Term
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Definition
| -broad erm encompassing inflammatory diseases that occur within a joint |
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Term
| What are other names for osteoarthritis? |
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Definition
| -arthrosis, degenerative joint disease |
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Term
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Definition
| -aberrant repair and eventual degradation of articualr cartilage in association with laterations in subchondral bone metabolism, periarticular osteophytosis, and variable degrees of synovial inflamamtion |
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Term
| What is the prevelence of arthritis in dogs? In cats? |
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Definition
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Term
| What is the most common cause of OA in cats? |
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Definition
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Term
| What are the secondary causes of OA? |
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Definition
-developmental disorder: hip dysplasia, elbow dysplasia, OCD
-joint instability: CCLR
-Trauma: articular fractures, joint luxation |
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Term
| How does body weight lead to OA? |
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Definition
-inc stress
-adipokines affect cartilage turnowver, induces cartilage degradation |
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Term
| How does gender affect OA? |
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Definition
| -estrogen receptors are present within the joint: estrogen protects from inflammation |
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Term
| Describe the pathogenesis of OA in the articualr cartilage? |
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Definition
-loss of compressive stiffness adn tensile strength
-dec responsiveness to mechanical stimuli |
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Term
| Describe the pathogenesis of OA in the synovium? |
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Definition
| -source of pro-inflammatory products and pain |
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Term
| Describe the pathogenesis of OA in the subchondral bone? |
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Definition
| -osteophyte formation, sclerosis |
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Term
| What happens during Stage I of OA? |
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Definition
| -proteolytic breakdown of cartilage matrix |
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Term
| What happens during Stage II of OA? |
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Definition
-fibrillation and erosion of cartilage surface
-breakdown products released in synovial fluid |
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Term
| What happens during Stage III of OA? |
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Definition
-synovial inflammaiton
-phagocytosis of breakdown products stimulates production of pro-inflammatory mediators: proteases, cytokines |
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Term
| How does synovial inflammation cause joint pain with OA? |
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Definition
-effusion and microinstability
-stimulation of nociceptors |
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Term
| How does subchondral bone issues cause joint pain with OA? |
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Definition
-neovascular invasion
-exposure of subchondral bone
-osteoclastic remdoeling |
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Term
| What are the sources of joint pain in OA? |
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Definition
-synovial inflammation
-subchondral bone
-degenerate cartilage
-osteochondral fragments
-major joint instability |
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Term
| What are the common sites of OA? |
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Definition
-hip
-elbow
-stifle
-shoulder |
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Term
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Definition
-clinical signs/PE
-rads
-MRI
-CT
-arthroscopy
-synovial fluid analysis |
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Term
| What do we see on history that is suggestive of OA? |
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Definition
-slow to rise
-slow in the AM and improves iwht exercise
-lame/slow after activity |
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Term
| What do we see on PE that is suggestive of OA? |
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Definition
-creptius/pain with ROM
-joint localizaiton
-severity of presentaiton |
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Term
| Describe the efficacy of rads for diagnosing OA. |
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Definition
| -most common modality but not sensitive in early stages but no info about soft tissue components of joint (synovium, subchondral bone, cartilage lesions) |
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Term
| True or False: In regards to OA, rads directly correlate with the severity of clinical signs. |
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Definition
| -FALSE, with OA rads do NOT correlate well with severity of clinical signs |
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Term
| Describe the efficacy of MRI for diagnosing OA. |
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Definition
-superior quality and sensitivity than rads
-xcellent for eval of joint components: cartilage defects/thickness and non-cartilagenous structures |
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Term
| What are the disadvantages of MRI for diagnosing OA? |
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Definition
-cost
-availability
-requires general anesthesia |
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Term
| What are the advantages and disadvantages of using CT to diagnose OA? |
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Definition
-useful in complex joints with superimposition and more sensitive for bone
-not as sensitive for soft tissue assessment as MRI |
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Term
| What are the advantages of using arthroscopy to diagnose OA? |
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Definition
-gross eval of joint
-can serve as a therapeutic option concurrently
-can directly assess cartilage damage |
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Term
| What do we evaluate cytologi of synovial fluid to diagnose OA? |
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Definition
-cell types and numbers
-infectious agents
-color, urbidity, viscosity |
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Term
| When do we perform an FNA in regards to imaging modalities to diagnose OA? |
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Definition
| -perform AFTER rads/CT/MRI |
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Term
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Definition
-no curative options available
-no approved disease-modifying agents
-multifactorial disease = multifactorial treatment |
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Term
| Descrive the multifactorial treatment of OA. |
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Definition
-weight control/ diet modificaiton
-activity management
-pharm supplementation
-surgical management |
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Term
| Why do we manage weight to treat OA? |
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Definition
-maintain deal BCS
-reduce stress on joints |
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Term
| How do we modify the diet to control weight to treat OA? |
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Definition
-low fat/weight loss diet
-smart treats
-family effort |
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Term
| Describe how we manage activity levels with OA? |
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Definition
| -exercise exacerbates OA pain but suggest regular, moderate (low-impact), controlled exercise |
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Term
| What are our options for rehabilitation for OA? |
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Definition
-passive range of motion exercises
-water treadmill
-muscle strengthening exercises
-heat/cold therapy
-acupuncture |
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Term
| What kind of pharma supplementation do we use to treat OA? |
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Definition
-analgesics
-NSAID: caution with long term use
-Tramadol, bagapentin, amantadine
-Gabapentin, amantadine |
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Term
| What are some of the nutritional supplements given to dogs ith OA? |
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Definition
-Glucosamine (sugar) + chondroitin sulfate (PSGAG)
-Essential fatty acids |
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Term
| What do Glucosamine and chondroitin sulfate supplements do for dogs with OA? |
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Definition
-chondrocyte stimulation
-anti-inflammatory effects
-takes 4-6w to se effect |
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Term
| What do essential fatty acid supplements do for dogs with OA? |
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Definition
-fish-oil derived, not cereal
-anti-inflammatory effects |
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Term
| What do chondroprotectives do? |
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Definition
-inhibit matrix metalloproteinases, prostaglandins (catabolic enzymes)
-cytokine inhibition
-inc the synthesis of hyaluronic acid, collagens, proteoglycans |
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Term
| What does stem cell therapy do for dogs with OA? |
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Definition
-regenerative medicine
-adult multipotent stem cells: adipose tissue, bone marrow, umbilical cord blood
-most commonly used as intra-articular injections
-anti-inflammatory effect
-promote tissue growth/regenration
-extremely expensive |
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Term
| What does platelet-rich plasma do for dogs with OA? |
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Definition
| -boost the body's natural response to healing |
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Term
| How do we surgically manage dogs with OA? |
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Definition
| -correct the underlying condition to slow down progression of OA |
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Term
| What types of surgical procedures are used to manage canine OA? |
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Definition
-Cranial cruciate ligament stabilization
-medial patellar luxation repair
-articular fracture repair
-removing fragmented medial coronoid process
-debridement of an OCD lesion |
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Term
| What procedures do we use to surgically salvage OA? |
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Definition
-joint replacement: removes pain and inflammaiton
-FHO: remove joint contact
-arthrodesis: removes joint mechanics all together and fuse it at a functional angle |
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