy to treat the metastatic disease we can’t yet see.
 Prognosis is fair to good.

34. Osteomyelitis
Introduction
 Inflammation of bone and related structures,
 Often caused by bacterial or fungal infection, but sometimes
secondary to trauma or bone surgery.

35. Osteomyelitis
Clinical sings
 Pain,
 Lameness,
 Fever,
 Swelling of the area,
 Lethargy,
 Poor appetite and
 Many cases will have open draining sores present.
 Inhibition of bone healing will occur.

36. Osteomyelitis
Radiographic appearance
 Fungal osteomyelitis
 Patterns of aggressive lysis (punctate, mouth-
eaten) with cortical lysis
 Bacterial osteomyelitis
 By 7-14 days of infection there is often a very
extensive periosteal reaction along the diaphysis of
the bone.
 There is variable cortical lysis

37. Osteomyelitis
Treatment
 If Systemic Fungal Disease is involved, treat accordingly.
 Bacterial osteomyelitis should be treated with antibiotics given
intravenously and orally; it is best if a culture performed to
determine what medications are likely to optimally treat the
infection.

38. Osteomyelitis
Treatment
 Open wounds or draining tracts should be cleaned and flushed
with antibiotic solutions (ingress and egress tube)
 This may involve surgical exploration and removal of damaged
tissues or attempting a secondary method of repair if the first
has failed.

39. Osteomyelitis
Treatment
 Repeat X-rays will be used to determine how the infection is
resolving and the fracture, if any, is healing.
It is important to note that osteomyelitis can be or become a
chronic problem so proper, aggressive and continuing treatment is
highly recommended.