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Developmental Osteochondrosis, Angular Limb Deformities, Flexural Limb…

- - - - aka Physitis or Epiphysitis
      - Failure of endochondral ossification--> widening of the growth plate
      - Common Locations:
        
        Distal 3rd metacarpal/metatarsal physis
        
        Distal radial physis
        
        Distal tibial physis
        
        Usually bilateral (or quad)
      - Signs:
        Age: 4-8m
        
        Widening of metaphyses - Metaphyseal flare
        
        +/- heat/pain
        
        Not lame or M1 to M2
        
        Dx: Age, signs, rads
        
        Tx:
        
        Dietary: decrease carbs, increase roughage
        
        Exercise restriction
        
        +/- NSAIDs
        
        Prognosis
        
        V good unless angular limb deformities
    - - Flap-like lesion of abn articular cartilage & bone
        
        Shear force & gliding surfaces
      - OCD of Tarsus
        
        Tibiotarsal joint lesions: Cranial, distal, intermediate ridge of tibia (DIRT)
        
        Signs:
        
        Effusion #1
        
        Lameness not until training usually
        
        Tx:
        
        Arthroscopic debridement
        
        Prognosis: Good to excellent
    - - In-folding of defective cartilage
        Compressive Forces & Central Weight Bearing
    - - OC Fragments of Proximal Palmar/Plantar P1
        
        Tx
        
        Arthroscopic debridement
        
        Prognosis: good - excellent
        
        Signs:
        
        M1 joint effusion
        
        Lameness (if present) @ high speeds
        
        Proximal Sesamoid
        
        Type 3: Fragments off the distal aspect of sesamoid bones
        
        Type 4: Fragments within the distal sesamoidean ligament
        
        1st Phalanx
        
        Type 1: subchondral flattening or fragments abaxial to sagittal groove (intra-articular)
        
        Type 2: Fragments on the abaxial aspect of the palmar/plantar process (extra articular)
      - OCD of distal, dorsal MC-3 & MT3 (saggital)
        
        Type 1: subchondral flattening
        
        Type 2: Flattening & fragment
        
        Type 3: Loose osseous body in dorsal joint
        
        Signs:
        
        Joint effusion
        
        M1 lameness
        
        Tx:
        
        Arthroscopic debridement of type 2 & 3
        
        Rest for Type 1
        
        Prognosis: very good
      - SBC's of distal MC3 & MT3
        
        Less common
        
        Tx:
        
        Arthroscopic Debridement
        
        Intralesional corticosteroid injection
        
        Intra-articular med and rest
        
        Prognosis for athletes is guarded
      - OC Fragment of proximal, dorsal P1
    - - Lesions
        
        OCD of lateral trochlear ridge of the femur
        
        Signs:
        
        Femoropatellar effusion
        
        Lameness M1-M2
        
        Tx:
        
        Arthroscopic debridement
        
        May improve w rest
        
        Prognosis: guarded to good
        
        SBC of medial condyle of femur
        
        Signs:
        
        Effusion (less common)
        
        Lameness M1-M3
        
        Tx:
        
        Arthrtoscopic debridement
        
        Cortico inj
        
        IA meds and rest
        
        Prognosis: less favourable
      - 6-12m rest necessary
    - - Lesions: 25% on humeral head, 25% on glenoid, 50% on both
      - Signs:
        -Lameness as weaning or yearling (M1-M3)
        
        Tx:
        
        Arthroscopic debridement
        
        Rest +/- IA meds
        
        Prognosis: guarded