Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
195 Cards in this Set
- Front
- Back
|
Cr Cd view
lateral aspect is to viewer's left |
|
|
what are the 6 roentgen signs
|
number
- frags size - may have expansive lesion that makes it bigger than norm shape opacity location/position margination/ contour |
|
|
normal visualization of fascial planes and margination of muscle groups
|
|
|
loss of visualization of fascial planes
due to edema/ hemorrhage/ inflamm/ tumor infiltration |
|
|
septic joint
notice gas lucencies in soft tissues cr to prox and dist row of tarsal bones due to - open wound (laceration/ open frx) - gas producing organisms - iatrogenic |
|
|
metastatic mineralization of the iliac vessels
due to elevated serum calcium or phosphorous levels |
|
|
dystrophic mineralization
mineralization of dead/ degen/ or devitalized tissues |
|
|
dystrophic mineralization
mineralization of dead/ degen/ or devitalized tissues |
|
|
|
|
|
neoplastic mineralization
mineral or bone production by a tumor extraskeletal osteosarcoma |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
normal stifle
|
|
|
|
|
|
|
|
|
|
|
|
normal bone density
|
|
|
|
|
|
|
|
|
geographic lysis
Short abrupt transition from lesion to bone |
|
|
geographic lysis
Short abrupt transition from lesion to bone |
|
|
|
|
|
|
|
|
Permeative lysis
Numerous small / pinpoint areas of lysis Can be in the medullary and cortex Margins are indistinct (long transition to normal bone) Most aggressive pattern Usually associated with neoplasia |
|
|
least aggressive periosteal rxn
Solid periosteal reaction Bone completely fills the area under the reaction Surface can be smooth or undulating Usually non-aggressive - Callus |
|
|
Solid periosteal reaction
Bone completely fills the area under the reaction Surface can be smooth or undulating Usually non-aggressive - Callus |
|
|
Lamellated periosteal reaction
Layered or “onion skin” appearance Indicates a cyclic or intermittent process More aggressive than solid, smooth new bone Stress fracture, osteomyelitis, hypertrophic osteopathy Transient feature of normal growth |
|
|
Columnar to spiculated periosteal reaction
- this example is columnar Can appear like columns of bone (palisading) to spiculated (“sun burst”) Columnar seen with diseases like hypertrophic osteopathy Spiculated seen with primary bone neoplasia like OSA |
|
|
Columnar to spiculated periosteal reaction
- this example is spiculated Can appear like columns of bone (palisading) to spiculated (“sun burst”) Columnar seen with diseases like hypertrophic osteopathy Spiculated seen with primary bone neoplasia like OSA |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
At distal aspect, looks like old frx and line that is where had medullary pin was and there is some bone fomation at area of bleed (the spikey part at back, then look at prox part that is more aggressive and lytic (sarcoma)
categorize based on most aggressive feature (so this would be an aggressive lesion) if unsure - met check - re-rad in 10-14 d - bx or fna |
|
|
mineralization of soft tissues
|
increased mineral opacity w/in the soft tissue
caused by - metastatic mineralization (min of norm tiss due to elevated Ca or P) - dystrophic mineralization (min of dead/ degen/ devitalized tiss) - idiopathic (min of soft tiss not due to met or dyst etiologies, pulm alveolar microlithiasis) - neoplastic (mineral or bone produced by a tumor) |
|
|
intracapsular soft tissue swelling
|
enlargement of soft tiss w/in joint capsule
- swelling conforms to joint margins causes - effusions - soft tiss proliferation (synovial prolif/ neoplas) displacement & compression of infrapatellar fat pad - can still trace patellar lig margin but lose or compress fat pad displacement of fascial planes cd to the joint |
|
|
extracapsular soft tissue swelling
|
enlargement of soft tissues outside of the joint
- diffuse or local causes - edema/hemorrhage/inflamm - ligamentous/ tendinous path - neopl swelling of patellar lig pushes fat pad cd |
|
|
what do you expect if there is intracapsular inflammation of the stifle?
extracapsular? both? |
intra cap
- pushes fat pad out - pushes fascial planes cd extra - pushes fat pad in both - have forces pushing fat pad in and out at the same time so not able to see it |
|
|
wolff's law
|
bone is constantly remodeling
|
|
|
what is the bone's response to inj/ dz
|
lysis or reabs
usually a combo of both |
|
|
what are the characteristics of an osseous lesion (3)
|
aggressive vs non-aggressive
active vs. inactive duration |
|
|
when do you see lytic changes radiographically?
productive changes? how much bone loss must occur before it can be detected on survey rads |
lytic
- 5-7 d productive (osteophytes/ periosteal rxn) - 10-14 d 30-60% bone loss |
|
|
how do you determine if a lesion is aggressive or non-aggressive?
|
location/ number of lesions
- axial = usually metastatic - appendicular = usually primary - monostotic = primary tumors - polyostotic = metastatic/ fungal/ juvenile osteomyelitis - primary tumors = usually metaphyseal - metastatic = diaphyseal or metaphyseal - fungal = metaphyseal - juvenile bact osteomyelitis = epiphyseal or metaphyseal pattern of lysis - geographic < moth-eaten < permeative pattern of new bone production (periosteal rxn) - aggressiveness : solid/smooth bone < lamellated < columnar (palisading) < spiculated (sun burst) < amorphous - activity (more sharp margins = less active) - duration (more bone like = longer duration) cortical disruption - indicates aggressive process - benign processes allow cortex to remodel or conform to the enlarging mass transition zone to norm bone - long transition zone = aggressive - short transition zone = non-aggressive change in lesion appearance over time - aggressive lesions will change rapidly compared to non-aggressive (change in 10-14 days) |
|
|
define lysis
|
radiographic term for focal/ multifocal bone loss
|
|
|
generalized osseous lesions
|
osteosclerosis
- increased bone opacity osteopenia - generalized decreased bone opacity - osteoporosis (loss of bone mass) - osteomalacia (loss of mineralization of bone matrix - decreased quality) |
|
|
what are some causes of generalized osteosclerosis and osteopenia
|
osteosclerosis
- osteopetrosis - myelofibrosis - FeLk - dietary imbalances (Ca2+/ Vit D tox) osteopenia - congenital (osteogenesis imperfecta) - metabolic dz - nutritional - disuse |
|
|
what are the roentgen signs of generalized osteopenia
|
decreased bone opacity
cortical thinning coarse trabeculation due to endosteal resorption relative increase in opacity of cortical bone and vertebral endplates intracortical bone loss (double cortical line) bone deformity or pathologic frx loss of lamina dura around teeth (hyperPTH) |
|
|
where are primary tumors normally found
|
metaphyseal
monostotic appendicular |
|
|
where are metastatic tumors usually found
|
diaphyseal (often around nutrient foramen)
can be metaphyseal often axial often polyostotic |
|
|
where are fungal lesions usually found
|
usually metaphyseal
usually polyostotic but can be indistinguishable from primary tumors |
|
|
where is juvenile bact osteomyelitis usually found
|
epiphyseal or metaphyseal
hematogenous spread |
|
|
periosteum is composed of what layers
how is it attached to cortex periosteal rxn is classified in terms of |
inner
- cambium layer (bone producing) - outer fibrous layer attached to cortex by - sharpey's fibers classified by - aggressiveness - activity - duration |
|
|
you should always characterize a lesion based on ______
|
the most aggressive feature
|
|
|
OC/ OCD
|
failure of endochondral ossification
- increased thickness of articular cartilage - appears as subchondral defect osteochondrosis = OC osteochondrosis dissecans = OCD - flap forms and separates from subchondral bone - only seen radiographically when mineralized or with arthrography |
|
|
OC/OCD is normally seen in which animals?
where? |
young rapidly growing large to giant breed dogs
usually signs b/w 6-9 mo locations - cd aspect of humeraln head - med aspect of humeral condyle - femoral condyles (lateral most common) - trochlear ridges of talus (medial most common) freq bilat |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
what is an osteophyte
|
areas of new growth, look like little spurrs
grow at margin of articular cartilage |
|
|
where do you find osteophytes in the shoulder joint
|
intertubicular groove
cd aspect of humeral head cd aspect of glenoid cavity |
|
|
stifle osteochondrosis
Roentgen signs - Subchondral defect and sclerosis of the distal aspect of the lateral (less commonly medial) femoral condyle - Joint effusion and DJD (if untreated) |
|
|
Normal anatomy
The extensor fossa of the long digital extensor muscle can be confused with an OC lesion! |
|
|
Normal anatomy
The extensor fossa of the long digital extensor muscle can be confused with an OC lesion! |
|
|
extensor fossa
(normal anatomic strx) |
|
|
oc lesion
|
|
|
normal tarsus
|
|
|
|
|
|
tarsal OC
Roentgen signs On the lateral view, the plantar aspect of the tibiotarsal joint will appear wide A mineral fragment may be seen => OCD |
|
|
what are the causes of elbow dysplasia
|
fragmented medial coronoid process
ununited anconeal process osteochondrosis of medial aspect of humeral condyle ununited medial epicondyle of humerus? asynchronous growth of radius and ulna? |
|
|
what is the most common developmental abn of the elbow?
Who is it seen in |
fragmented medial coronoid process
med/lg breed dogs 5-12 mo old males>females |
|
|
what views do you want to evaluate frag med coronoid process
|
flexed lat
neutral lat cc |
|
|
|
|
|
|
|
|
|
|
|
Ununited Anconeal Process
Occurrence - Anconeal process forms from separate center of ossification - Normally fuses to proximal ulna by 5 months of age - Failure to fuse (likely due to joint incongruity) =>UAP - GSD predisposed; also seen in other large breeds and Bassett hounds Roentgen signs - Irregular, lucent line crossing the anconeal process with adjacent sclerosis - Best seen on flexed lateral view - Secondary DJD |
|
|
Ununited Anconeal Process
Occurrence - Anconeal process forms from separate center of ossification - Normally fuses to proximal ulna by 5 months of age - Failure to fuse (likely due to joint incongruity) =>UAP - GSD predisposed; also seen in other large breeds and Bassett hounds Roentgen signs - Irregular, lucent line crossing the anconeal process with adjacent sclerosis - Best seen on flexed lateral view - Secondary DJD |
|
|
what view should you take to evaluate for ununited anconeal process
|
flexed lat
|
|
|
what are the big differentials for causes of elbow displasia in a GSD?
in a lab? in an engl setter? |
GSD
- ununited anconeal process - frag med coronoid process - ununited med humeral epicondyle labs - ununited med epicondyle - frag med coronoid process engl setter - ununited med humeral epicondyle |
|
|
|
|
|
panosteitis occurrence
|
|
|
|
|
|
|
metaphyseal osteopathy occurrence
|
|
|
|
|
|
|
|
|
|
metaphyseal osteopathy
(hypertrophic osteodystrophy) Late - Formation of a cuff of periosteal new bone adjacent to the metaphysis, which is separated from cortex by thin, lucent zone - Represents subperiosteal hemorrhage |
|
|
metaphyseal osteopathy
(hypertrophic osteodystrophy) Late - Periosteal reaction becomes more solid and confluent with the cortex later on - Results in marked bony enlargement of the metaphysis - Usually affects all physis of all the long bones (esp rad/ ulna/ tibia) |
|
|
|
|
|
|
|
|
what is a retained cartilagenous core and what is the occurrence
|
Failure of endochondral ossification resulting in formation of core of cartilage in the metaphysis
Occurrence - Unknown etiology - Form of OC of the distal ulnar metaphysis/physis - Often bilateral - Large to giant breeds (Saint Bernard) - Often an incidental finding - Clinical signs may develop around 6-12 months of age |
|
|
Retained Cartilagenous Core
Roentgen signs - Conical, radiolucent zone extending from the distal ulnar physis proximally into the distal ulnar metaphysis - Smoothly marginated or irregular - Can cause asynchronous growth of the radius and ulna and angular limb deformity - DJD of elbow and carpus |
|
|
Retained Cartilagenous Core
Roentgen signs - Conical, radiolucent zone extending from the distal ulnar physis proximally into the distal ulnar metaphysis - Smoothly marginated or irregular - Can cause asynchronous growth of the radius and ulna and angular limb deformity - DJD of elbow and carpus |
|
|
Retained Cartilagenous Core
Roentgen signs - Conical, radiolucent zone extending from the distal ulnar physis proximally into the distal ulnar metaphysis - Smoothly marginated or irregular - Can cause asynchronous growth of the radius and ulna and angular limb deformity - DJD of elbow and carpus |
|
|
|
|
|
|
|
|
understand the standard positioning for evaluating the hips
|
|
|
|
understand the effect that rotation has on the interpretion of hip rads (vd extn)
|
|
|
|
Hip Dysplasia
Roentgen signs - Shallow, flattened acetabulum - Inadequate femoral head coverage – wedging / incongruity subluxation – luxation - Periarticular osteophytes production along the cranial and dorsal acetabular rims, resulting in an irregular edge |
|
|
Hip Dysplasia
Roentgen signs - Shallow, flattened acetabulum - Inadequate femoral head coverage – wedging / incongruity subluxation – luxation - Periarticular osteophytes production along the cranial and dorsal acetabular rims, resulting in an irregular edge |
|
|
Hip Dysplasia
Roentgen signs - Shallow, flattened acetabulum - Inadequate femoral head coverage – wedging / incongruity subluxation – luxation - Periarticular osteophytes production along the cranial and dorsal acetabular rims, resulting in an irregular edge |
|
|
|
|
|
|
|
|
|
|
|
OFA hip evaluation
|
|
|
|
penn hip eval
|
|
|
|
distraction view of hips
|
|
|
norberg angle
|
|
|
|
aseptic necrosis of the femoral head
occurrence and pathogenesis |
Immature toy and small breed dogs
- Poodles, miniature pinscher, terriers - Esp yorkie terrors Bilateral <15% of the time (usually unilat) Compromised blood supply to proximal femoral epiphysis => necrosis of subchondral bone Normal blood supply to femoral head in adult dogs - Synovial membrane (sole supply in puppies) - Arteries in round ligament of the head of the femur - Nutrient vessels through metaphysis (after physeal closure) |
|
|
Asep Necrosis of Fem Head
Increased width of joint space - Articular cartilage thickens as ischemia causes necrosis of subchondral bone - DEFORMITY AND FLATTENING OF THE FEMORAL HEAD |
|
|
Asep Necrosis of Fem Head
Increased width of joint space - Articular cartilage thickens as ischemia causes necrosis of subchondral bone - Deformity and flattening of the femoral head |
|
|
Asep Necrosis of Fem Head
Increased width of joint space - Articular cartilage thickens as ischemia causes necrosis of subchondral bone Deformity and flattening of the femoral head |
|
|
|
|
|
patellar luxation
occurrence/ pathogenesis |
Occurrence & Pathogenesis
- Young, small breed dogs; also seen in large breeds - Medial luxation in small breeds - Lateral in large breeds - Most commonly congenital /developmental - Can be traumatic - Associated with malalignment of the quadriceps due to rotation and/or deformity of the femur and/or tibia |
|
|
hypertrophic osteopathy
|
|
|
|
|
|
|
|
|
|
|
|
|
hypertrophic osteopathy
Solid, irregularly marginated periosteal reaction - Palisading or columnar Never confined to a single location - Usually bilaterally symmetrical and generalized Begins on the abaxial surface of the 2nd and 5th metacarpal/metatarsal bones and progresses proximally - Fuzzy rxn on 2nd and 5th Spares the small bones of the carpus and tarsus - But is seen on the accessory carpal bone and calcaneus |
|
|
hypertrophic osteopathy
Solid, irregularly marginated periosteal reaction - Palisading or columnar Never confined to a single location - Usually bilaterally symmetrical and generalized Begins on the abaxial surface of the 2nd and 5th metacarpal/metatarsal bones and progresses proximally - Fuzzy rxn on 2nd and 5th Spares the small bones of the carpus and tarsus - But is seen on the accessory carpal bone and calcaneus |
|
|
hypertrophic osteopathy
Solid, irregularly marginated periosteal reaction - Palisading or columnar Never confined to a single location - Usually bilaterally symmetrical and generalized Begins on the abaxial surface of the 2nd and 5th metacarpal/metatarsal bones and progresses proximally - Fuzzy rxn on 2nd and 5th Spares the small bones of the carpus and tarsus - But is seen on the accessory carpal bone and calcaneus |
|
|
Hypertrophic Osteopathy
Location of periosteal reaction is diaphysis of tubular bones Radiographs of the thorax and abdomen should be obtained to investigate for underlying disease - If you treat primary dz, won’t go back to normal, but may get a bit better |
|
|
fungal osteomyelitis
occurrence/ presentation |
|
|
|
|
|
|
|
|
|
|
|
|
what is the earliest sign of bact osteomyelitis
|
severe soft tiss swelling
|
|
|
bact osteomyelitis (tell me everything about it)
|
Occurrence
In adult animal, usually secondary to - Direct inoculation (bite wound, open fracture, or surgery) - Extension from soft tissue injury - May be hematogenous in young or immunocompromised animals - Hematogenous route is much less common in small animals that it is in large animals (foals and calves) Roentgen signs - The earliest sign is severe soft tissue swelling - May take 7-14 days before periosteal reaction becomes visible - Periosteal reaction extends along shaft of diaphysis; however, can be lamellar to palisading/columnar to solid depending on age Non-hematogenous origin - Location depends on affected area - May affect multiple bones in the same limb - Lucencies around surgical implants - Draining tract (from surgical implant / foreign body) may be present Hematogenous origin - Metaphyseal - due to extensive capillary network - Often multiple limbs affected (polyostotic) Differential Diagnoses - Healing fracture - Primary or metastatic bone tumor - Fungal osteomyelitis |
|
|
bact osteomyelitis
|
|
|
primary bone tumor
occurrence |
Occurrence
More common in large and giant breed dogs; no breed predilection Mean age = 7 years Bimodal distribution seen in animals as young as 6 months Slightly more common in male dogs Lung metastases – micromets usually present at the time of diagnosis Can metastasize to other bones |
|
|
what is the most common primary bone tumor?
where is it found |
OSA
away from elbow towards the knee |
|
|
primary bone tumor types
|
osteosarc
fibrosarc chondrosarc hemangiosarc |
|
|
primary bone tumor
|
|
|
primary bone tumor
|
|
|
primary bone tumor
|
|
|
ouch
|
|
|
Non-displaced fractures
- May not be seen initially - Seen days later when resorption of bone at fracture margins has occurred - Some may only be visible when bony callus forms - If clinical suspicion of fracture is high but equivocal => nuclear medicine (bone scan) |
|
|
hmm.... something 'aint right
|
|
|
REFER!
|
|
|
frx types
|
Open vs closed
Incomplete vs complete Simple vs complex/comminuted Transverse, oblique or spiral Extra-articular, articular, compression, avulsion Displaced vs. non-displaced |
|
|
primary bone healing
|
Occurs with rigid internal
fixation Results in bony union through direct growth of haversian system across the fracture Minimal to no bony callus Cannot occur across a fracture gap Usually occurs with compression plate reduction Radiographic signs of primary bone union - Lack of callus - Gradual loss in opacity of fracture ends - Progressive disappearance of fracture line |
|
|
primary bone healing
Radiographic signs of primary bone union - Lack of callus - Gradual loss in opacity of fracture ends - Progressive disappearance of fracture line |
|
|
secondary bone healing
|
|
|
secondary bone healing
|
|
|
what is the most common type of bone healing in sm animal
|
secondary
|
|
|
secondary bone healing
|
Lack of rigid internal fixation and excellent anatomic reduction
Bone heals through initial deposition of fibrous tissue Callus formed by series of maturations Granulation tissue => cartilage => mineralized cartilage =>replaced by bone |
|
|
what factors affect bone healing
|
Fracture location
Vascular integrity Degree of immobilization Fracture type Degree of anatomic reduction Degree of soft tissue trauma Degree of bone loss Type of bone involved Presence of infection Local malignancy Metabolic factors - Age, breed, species - Presence of systemic disease - Steroid administration |
|
|
what are the 4 As of post op frx eval
|
Alignment (of the fracture fragments)
Apposition (of the fracture fragments) Apparatus (the implant used to reduce and stabilize the fragments) Activity (callus formation) |
|
|
what are you looking at during the initial postop frx eval
|
Fracture alignment
- Rotation of fracture fragments Degree of fracture reduction - Needs to be at least 50% reduction of fracture margins - Presence of joint incongruities - Step deformities and gaps along the joint margin - Steps will result in djd Placement of fixation devices |
|
|
growth plate inj
occurrence |
Skeletally immature animals <1 year
Etiologies - Trauma - Severe metaphyseal osteopathy (rare) - Retained cartilaginous core (very rare) Prognosis - Salter Harris Type I and II have better prognosis - Type III and IV have poorer prognosis due to disturbance of resting cell layer - Type V have guarded prognosis due to damage of proliferative zone |
|
|
roentgen signs of growth plate injury
|
Unilateral or bilateral
- Radiographs both limbs for comparison Affected physis may initially appear normal With time, affected physis may close prematurely (partially or completely) Skeletal deformities Distal ulnar physis is commonly affected due to shape - Often type V |
|
|
secondary bone healing
|
|
|
premature distal ulnar physis closure
|
|
|
|
|
|
Premature Distal Radial Physis Closure
Roentgen signs - Shortened length of the radius compared to contralateral side (unless bilateral) - Increased radiocarpal joint space - Increased humero-radial joint space (subluxation) |
|
|
know the salter harris classifications
|
|
|
|
|
|
|
A) premature distal ulnar physis closure
B) premature distal radial physis closure C) premature distal ulnar physis closure |
|
|
malunion
Healed but in an abnormal anatomic position Malunion involving joints will lead to osteoarthrosis Many malunions in immature dogs are difficult to recognize after 6-12 months due to extensive remodeling |
|
|
malunion
Healed but in an abnormal anatomic position |
|
|
delayed union
Fracture is healing but not as quickly as expected Duration compared to similar fractures and fixation Subjective assessment – healing is dependant on many factors Causes of delayed union - Severe soft tissue damage (poor blood supply) - Distracted or over-riding fragments - Improper or inadequate reduction or fixation - Significant periosteal stripping - Removal of large bone fragments - Obstruction or destruction of blood supply by implant |
|
|
nonunion
|
|
|
|
nonunion
|
|
|
|
|
|
oligotrophic nonunion
|
|
|
defect nonunion
notice lack of callus formation |
|
|
nonviable nonunion
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
why and where do you get osteophytes in djd
|
|
|
|
djd
|
|
|
|
anatomy/ fxn of cr cruciate lig
|
Medial aspect of lateral
femoral condyle to intercondylar area of tibia Cranial cruciate ligament (CCL) prevents cranial displacement of the tibia, limits internal rotation of the tibia and prevents hyperextension of the stifle |
|
|
occurrence & roentgen signs of ccl rupture
|
Occurrence
- Females > males - Young athletic dogs and middle age, over-weight dogs - Acute, non weight-bearing lameness Roentgen signs - Tibia may be displaced cranially - Uncommonly seen in dogs since the radiographs are not taken while weight bearing |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
