Knee Injuries in Dogs Quiz
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Questions and Answers

What condition is indicated by osteophytes around the distal patella and other knee joint areas?

  • Cruciate ligament injury
  • Fat pad syndrome
  • Patellar luxation
  • Joint degeneration (correct)

    • Which treatment option is recommended for small dogs with knee injuries?

  • Strict rest for 6-8 weeks (correct)
  • Arthroscopy
  • Tibial plateau levelling osteotomy (TPLO)
  • Tibial tuberosity advancement (TTA)

    • What complication can arise in 40% of patients with a cruciate ligament injury?

  • Contralateral cruciate ligament injury (correct)
  • Patella luxation
  • Infection
  • Meniscal damage

    • Which breed type is most commonly associated with medial patellar luxation?

    <p>Small breed dogs</p> Signup and view all the answers

    What radiographic finding corresponds to the fat pad sign?

    <p>Whitening of the area cranial to the femur</p> Signup and view all the answers

    What does the severity of lameness correlate with?

    <p>Grade of luxation</p> Signup and view all the answers

    What is a characteristic behavior of a patient with intermittent weight bearing lameness?

    <p>Skips while walking</p> Signup and view all the answers

    What sensation is associated with stifle luxation during a clinical examination?

    <p>Popping sensation</p> Signup and view all the answers

    Which technique is appropriate for luxating the patella manually?

    <p>Partially flex the stifle and push laterally</p> Signup and view all the answers

    How are standard orthogonal radiographs utilized in evaluating patella position?

    <p>To evaluate the position of the patella</p> Signup and view all the answers

    What indicates a substantial change on radiographs concerning patella luxation?

    <p>Joint effusion and degenerative changes</p> Signup and view all the answers

    What grades of luxation may allow the patella to temporarily be located in the trochlear groove?

    <p>Grade 2 and 3</p> Signup and view all the answers

    What finding on radiographs cannot be used to completely rule out?

    <p>Patella luxation</p> Signup and view all the answers

    What lameness is typically associated with chronic osteoarthritis (OA)?

    <p>Weight bearing lameness</p> Signup and view all the answers

    What treatment option is indicated for dogs with Grade 1 and 2 bone tumours?

    <p>Conservative treatment</p> Signup and view all the answers

    Which test is used to assess the integrity of the cranial cruciate ligament (CCL)?

    <p>Cranial drawer test</p> Signup and view all the answers

    Which type of bone neoplasm is most common in dogs?

    <p>Osteosarcoma</p> Signup and view all the answers

    Which of the following is NOT a sign of stifle joint effusion during palpation?

    <p>Muscle atrophy</p> Signup and view all the answers

    During the cranial tibial thrust test, what indicates a loss of integrity of the cranial cruciate ligament?

    <p>Tibia moves forward relative to the femur</p> Signup and view all the answers

    What is a key characteristic of bone tumours in dogs that may indicate malignancy?

    <p>Erosion of surrounding tissues</p> Signup and view all the answers

    What imaging result is commonly associated with panosteitis in dogs?

    <p>Thumb print sign</p> Signup and view all the answers

    What is indicated by a positive 'sit-test' in a physical examination?

    <p>Presence of lameness</p> Signup and view all the answers

    What is the prognosis for dogs with Grade 4 bone tumours?

    <p>Challenging with a less favourable prognosis</p> Signup and view all the answers

    Which condition can you infer when observing pain on flexion of the stifle joint?

    <p>Arthritis</p> Signup and view all the answers

    What symptom is typically NOT associated with osteoarthritis as it worsens over time?

    <p>Lameness responding to rest</p> Signup and view all the answers

    In what age group are bone tumours most commonly found in cats?

    <p>Mature cats</p> Signup and view all the answers

    What does a positive cranial drawer test suggest?

    <p>Ruptured cranial cruciate ligament</p> Signup and view all the answers

    What are common signs of bone tumours in dogs?

    <p>Lameness and bone swelling</p> Signup and view all the answers

    What is a characteristic sign of emotional distress related to panosteitis in young dogs?

    <p>Shifting lameness</p> Signup and view all the answers

    What observable sign indicates fore limb lameness?

    <p>The head nods downward as the sound limb is placed.</p> Signup and view all the answers

    Which of the following is NOT a sign of hind limb lameness?

    <p>Increased range of movement.</p> Signup and view all the answers

    What is the recommended approach for examining a lame limb?

    <p>Examine the lame limb last to elicit pain effectively.</p> Signup and view all the answers

    Which of the following conditions is classified as a disorder of growth in dogs under 1 year?

    <p>Panosteitis.</p> Signup and view all the answers

    What is a common presentation of acute cranial cruciate ligament disease (CCLD)?

    <p>Sudden onset of non-weight bearing or partial weight bearing lameness.</p> Signup and view all the answers

    Which breed types can be affected by cranial cruciate disease (CCLD)?

    <p>Both small and large breeds.</p> Signup and view all the answers

    Which of these is NOT a component of an orthopedic examination?

    <p>Using imaging technology first.</p> Signup and view all the answers

    What is a common issue for large breeds that is listed as a differential diagnosis?

    <p>Elbow dysplasia.</p> Signup and view all the answers

    What is a common sign of joint issues in cats related to lameness or stiffness?

    <p>Urination and defecation outside the litter tray</p> Signup and view all the answers

    Which of the following is NOT considered an investigation method for diagnosing joint issues?

    <p>Electrocardiogram</p> Signup and view all the answers

    What is a notable behavioral change observed in pets with joint problems?

    <p>Increased sleep time</p> Signup and view all the answers

    Which treatment option is suitable for managing degenerative joint disease in pets?

    <p>Regularly controlled exercise on a leash</p> Signup and view all the answers

    What is a common physical examination finding in animals with joint problems?

    <p>Muscular atrophy</p> Signup and view all the answers

    What type of medication should be avoided for pain management in cats?

    <p>Paracetamol</p> Signup and view all the answers

    Which sign is commonly associated with chronic joint problems in dogs or cats?

    <p>Altered gait with reduced stride length</p> Signup and view all the answers

    Which aspect is crucial for managing client expectations in pets with joint issues?

    <p>Ongoing management is necessary</p> Signup and view all the answers

    Study Notes

    Lameness in Companion Animals

    • Lameness is a disruption of normal locomotion
    • Understanding how various presentations of lameness relate to different injuries is crucial
    • Constructing a differential diagnosis list based on clinical presentations, selecting appropriate diagnoses, and identifying suitable medical/surgical interventions are essential
    • Determining an appropriate prognosis for the common causes of lameness is also vital.

    Learning Objectives

    • Understand how various presentations of lameness in companion animals relate to different injuries
    • Construct a differential diagnosis list based on clinical presentations related to common causes of lameness
    • Determine appropriate diagnostics
    • Determine appropriate medical and surgical interventions for the management and treatment of common causes of lameness
    • Determine appropriate prognosis for common causes of lameness

    Lameness: Disruption of Normal Locomotion

    • Categories include: orthopaedic, oncological, and neurological
    • Images of each category are included.

    Clinical Approach

    • History and signalment
    • Distant observation
    • Gait observation
    • General physical examination
    • Orthopaedic/neurological assessment
    • Systemic issue or not?
    • Affected limb(s)
    • Affected structure(s)
    • List of differential diagnosis

    History

    • Owner's complaint (affected limb(s), severity, onset)
    • Acute or insidious onset?
    • Traumatic episode associated?
    • Is the lameness intermittent or continuous?
    • Does the lameness improve, worsen, or remain static during the day/after rest/exercise?
    • Does the severity change with the ground surface?
    • Is the animal comfortable lying, sitting, and standing?
    • How much exercise does the animal receive currently?
    • General well-being
    • Travel history/imported from abroad?

    Distant Observation

    • Off-loading of affected limb during standing
    • Weakness
    • Plantigrade stance
    • Difficulty in rising/sitting
    • Does the animal sit square?

    Gait Analysis

    • Observe animal's gait at walk and trot
    • Bilateral lameness may be difficult to observe.
    • Forelimb lameness: head nods downward as the sound limb is placed, head nods upward when the lame limb is placed.
    • Hindlimb lameness: dorsal displacement of the pelvis, shortened stride

    Lameness Grading

    • Scoring system for assessing lameness
    • Includes descriptions of the lameness associated with each grade
    • Grade 0-5
    • Scoring for lameness should use various clinical tools

    Orthopaedic Examination

    • Examine the lame limb last (pain elicited)
    • Large/giant breed dogs are most easily examined on the floor.
    • Small breed dogs/cats examined on the clinical examination table.
    • Assistance may be required
    • Purpose: to identify anatomical deformities/displacement, pain/crepitus, range of movement of joints, integrity of supporting structures of each joint

    List of Differential Diagnosis

    • Lists potential diagnoses by age group (dogs <1 vs >1 year) and breed (large vs. small vs. chondrodystrophic)
    • Specific diagnoses include: cranial cruciate disease, patella luxation, panosteitis, osteosarcoma, degenerative joint disease, and avascular necrosis.

    Cranial Cruciate Disease (CCLD)

    • Signalment: small and large breeds, young and old, males and females, cats
    • History: sudden onset of non-weight-bearing or partial weight-bearing lameness (acute CCLD), or mild weight-bearing lameness associated with exercise, improves with rest (partial tear)
    • Chronic: weight bearing lameness associated with osteoarthritis

    Physical Examination

    • Postural changes (lameness, off-loading affected limb during stance, "sit-test")
    • Palpation (effusion, pain on hyperextension, pain on flexion, loss of ROM, atrophy of muscles, medial buttress, cranial drawer/tibial compression test, meniscal click)

    Cranial Drawer Test

    • Patient in lateral recumbency
    • Hold the patella/caudal aspect of lateral femoral condyle
    • Locate tibial tuberosity/fibular head
    • The tibia is moved forward/relative to the femur
    • Painful-difficult to perform

    Cranial Tibial Thrust

    • Patient’s stifle in near full extension
    • Use one hand on patellar ligament / tibial tuberosity
    • Flex the hock with the other hand
    • Observe for movement of the tibial crest in relation to femur

    Radiology

    • Osteophytes (around distal patella, supratrochlear region, tibial and femoral margins)
    • Fat pad sign (area cranial to the femur whiter than normal stifle)

    Treatment Options

    • Conservative treatment (rest, 6-8 weeks), more effective in small dogs (<15kg) if ineffective meniscal damage
    • Surgical treatment (medium/large dogs >15kg), arthrotomy/arthroscopy, tibial plateau leveling osteotomy, tibial wedge osteotomy, TTA

    Patella Luxation

    • Signalment: younger dogs (small breeds >> large breeds), MPL more frequent in small than large breeds, cats
    • History: intermittent, weight-bearing lameness related to grade of luxations
    • Leg in flexed position, few steps, skipping
    • Concurrent CCLD 25%

    Grading of Patella Luxation

    • Grade 1, 2, 3, 4
    • Clinical symptoms and deformities are considered for proper grading

    Clinical Examination

    • Identify the patella
    • Move the stifle through its ROM
    • A popping sensation when luxating is often associated with the sign

    Investigations: Radiology

    • Standard orthogonal radiographs of the stifle should be obtained (craniocaudal, lateral)
    • Evaluate patella position
    • Assess for joint effusion and degenerative changes
    • Substantial changes indicate CCLD

    Treatment Plan

    • Conservative treatment (Grade 1 and 2): physiotherapy, hydrotherapy
    • Surgical treatment (Grade 3 and 4); also Grade 2 if the dog is lame/painful

    Bone Tumours in Dogs

    • Signalment: middle-aged/older patients, large breeds
    • History: severe lameness, poor response to analgesia, bony swelling, pathological fracture
    • Most common: osteosarcoma
    • Other diagnoses: chondrosarcoma, hemangiosarcoma, fibrosarcoma, secondary metastasis (urogenital, mammary)
    • Common sites: 75% appendicular, forelimbs > hindlimbs

    Investigations

    • Imaging findings (cortical bone thinning, bone lysis, bone proliferation, elevation of periosteum mottled appearance, thoracic imaging, high metastasic rate required 3 chest views (radiography or CT))
    • Tissue biopsy (Jamshidi bone biopsy needle)

    Bone Neoplasia in Dogs: Treatment and Prognosis

    • Tumor-specific information on incidence, metastasis, treatment, and prognosis

    Bone Tumours in Cats

    • Rare in comparison to dogs
    • Osteosarcoma most common.
    • Signalment: mature cats
    • Presentation: lameness, limb deformities, pathological fractures
    • Diagnosis; local radiographs and thoracic radiographs
    • Treatment: amputation
    • Prognosis: reasonable with amputation, 10% risk of metastasis

    Panositis

    • Signalment: Young dogs (<2-year-old), male > female, large breeds
    • History: shifting lameness, pain on palpation, chronic intermittent lameness
    • Investiation: patchy areas of increased opacity within medullary canal (thumb print sign)

    Treatment and Prognosis (Panositis)

    • Conservative treatment: pain relief, exercise restrictions
    • Self-limiting: resolves within 2 years

    Degenerative Joint Disease (DJD)

    • Signalment: middle-aged/older patients, small and large breeds (cats affected as well)
    • History: lameness/stiffness, chronic presentation, insidious onset, worsens morning/rest, improves with exercise/warming up
    • Difficulty raising/jumping/stairs, altered behaviour(aggression, lethargy), urination and defecation outside the litter tray (cats)

    Clinical Examination (DJD)

    • Stiffness, lameness, muscular atrophy, reduction in ROM, crepitus, altered gait (reduce stride length, altered swing phase), unkept appearance (cat), pain on examination, swollen joints

    Investigations (DJD)

    • Radiography (signs nonspecific, osteophytes, enthesophytes, intra-articular mineralisation, subchondral sclerosis, soft tissue enlargement)
    • Synovial fluid analysis, arthroscopy

    Conservative Treatment (DJD)

    • Client education, expectations, weight control(ideal body condition score), exercise control, environmental changes for cats (access to feeding bowl, favourite sleeping spot, litter box)
    • Physiotherapy/Hydrotherapy
    • Medical management (NSAIDs, paracetamol, gabapentin, amantadine, monoclonal antibody therapy)
    • Nutritional supplementation

    Avascular Necrosis of Femoral Head (Legg-Calvé-Perthes Disease)

    • Signalment: small breed dogs (miniature poodles, WHWT), young 4-11 months, cats affected by similar issue
    • History: variable lameness, potentially non-weight bearing
    • Clinical findings: pain, crepitus on hip examination
    • Investigations: radiography
    • Treatment: femoral head and neck osteotomy, total hip arthroplasty

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    Lameness in Companion Animals PDF

    Description

    Test your knowledge on canine knee injuries and conditions. This quiz covers topics like osteophytes, treatment for small dogs, and complications from cruciate ligament injuries. Evaluate your understanding of radiographic findings and various types of luxation in dogs.

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