Changes

Also known as: '''''DJD — Osteoarthritis — Degenerative arthritis — Osteroarthrosis'''''

Also known as: '''''DJD — Osteoarthritis — Degenerative arthritis — Osteroarthrosis'''''

==Introduction==

==Introduction==

Degenerative joint disease is the '''progressive deterioration of articular cartilage''' and is characterised by hyaline cartilage thinning, joint effusion and periarticular osteophyte formation.

Degenerative joint disease is the '''progressive deterioration of articular cartilage''' and is characterised by hyaline cartilage thinning, joint effusion and periarticular osteophyte formation.

DJD is the '''end-stage''' to many common diseases of '''small and large animals''' and therefore prompt diagnosis and management of these diseases is critical in preventing the condition.

DJD is the '''end-stage''' to many common diseases of '''small and large animals''' and therefore prompt diagnosis and management of these diseases is critical in preventing the condition.

==Predisposing factors==

==Predisposing Factors==

These include any condition causing:

These include any condition causing:

==Clinical Signs==

 

 

 

==Clinical signs==

These include: '''lameness, pain, joint swelling, muscle atrophy, pericapsular fibrosis, crepitation and decreased range of motion'''.

These include: '''lameness, pain, joint swelling, muscle atrophy, pericapsular fibrosis, crepitation and decreased range of motion'''.

A history of joint disease is common.

A history of joint disease is common.

'''Radiography''' will reveal: joint effusion, periarticular soft tissue swelling, osteophytosis, enthesitis, subchondral bone sclerosis and narrowed joint space.

'''Radiography''' will reveal: joint effusion, periarticular soft tissue swelling, osteophytosis, enthesitis, subchondral bone sclerosis and narrowed joint space. It is important to note that radiographic changes do not always correlate with clinical signs and not all degenerate joints are associated with lameness.

 

It is important to note that radiographic changes do not always correlate with clinical signs and not all degenerate joints are associated with lameness.

'''Arthrocentesis''' is usually unremarkable, but may reveal slight changes in viscosity, colour and volume.

'''Arthrocentesis''' is usually unremarkable, but may reveal slight changes in viscosity, colour and volume.

Corticosteroids should only be given to severe, non-responsive cases and never combined with NSAIDs.

Corticosteroids should only be given to severe, non-responsive cases and never combined with NSAIDs.

'''New therapies''': acupuncture is become more popular in small animals.

'''New therapies''': [[acupuncture]] has become more popular in small animals.

Neutraceuticals such as glycosamide sulphate, chondroitin sulphate and pentosan polysulphate might improve signs, however few controlled studies in dogs and horses are available to support any claims.

Neutraceuticals such as glycosamide sulphate, chondroitin sulphate and pentosan polysulphate might improve signs, however few controlled studies in dogs and horses are available to support any claims.

'''Surgical treatment options''' include:

'''Surgical treatment options''' include:

 

:'''Joint lavage''': minimally invasive and may help remove inflammatory mediators and improve clinical signs for several months

'''Joint lavage''': minimally invasive and may help remove inflammatory mediators and improve clinical signs for several months

:Salvage procedures such as:

 

::'''Excision arthroplasty''': in small animals, for example Femoral Head and Neck Excision

Salvage procedures such as:

::'''Replacement arthroplasty''': total hip replacement and total elbow replacement in dogs

 

::'''Arthrodesis''': in all species depending on the joint, carpal arthrodesis in dogs, pastern and hock joint arthrodesis in horses, fetlock as a last resort.

'''Excision arthroplasty''': in small animals, for example Femoral Head and Neck Excision

::'''Amputation''' in small animals in cases of intractable pain or where financial issues prevent any other treatment.

 

'''Replacement arthroplasty''': total hip replacement and total elbow replacement in dogs

 

'''Arthrodesis''': in all species depending on the joint, carpal arthrodesis in dogs, pastern and hock joint arthrodesis in horses, fetlock as a last resort.

 

'''Amputation''' in small animals in cases of intractable pain or where financial issues prevent any other treatment.

Ultimately, DJD is an '''incurable disease''' and conservative treatment will only slow the progression of the disease.  

Ultimately, DJD is an '''incurable disease''' and conservative treatment will only slow the progression of the disease.  

'''Prognosis''' depends on the location and severity of the arthropathy, but is usually guarded for return to athletic function.

Prognosis depends on the location and severity of the arthropathy, but is usually guarded for return to athletic function.

{{Learning

{{Learning

[[Category:To Do - Helen]]

[[Category:To Do - Review]]

[[Category:Musculoskeletal Diseases - Horse]]

 

[[Category:Musculoskeletal Diseases - Dog]]

[[Category:Joints - Degenerative Pathology]]

[[Category:Joints - Degenerative Pathology]]

[[Category:To Do - Manson]]

[[Category:Expert Review]]