Osteochondrosis

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Osteochondrosis
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Osteochondrosis is a family of orthopedic diseases of the joint that occur in children, adolescents and rapidly growing animals, particularly pigs, horses, dogs, and broiler chickens. They are characterized by interruption of the blood supply of a bone, in particular to the epiphysis, [1] followed by localized bony necrosis, [2] and later, regrowth of the bone. [3] This disorder is defined as a focal disturbance of endochondral ossification and is regarded as having a multifactorial cause, so no one thing accounts for all aspects of this disease. [1]

Contents

Osteochondrosis is a developmental disease. It usually occurs in an early stage of life. It has personified features as focal chondronecrosis and confinement of growth cartilage due to a failing of endochondral ossification. Fissures can develop from lesions over the top articular cartilage and form a cartilage flap and an osteochondral fragment. It is diagnosed as osteochondritis dissecans. [4]

In animals

In dogs osteochondrosis is seen in elbow, shoulder, knee, and ankle joints. Elbow osteochondrosis is also known as "elbow dysplasia". There are three types of elbow dysplasia:  fragmented medial coronoid process, ununited anconeal process and Osteochondritis dissecans of the medial humeral condyle.

Breeds that have the predisposition to these are Basset Hound, Labrador, Golden Retriever, and Rottweiler. Other breeds can also be diagnosed with this condition but it is not common. [5]

One of the leading factors to some elbow osteochondrosis is that the radius and ulna are growing at different rates. In this situation, the stress to the joint surface is not even and can cause some form of osteochondrosis in the elbow when the puppy grows or make already existing elbow dysplasia even worse. Some of the breeds that are susceptible to that are for example Dachshunds, Corgis, Pugs, Bulldogs, and Beagles. [4]

Signs and symptoms

These conditions nearly all present with an insidious onset of pain referred to the location of the bony damage. Some, notably Kienbock's disease of the wrist, may involve considerable swelling, [6] and Legg-Calvé-Perthes disease of the hip causes the victim to limp. [7] The spinal form, Scheuermann's disease, may cause bending, or kyphosis of the upper spine, giving a "hunch-back" appearance. [8]

Symptoms in animals

The most common symptoms are lameness and pain in the affected joints. Animals may try to ease the pain and walk differently and the pain can be noticed by the change in animals walking style. The condition affects both sides (right and left leg). On most occasions, the other leg is worse. This can result that the dog starts encumbering the other leg and the healthier leg becomes more strained. [5] Sometimes the symptoms are so mild or there are no symptoms which can make it hard to detect that there is something wrong with that dog. [9]

Cause

The ultimate cause for these conditions is unknown, but the most commonly cited cause factors are rapid growth, heredity, trauma (or overuse), anatomic conformation, and dietary imbalances; however, only anatomic conformation and heredity are well supported by scientific literature. The way that the disease is initiated has been debated. Although failure of chondrocyte differentiation, formation of a fragile cartilage, failure of blood supply to the growth cartilage, and subchondral bone necrosis all have been proposed as the starting point in the pathogenesis, recent literature strongly supports failure of blood supply to growth cartilage as most likely. [1] Osteochondrosis can be usually inherited.

Factors

There are four factors: genetics, environment, diet, and exercise.

Environment is found to be a key factor in osteochondrosis occurring. The environment is related to diet and exercise. If the dog has good facilities to live a healthy life, meaning having a good diet and enough and the right kind of exercise, osteochondrosis may never occur even if there would be genetic susceptibility. Sometimes even if the environmental conditions are optimal there is still a chance that osteochondrosis will occur in the animal. [5]

Dogs are very susceptible to calcium when they are growing up. Too much calcium in a diet can affect how the bone starts ossifying. That's one of the reasons why a correct diet for young growing dogs is important. [4]

Diagnosis

Classification

In humans, these conditions may be classified into three groups:[ citation needed ]

  1. Spinal: Scheuermann's disease [10] (of the interspinal joints) which is a curve in the thoracic spine.
  2. Articular: Legg-Calvé-Perthes disease (or, avascular necrosis of the femoral head in the hip), Köhler's disease (of the tarsal navicular bone of the foot), Freiberg's infraction (of the second or third metatarsal of the foot and less frequently the first or fourth; sometimes called Freiberg's Infraction or Freiberg's disease), [10] Blount's disease (tibia vara), Kienböck's disease (lunate), Panner's disease (of the capitulum of the elbow). Other entities affecting mostly adults, but sometimes loosely lumped into these conditions include Preiser's disease (scaphoid) and Mueller-Weiss syndrome (tarsal navicular).
  3. Non-articular: This group includes Sever's disease (of the calcaneus, or heel), and other conditions not completely characteristic of the osteochondroses, such as Osgood-Schlatter's disease (of the tibial tubercle) [10] and Sinding-Larsen-Johansson syndrome (proximal patellar tendon).

Treatment

There are many different kinds of treatments. One is to remove the loose piece of the leg. Or serving the branch of the lumbar muscle and ulnas attachment. [4]

Most of the time if the osteochondrosis is in the shoulder joint, the veterinarian diagnoses it from X-rays or CT scans. [9] Some studies show that osteochondrosis is more common in male dogs than in female dogs. [4]

Prognosis

The term osteochondrosis has been used to describe a wide range of lesions among different species. There are different types of the prognosis: latens, which is a lesion restricted to epiphyseal cartilage, manifesta, a lesion paired with a delay in endochondral ossification, and dissecans which is a cleft formation in the articular cartilage. [1] The prognosis for these conditions is very variable, and depends both on the anatomic site and on the time at which it is detected. In some cases of osteochondrosis, such as Sever's disease and Freiberg's infraction, the involved bone may heal in a relatively normal shape and leave the patient asymptomatic. [11] On the contrary, Legg-Calvé-Perthes disease frequently results in a deformed femoral head that leads to arthritis and the need for joint replacement. [7]

See also

Related Research Articles

<span class="mw-page-title-main">Legg–Calvé–Perthes disease</span> Osteochondrosis that results in death and fracture located in hip joint

Legg–Calvé–Perthes disease (LCPD) is a childhood hip disorder initiated by a disruption of blood flow to the head of the femur. Due to the lack of blood flow, the bone dies and stops growing. Over time, healing occurs by new blood vessels infiltrating the dead bone and removing the necrotic bone which leads to a loss of bone mass and a weakening of the femoral head.

<span class="mw-page-title-main">Epiphysis</span> End of a long bone that ossifies from a secondary center

An epiphysis is one of the rounded ends or tips of a long bone that ossify from a secondary center of ossification. Between the epiphysis and diaphysis lies the metaphysis, including the epiphyseal plate. At the joint, the epiphysis is covered with articular cartilage; below that covering is a zone similar to the epiphyseal plate, known as subchondral bone. In evolution, reptiles do not have epiphyses and diaphyses, being restricted to mammals.

<span class="mw-page-title-main">Hip dysplasia (canine)</span> Joint abnormality in dogs

In dogs, hip dysplasia is an abnormal formation of the hip socket that, in its more severe form, can eventually cause lameness and arthritis of the joints. It is a genetic (polygenic) trait that is affected by environmental factors. It is common in many dog breeds, particularly the larger breeds, and is the most common single cause of arthritis of the hips.

<span class="mw-page-title-main">Coxa vara</span> Deformity of the hip

Coxa vara is a deformity of the hip, whereby the angle between the head and the shaft of the femur is reduced to less than 120 degrees. This results in the leg being shortened and the development of a limp. It may be congenital and is commonly caused by injury, such as a fracture. It can also occur when the bone tissue in the neck of the femur is softer than normal, causing it to bend under the weight of the body. This may either be congenital or the result of a bone disorder. The most common cause of coxa vara is either congenital or developmental. Other common causes include metabolic bone diseases, post-Perthes deformity, osteomyelitis, and post traumatic. Shepherd's Crook deformity is a severe form of coxa vara where the proximal femur is severely deformed with a reduction in the neck shaft angle beyond 90 degrees. It is most commonly a sequela of osteogenesis imperfecta, Paget's disease, osteomyelitis, tumour and tumour-like conditions.

<span class="mw-page-title-main">Chondrocyte</span> Cell that makes up cartilage

Chondrocytes are the only cells found in healthy cartilage. They produce and maintain the cartilaginous matrix, which consists mainly of collagen and proteoglycans. Although the word chondroblast is commonly used to describe an immature chondrocyte, the term is imprecise, since the progenitor of chondrocytes can differentiate into various cell types, including osteoblasts.

<span class="mw-page-title-main">Avascular necrosis</span> Death of bone tissue due to interruption of the blood supply

Avascular necrosis (AVN), also called osteonecrosis or bone infarction, is death of bone tissue due to interruption of the blood supply. Early on, there may be no symptoms. Gradually joint pain may develop, which may limit the person's ability to move. Complications may include collapse of the bone or nearby joint surface.

<span class="mw-page-title-main">Synovial osteochondromatosis</span> Medical condition

Synovial osteochondromatosis (SOC) (synonyms include synovial chondromatosis, primary synovial chondromatosis, synovial chondrometaplasia) is a rare disease that creates a benign change or proliferation in the synovium or joint-lining tissue, which changes to form bone-forming cartilage. In most occurrences, there is only one joint affected, either the knee, the hip, or the elbow. Rarely involves the TMJ.

Osteochondritis is a painful type of osteochondrosis where the cartilage or bone in a joint is inflamed.

<span class="mw-page-title-main">Osteochondritis dissecans</span> Ischemic bone disease

Osteochondritis dissecans is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. OCD usually causes pain during and after sports. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Physical examination in the early stages does only show pain as symptom, in later stages there could be an effusion, tenderness, and a crackling sound with joint movement.

<span class="mw-page-title-main">Elbow dysplasia</span> Medical condition in dogs

Elbow dysplasia is a condition involving multiple developmental abnormalities of the elbow-joint in the dog, specifically the growth of cartilage or the structures surrounding it. These abnormalities, known as 'primary lesions', give rise to osteoarthritic processes. Elbow dysplasia is a common condition of certain breeds of dogs.

<span class="mw-page-title-main">Orthopedic Foundation for Animals</span> American non-profit veterinarian organization

The Orthopedic Foundation for Animals (OFA) is a nonprofit organization based in Columbia, Missouri, that aims to research and prevent orthopedic and hereditary diseases in companion animals.

As a private not-for-profit foundation, the OFA has funded nearly $3 million in research aimed at reducing the incidence and prevalence of inherited companion animal disease. The OFA funds projects through the AKC Canine Health Foundation, the Morris Animal Foundation, and occasionally through direct grants. The OFA has achieved Ruby Donor status with MAF, and Millennium Founder status with the AKC CHF. OFA supported research is not limited to orthopedic disease, and has included cancers, heart disease, and thyroid disease as examples. Some research has been breed specific, some for all breeds, some for multiple species, and has been done at many of our leading universities and research institutions. With the recent completion of the mapping of the canine genome, the OFA is focusing more of its research dollars towards research at the molecular level.

<span class="mw-page-title-main">Transient synovitis</span> Medical condition

Transient synovitis of hip is a self-limiting condition in which there is an inflammation of the inner lining of the capsule of the hip joint. The term irritable hip refers to the syndrome of acute hip pain, joint stiffness, limp or non-weightbearing, indicative of an underlying condition such as transient synovitis or orthopedic infections. In everyday clinical practice however, irritable hip is commonly used as a synonym for transient synovitis. It should not be confused with sciatica, a condition describing hip and lower back pain much more common to adults than transient synovitis but with similar signs and symptoms.

<span class="mw-page-title-main">Femoral head</span>

The femoral head is the highest part of the thigh bone (femur). It is supported by the femoral neck.

Bone disease refers to the medical conditions which affect the bone.

Panner disease is an osteochondrosis of the capitellum of the elbow. Panner disease is primarily seen in boys between the ages of five and ten years old. Panner disease is often caused by excessive throwing due to valgus stress. The disease causes pain and stiffness in the affected elbow and may limit extension; the affected elbow is usually on the dominant arm the child uses. The disease may be associated with pitching and athletic activity. On radiographs, the capitellum may appear irregular with areas of radiolucency. Treatment is symptomatic, with a good prognosis. Treatment is minimal and includes restricting athletic activity to allow for the elbow to heal and for pain to be relieved. The disease is named after the Danish radiologist Hans Jessen Panner (1871–1930).

Cartilage repair techniques are the current focus of large amounts of research. Many different strategies have been proposed as solutions for cartilage defects. Surgical techniques currently being studied include:

<span class="mw-page-title-main">Index of trauma and orthopaedics articles</span>

Orthopedic surgery is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal injuries, sports injuries, degenerative diseases, infections, bone tumours, and congenital limb deformities. Trauma surgery and traumatology is a sub-specialty dealing with the operative management of fractures, major trauma and the multiply-injured patient.

<span class="mw-page-title-main">Hip pain</span>

Pain in the hip is the experience of pain in the muscles or joints in the hip/ pelvic region, a condition commonly arising from any of a number of factors. Sometimes it is closely associated with lower back pain.

References

  1. 1 2 3 4 Ytrehus B, Carlson CS, Ekman S (July 2007). "Etiology and pathogenesis of osteochondrosis". Vet. Pathol. 44 (4): 429–48. doi:10.1354/vp.44-4-429. PMID   17606505. S2CID   12349380. Archived from the original on 2009-01-31. Retrieved 2008-10-03.
  2. ↑ "osteochondrosis" at Dorland's Medical Dictionary
  3. ↑ "Medical College of Wisconsin". Archived from the original on 2012-02-04. Retrieved 2005-12-10.
  4. 1 2 3 4 5 "Osteokondroosi, kyynärnivelen kasvuhäiriöt". Evidensia Eläinlääkäriasemat (in Finnish). Retrieved 2021-11-30.
  5. 1 2 3 Carlson, C. S.; Meuten, D. J.; Richardson, D. C. (1991). "Ischemic necrosis of cartilage in spontaneous and experimental lesions of osteochondrosis". Journal of Orthopaedic Research. 9 (3): 317–329. doi:10.1002/jor.1100090303. ISSN   1554-527X. PMID   2010836. S2CID   21411608.
  6. ↑ "Bone Scintigraphy in Kienbock's Disease" . Retrieved 2008-11-17.
  7. 1 2 "Legg-Calvé-Perthes Disease" . Retrieved 2008-11-17.
  8. ↑ "Scheuermann's Disease - Orthogate - Improving orthopedic care, education and research with Internet technologies" . Retrieved 2008-11-17.
  9. 1 2 "Olkanivelen osteokondroosi". Kennelliitto (in Finnish). 9 December 2020. Retrieved 2021-12-28.
  10. 1 2 3 Ytrehus, B.; Carlson, C. S.; Ekman, S. (2007-07-01). "Etiology and Pathogenesis of Osteochondrosis". Veterinary Pathology. 44 (4): 429–448. doi:10.1354/vp.44-4-429. ISSN   0300-9858. PMID   17606505. S2CID   12349380.
  11. ↑ "Sever's Disease - The Southern California Orthopedic Institute". Archived from the original on 2012-07-22. Retrieved 2008-11-17.
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