Shared Flashcard Set

Details

Exam 4
Hip Dysplasia
61
Veterinary Medicine
Professional
11/30/2016

Additional Veterinary Medicine Flashcards

 


 

Cards

Term
What is hip dysplasia?
Definition
-abnormal development of the coxofemoral joint
Term
True or FAlse: Hip dysplasia is the most common disease of the coxofemoral joint.
Definition
-TRUE
Term
What is the primary etiology behind hip dysplasia?
Definition
-hereditary
Term
Describe the etiopathogenesis of hip dysplasia.
Definition
-abnormal development of hip => axcessive joint laxity (subluxation) => OA
Term
What are some environmental factors that can lead to hip dysplasia?
Definition
-rapid weight gain
-rapid growth
-excessive nutritional intake
-activity, flooring
-conformation: dec pelvic muscle mass
Term
What is the etiopathogenesis of joint laxity?
Definition
-round ligament an djoint capsule
-permits subluxation of the femoral head
-greater laxity =greater damage
-laxity leads to stretching of the joint capsule = pain response
Term
What can hip joint laxity cause damage to?
Definition
-cartilage
-can cause trabecular bone microfracture
-synovitis
Term
What is the etiopathogenesis of OA?
Definition
-end stage result of chronic inflammation
-bone remodeling, synovial thickening, new bone formation
Term
Which dogs are especially at risk for hip dysplasia?
Definition
-rapid growth
-large and giant breeds
-small breeds can also be affectd
Term
Which cats are especially at risk for hip dysplasia?
Definition
-main coon, persian, and Devon Rex
Term
Is there a sex predilection with hip dysplasia?
Definition
-none
Term
Is hip dysplasia more commonly bilateral or unilateral?
Definition
-bilateral
Term
Why is hip dysplasia considered a biphsic disease?
Definition
-clinical signs overlap in different phases
Term
What clinical signs do we see with hip dysplasia in animals less than 8m?
Definition
-abnormal gait: bunny hopping, asymmetric sitting, waddling
-mildly painful (unless subluxation is severe or OA has started)
Term
What clinical signs do we see with hip dysplasia in animals at 6-12m?
Definition
-unilateral/bilateral hindlimb lameness
-difficulty moving
-exercise intolerance
-waddling/stiff gait
-thich muscle atrophy
-pain
-dec muscle mass
Term
What clinical signs do we see with hip dysplasia in animals at 10-12m?
Definition
-significant functional improvement: dut to joint capsule fibrosis/tightening
-variable residual lameness
Term
What is the clinical presentation of long-term hip dysplasia?
Definition
-lameness/stiffness: worse in morning and after exercise
-thich muscle atrophy
-hip pain +/- crepitus
-chronic/persistet
-lw-grade
Term
What do we see on orthopedic exam of hip dysplasia?
Definition
-abnormal gait
-thich muscle atrophy
-pain with hip extension and abduction
-dec joint ROM
-instability
-crepitus/OA
Term
How common is CCL rupture with dogs presenting for hip dysplasia?
Definition
-32% of cases
Term
How do we differentiate hip dysplasia from lumbosacral dz on orthopedic exam?
Definition
-direct palpation should be done in lateral
-weakness due to neuro dz = CP deficits
-rectal palpation pain = LS dz
-hip extension
-elevate tail head pain = LS dz
Term
HOw can we definitively diagnose hip dysplasia via palpation?
Definition
-Ortolani maneuver
-Passive subluxation
-Also: Barlow test and Barden test
Term
What is the Ortolani maneuver?
Definition
-force femur to subluxate and then evaluate the angle of reduction
-UNDER SEDATION
Term
What is the Barlow test?
Definition
-force femur to subluxate and evaluate the angle of subluxation
-UNDER SEDATION
Term
What is the Barden test? Why is it less commonly used to diagnose hip dysplasia?
Definition
-laterally displace the femur
-highly subjective
Term
Why might you not get a clunk with the Ortolani maneuver when hip dysplasia is highly suspected?
Definition
-hip is normal
-shallow acetabulum
-severe OA
-user error
Term
Describe the Orthopedic Foundation for Animals in terms of rads for hip dysplasia.
Definition
-evaluates passive laxity
-works at 2y of age
-Normal hip: excellent, good, fair, borderline
-Dysplastic hip: mild, moderate, severe
Term
Describe the PennHip Distraction Index for hip dysplasia.
Definition
-evaluates laxity via passive distraction
-works at 16w of age
-grade scale: 0-1 )0= normal & 1 = laxity 100%)
Term
which radiographic view is most useful for hip dysplasia?
Definition
-standard VD
Term
What is the ideal acetabular coverage of hte head of the femur on rads?
Definition
->50%
Term
What changes to the bones are we looking for on rads suspecting hip dysplasia?
Definition
-dec acetabular coverage
-acetabular subchondral bone sclerosis
-acetabular shallowing
-femoral head flattening
-femoral neck thickening
-osteopytisis
-enthesiophytosis
Term
What is the earliest sign of OA that can be seen on rds?
Definition
-Morgan's line
Term
Why do we not commonly use CT/MRI for hip dysplasia?
Definition
-no advantage and it is costly
Term
Why would we perform arthrocentesis on a hip dysplasia case?
Definition
-to rule out infectious or neopalstic diseases
Term
Why would we use arthroscopy on a hip dysplasia case?
Definition
-rarely done
-useful to eval for articular lesions prior to TPO
Term
What are the patient factors that affect our course of treatment for hip dysplasia?
Definition
-age
-quality of lige
-purpose of the animal
-activity level
Term
Is medical or surgical management our go-to for hip dysplasia?
Definition
-medical management is always better b/c surgery is a salvage procedure
Term
What are the treatment goals for hip dysplasia?
Definition
-prevention of articular damage leadint to development of OA
-restoration of joint function
-improve patient comfort
Term
Describe medical management of hip dysplasia.
Definition
-treat OA
-maximize until patient becomes refractory or muscle mass begins to siginifantly decrease
Term
Definition
-
Term
Why would we perform a Juvenile Pubic Symphysiodesis (JPS)?
Definition
-prophylaxis of hip dysplasia
Term
What is the goal of juvenile pubic symphysiodesis?
Definition
-to inc femoral head coverage by acetabulum via stopping pubic symphysis growth
Term
At which age do we perform juvenile pubic sympydiodesis?
Definition
-12-16 weeds of age
-can do up to 24w
Term
What is the expected outcome of a juvenile pubic symphysiodesis?
Definition
-dec OA progression rate
-improved joint congruency
Term
Why would we perform a triple pelvic osteotomy (TPO)?
Definition
-prevention or palliation of hip dysplasia
Term
What is the goal of triple pelvic osteotomy?
Definition
-to inc femoral head coverage by rotatin the acetabulum
Term
How do we perform a triple pelvic osteotomy?
Definition
-cut the pelvis in 3 places: ilial body, pubis, ischium
Term
At what age do we perform triple pelvic osteotomy?
Definition
-perior to 10-12m when they are skeletally immature
Term
What are the criteria of triple pelvic osteotomy?
Definition
-laxity present but NO evidence of OA (angle of reduction should not exceed 20-30 degrees)
-mostly for medium/large breeds
Term
What is the success rate of triple pelvic osteotomy?
Definition
-90% success rate
Term
What is the outcome of triple pelvic osteotomy?
Definition
-OA continues to progress but slower rate
Term
Why would we perform a total hip arthroplasty?
Definition
-salvage of hip dysplasia
Term
What is the goal of a total hip arthroplasty?
Definition
-replace end-stage joint disease with a prosthetic joint
Term
Who is a candidate for total hip arthroplasty?
Definition
-patient with which other treatments have failed
Term
What is the success rate of total hip arthroscopy?
Definition
-75-95%
Term
What is the outcome of total hip arthroplasty?
Definition
-obtain near-normal biomechanics
-prmpt return to function
Term
What is the major downfall of total hip arthroplasty?
Definition
-very expensive
Term
Why would we perform a femoral head and neck ostectomy?
Definition
-salvage procedure for hip dysplasia
Term
What is the goal of a femoral heand and neck ostectomy?
Definition
-remove pain from diseased joint by excising the joint
Term
Who is a candidate for femoral heand and neck ostectomy?
Definition
-patient with which treatment options have failed
Term
Is a FHO or THR better for the patient? Which is more common?
Definition
-THR
-FHO is mroe common b/c cheap and easy
Term
How can you improve the outcome of FHO?
Definition
-ensure adequate muscle mass is present
-begin aggressive rehabilitation program immediately
Supporting users have an ad free experience!