Presentation about bone affections . Pdf

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
Boneshaveasmoothareaofcartilagecoverstheirsurfaces.
Thisactsasacushionandprotectstheunderlyingbone.
Ifanythingdisruptsthissmoothcartilagesurface,movementof
thejointbecomespainful.

5. Osteochondrosis
Introduction
InOCD,thiscartilageisdamagedorgrowsabnormally.
Insteadofbeingattachedtotheboneitcovers,itseparatesor
cracks.
Alooseflapofcartilagemayform,oranentirepiecemay
breakloose.Theseareknownasjointmice/mouse.

6. Osteochondrosis
Introduction

7. Osteochondrosis
Introduction
OCresultsfromafocalareaofdysfunctionofendochondral
ossification(bonethatformsfromacartilagematrix)and
occursinboththearticular-epiphysealcartilagecomplexand
thegrowthplate.

8. Osteochondrosis
Introduction
Thearticularcartilagebecomesthickenedandappears
radiographicallyasadefectinthearticularsurface.
Areasofthethickenedcartilagemayundergonecrosis

9. Osteochondrosis
Introduction
Repeatedconcussionfromdaily
stressandstrainmayresultinfissure
formationthatwilleventuallyformsa
cartilageflap.
Thisflapmaymineralizeandthen
canbeseenradiographically.

10. Osteochondrosis
Introduction
When aflaporjoint
mice/mouse(osteochondral
fragment)ispresent,the
conditionisknownas
osteochondritisdissecans
(OCD).

11. Osteochondrosis
Causes
Multifactorial,Itisthoughtthatthereare
Genetics,
Traumatothejoint,
Rapidgrowth,
Hormoneimbalances,and
Nutrition.

12. Osteochondrosis
Clinical signs
Mostcommonindogsandhorsesthatareunder1yearof
age,andoflarger,rapidlygrowingbreeds.
ThemostcommonsiteforOCDlesionsistheheadofthe
humerus,buttheelbow,andstifle(knee)canallbeinvolved.

13. Osteochondrosis
Clinical signs
Theclinicalsignsfortheseconditionsinclude
Lamenesswhichoftenbecomesworsewithexercise,andimprovesafter
rest
Painuponjointmanipulation
Swellingofthejoint
Atrophy(shrinking)ofmusclesintheareaduetodisuse.

14. Osteochondrosis
Diagnosis
History,
Physicalexamination
X-rays.

15. Osteochondrosis
Treatment
Conservativemedicaltreatment
Surgicalremovalofthelesion.

16. Osteochondrosis
Treatment
Conservativemedicaltreatment
IndicatedforanimalsthathaveearlymildsymptomsofOCD
Strictrestfor4to8weeks.
Walkingispermittedbutnorunningorplayingisallowed.
Anti-inflammatoriesandpain-killersmaybeindicated.
Ifthesymptomsdonotimprove,surgeryisindicated.

17. Osteochondrosis
Treatment
Conservativemedicaltreatment
Surgicalremovalofthelesion.
Indicatedinanimalsthatshowseveresymptoms,incaseswherelarge
lesionsareidentifiedonradiographsorwhenconservativetreatments
fail.
Thesurgeryisverystraightforward.Theaffectedjointisopenedandthe
offendingflap,defect,orjointmouseisremoved.

18. Osteochondrosis
Treatment
Conservativemedicaltreatment
Surgicalremovalofthelesion.
Curette(scrape)thesurfaceofthedefecttostimulatehealing.
Strictrest,confinementandpassiveexerciseforabout4weeksafter
surgerywillbeneeded.
Theprognosisisgenerallygood

19. Panosteitis
Introduction
PanosteitisisanSelf-limitinginflammatorydiseaseofthelong
bonesoflargeandgiantbreeddogsthatusuallyoccursin
dogsunderoneyearofage.
Thecauseofthisconditionisunknownbutstress,allergies
andhormonalconditionsmayallcontributetothecause.

20. Panosteitis
Introduction
Thediseasewilltypicallygoawaywithouttreatmentbut
lamenessmaypersistformonths.

21. Panosteitis
Clinical signs
Involveoneormorelegs.
Lamenessthatcomesandgoes
Patientsoftenpresentwithshiftingleglameness
Painondeeppalpationofaffectedlongbones.

22. Panosteitis
Diagnosis
Isbasedonhistory,clinicalexamandx-rays
oftheaffectedbones(patchynodular
opacities).
Bloodcountsandrelatedtestswillreveal
little.

23. Panosteitis
Traetment
Thisdiseasewillusuallygoawaywithoutspecifictreatment,
ButMeloxicamandotherNSAIDscanallbegiventoalleviate
pain.
Restrictedexerciseisadvisedandpatienceisneededas
severalmonthsmaypassbeforetheanimalisbackto100%.

24. Osteoporosis
Introduction
Themineraldensityoftheboneisusuallynotalteredbutthe
amountofmatrixisreduced.
Thebonebecomesporous,lightandfragileandisproneto
fracture.

25. Osteoporosis
Introduction
Generalizedosteoporosis
Localizedosteoporosis(Disusedosteoporosis):

26. Osteoporosis
Introduction
Generalizedosteoporosis:
Seeninpostmenopausalwomen
Osteoporosisisseeninanimalsoccasionallywithundernutritionrather
thanactualdeficienciesofcalcium,phosphorus,orvitaminD.
Itisseenincopperdeficiencyandchronicleadpoisoninginlambs.

27. Osteoporosis
Introduction
Generalizedosteoporosis:
Localizedosteoporosis(Disusedosteoporosis):
Common,especiallyinhorseswithcast(externalimmobilization)ontheir
limbs.
Immobilizationoftheaffectedbonereducedthenormalmuscularactivity
aroundthebone,whichinturndiminishestheflowofbloodthroughthe
bone

28. Neoplasia of Bone

29. Neoplasiaof Bone
Primary Bone Neoplasia
Clinicalfeatures:
Osteosarcomaisthemostcommonprimarybonetumor
Aggressivelesionoriginatinginthemetaphysisofthelongbones
Commonsites:
Distalradiusandproximalhumerus,
Distalfemurandproximaltibia,
Frontlimbsareaffectedtwiceasoftenasrearlimbs

30. Neoplasiaof Bone
Primary Bone Neoplasia
Radiographicfindings::
Lytictoproliferativeormostcommonlyacombinationofboth
Lysisisgenerallyaggressive(mouth-eaten)andalsogenerallyinvolvesthe
cortex
Softtissueextensionandswellingmaybepresent

31. Neoplasiaof Bone
Metastatic Bone Neoplasia
Clinicalfeatures:
Canoccurwithanytumortype
Commonsites:vertebrae,pelvis,femur,humerus,andribs.
Oftenapolyostoticaggressivelesionoriginatinginthediaphysisofthe
bone(nearthenutrientforamen),butmetaphyseallocationalsocommon

32. Neoplasiaof Bone
Metastatic Bone Neoplasia
Radiographicfindings:
Variablefindingsofaggressivelysis,proliferationorcombination
Inlongbones,eitherdiaphysealormetaphyseallocation
Generallypolyostotic

33. Neoplasiaof Bone
Treatment Bone Neoplasia
Amputationtoremovetheprimarytumor,combinedwith
chemotherapytotreatthemetastaticdiseasewecan’tyetsee.
Prognosisisfairtogood.

34. Osteomyelitis
Introduction
Inflammationofboneandrelatedstructures,
Oftencausedbybacterialorfungalinfection,butsometimes
secondarytotraumaorbonesurgery.

35. Osteomyelitis
Clinical sings
Pain,
Lameness,
Fever,
Swellingofthearea,
Lethargy,
Poorappetiteand
Manycaseswillhaveopendrainingsorespresent.
Inhibitionofbonehealingwilloccur.

36. Osteomyelitis
Radiographic appearance
Fungalosteomyelitis
Patternsofaggressivelysis(punctate,mouth-
eaten)withcorticallysis
Bacterialosteomyelitis
By7-14daysofinfectionthereisoftenavery
extensiveperiostealreactionalongthediaphysisof
thebone.
Thereisvariablecorticallysis

37. Osteomyelitis
Treatment
IfSystemicFungalDiseaseisinvolved,treataccordingly.
Bacterialosteomyelitisshouldbetreatedwithantibioticsgiven
intravenouslyandorally;itisbestifacultureperformedto
determinewhatmedicationsarelikelytooptimallytreatthe
infection.

38. Osteomyelitis
Treatment
Openwoundsordrainingtractsshouldbecleanedandflushed
withantibioticsolutions(ingressandegresstube)
Thismayinvolvesurgicalexplorationandremovalofdamaged
tissuesorattemptingasecondarymethodofrepairifthefirst
hasfailed.

39. Osteomyelitis
Treatment
RepeatX-rayswillbeusedtodeterminehowtheinfectionis
resolvingandthefracture,ifany,ishealing.
It is important to note that osteomyelitis can be or become a
chronic problem so proper, aggressive and continuing treatment is
highly recommended.