La 2: Stifle

Front 1

Stifle
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Back 1

Stifle
-Three joints
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-Standard views
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Hint 1

Stifle
-Three joints
.medial femorotibial joint
.lateral femorotibial joint
.femoropatellar joint
-Standard views
.lateromedial
.caudocranial
.caudolateral-craniomedial oblique
.patella skyline

Front 2

Back 2

lateral view

condyles superimposed over each other
femoral condyle over intercondylar emminence
medial trochlear ridge - bigger more angular
lateral - smoother, less angulated, smaller

-evaluate soft tissue for effusion and ligaments

Front 3

Back 3

caudo-cranial view

weight bearing - can't evaluate jt space narrowing
medial compartment is more likely narrowed
convex conture to femoral condyle - mild flattening
uniform bone opacity, alignment

Front 4

Back 4

caudolateral-craniomedial oblique

lateral trochlea is projected cranially over the medial trochlea

medial condyle is caudal to the lateral condyle

Front 5

Back 5

skyline view of patella

Front 6

Osteochondrosis
osteochondritis dissecans

Back 6

-disturbance of endochondral ossification
-increasing evidence of primary subchondral bone lesion
-radiographic changes:

Hint 6

-radiographic changes:
. discrete osteochondral fragments
. irregularly shaped subchondral bone surface
. sclerosis
. secondary modelling changes of joints
. irregularity of bony surfaces

Front 7

OC/OCD lesion locations
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Back 7

OC/OCD lesion locations
- Lateral trochlear ridge of femur (most common)
-medial trochlear ridge of femur
- patella
-medial femoral condyle
.always radiograph contralateral limb

Front 8

view:
lesion:

Back 8

CdL-CrMO

lateral trochlear ridge of femur

-soft tissue opacity, reduced visibility of patellar lig
defect on lateral trochlear ridge, heterogenity
reduced bone opacity, sclerosis

Front 9

Back 9

changes to articular margin or patella and lateral femoral trochlea

irregular margin defect to subchondral bone - lucency in bone

Front 10

Subchondral cyst-like lesions
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Back 10

Subchondral cyst-like lesions
- solitary circular lucent areas in bone with well defined rim of sclerosis
- some will fill in radiographically while others persist
-secondary degenerative joint disease
-etiology is unknown
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Hint 10

Subchondral cyst-like lesions
- solitary circular lucent areas in bone with well defined rim of sclerosis
- some will fill in radiographically while others persist
-secondary degenerative joint disease
-etiology is unknown
. true subchondral bone cyst
.possible osteochondrosis syndrome
.may be due to previous trauma

Front 11

Subchondral cyst-like lesion
locations:
Most Common:
Less Common:
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Back 11

Subchondral cyst-like lesion
locations:
Most Common:
Medial femoral condyle (CrCd view)
Less Common:
- lateral femoral condyle
-proximal ephiphysis of the tibia
- intercondylar eminence lesions associated with cruciate or cranial meniscal ligament injuries

.always radiograph contralateral limb

Front 12

Back 12

Lateral view CrCd view

medial femoral condyle

radiolucency marginated by sclerosis

radiolucency defect to articular margin with sclerosis

Front 13

Back 13

osseous cyst-like lesion

secondary degenerative joint disease

progressive extensive bone sclerosis
heterogenous radiolucency into femoral condyle

osteophyte on condyle, epicondyle, medial condyle, intercondylar eminence

sclerotic changes to tibia

Front 14

Back 14

osseous cyst like lesion

proximal tibia

uniform bone opacity - radiolucency to articular margin

Front 15

Degenerative joint disease
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Back 15

Degenerative joint disease
- any number of causes that affect the joint and supporting structures
- Arthritis
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- Osteoarthrosis/osteoarthritis
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-Secondary joint disease
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Hint 15

Degenerative joint disease
- any number of causes that affect the joint and supporting structures
- Arthritis
. inflammation of a joint
- Osteoarthrosis/osteoarthritis
. bone involvement +/- inflammation of soft tissues
-Secondary joint disease
. primary cause unknown (ligament instability, meniscal injury, fractures to articular margin, chronic OC, chronic osteocyst, chronic infection)

Front 16

Degenerative joint disease
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Back 16

Degenerative joint disease
-Periarticular osteophyte formation
-subchondral bone sclerosis
-ill defined small lucent zones in the subchondral bone
-narrowing of the joint space
-joint capsule distention
-periarticular soft tissue swelling

Front 17

Back 17

osteophyte intercondylar eminence
large osteophyte off medial condyle

Front 18

Back 18

CdLCrMO

change to subchondral bone, lucency, sclerosis

jt space narrowing, not unifrom medial to lateral
-meniscal injury, medial collaps

radiolucency medial condyle

Front 19

other diseases:
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Back 19

- Ligament and tendon tears/avulsions
- patella luxations
- fractures
- infection
- periarticular soft tissue swelling

Front 20

Back 20

Cranial cruciate ligament injury

effusive, chronic
apex of patella
fragmentation at attachement of CranialCruciate lig

femoral condyle caudally luxated

effusion of joint, avulsion injury, bone fragements

Hint 20

Front 21

Back 21

Patella Luxation

developmental problem, dysplasia of femoral trochlea
patella not fixed while standing
overlap, malaligned
laterally positioned, dysplasia of lateral femoral trochlea

Hint 21

Front 22

Back 22

fractured patella
comminuted fracture
damage to medial femoral trochlea

skyline view