Difference between revisions of "Hypertrophic Osteodystrophy"

Revision as of 12:35, 3 March 2011

Hypertrophic osteodystrophy (Image sourced from Bristol Biomed Image Archive with permission)

Also called - metaphyseal osteopathy
Young (usually 3-6 months old), fast growing dogs of large or giant breeds
Distal radius and ulna most severely affected
Clinical signs:
- Fever
- Anorexia
- Severe lameness
- Swelling in metaphyses of long bones corresponding with neutrophilic infiltrate
Radiologically:
- Increased lucency and increased density areas in metaphyses
- Enlarged metaphyses
Usually bilaterally symmetrical
Histologically:
- Haemorrhage and necrosis of osteoblasts in the growth plates and primary spongiosa
- Intense infiltration by neutrophils
- Periosteal reaction + formation of new bone on external surface above the lesion
Many resolve spontaneously with complete remodelling and healing of the bone
Can progress to periosteal bone proliferation
Cause is unknown
- Unlikely to be dietary deficiency
- Likely to be infectious cause
Contrast with canine panosteitis

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-{{OpenPagesTop}}
+[[Image:Hypertrophic osteodystrophy.jpg|right|thumb|100px|<small><center>Hypertrophic osteodystrophy (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]
-[[Image:Hypertrophic osteodystrophy.jpg|right|thumb|200px|<small><center>Hypertrophic osteodystrophy (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]
+*Also called - '''metaphyseal osteopathy'''
-Also known as: '''''Metaphyseal Osteopathy — HOD'''''
+*Young (usually 3-6 months old), fast growing '''dogs''' of large or giant breeds
+*'''Distal radius and ulna''' most severely affected
+*Clinical signs:
+**Fever
+**Anorexia
+**Severe lameness
+**Swelling in '''metaphyses''' of long bones corresponding with neutrophilic infiltrate
+*Radiologically:
+**Increased lucency and increased density areas in metaphyses
+**Enlarged metaphyses
+*Usually bilaterally symmetrical
+*Histologically:
+**Haemorrhage and necrosis of [[Bones - Anatomy & Physiology|osteoblasts]] in the growth plates and primary spongiosa
+**Intense infiltration by [[Neutrophils|neutrophils]]
+**Periosteal reaction + formation of new bone on external surface above the lesion
+*Many resolve spontaneously with complete remodelling and healing of the bone
+*Can progress to '''periosteal bone proliferation'''
+*Cause is unknown
+**Unlikely to be dietary deficiency
+**Likely to be infectious cause
+*Contrast with [[Panosteitis|'''canine panosteitis''']]
-==Introduction==
-This is a '''developmental disease''' of '''young, large, rapidly-growing large and giant breeds''' such as the Great Dane, St Bernard, Irish Setter, Labrador, German Shepherd, Doberman and Weimaraner.
-It most frequently presents at the age of '''3-4 months''' (range 2-8) and '''males''' are affected more commonly than females.
-The disease occurs at the metaphysis of long bones, especially the '''distal ulna and radius'''.
-The aetiology of the condition is '''unknown''', but theories include: an excessive plane of nutrition, calcium/phosphate imbalance, vitamin C deficiency or an '''infectious agent'''.
-==Clinical Signs==
-Respiratory or gastrointestinal illness may precede the onset of skeletal disease.
-Clinical signs vary from '''mild lameness to severe systemic illness''', pyrexia, depression, inappetance, weight loss and inability to stand.
-'''Pain''' can be elicited by digital pressure on the metaphysis.
-The condition is usually '''bilaterally symmetrical''' and may affect all four limbs.
-In severe cases, the long bone metaphyses are visibly '''swollen, hot and painful on palpation'''.
-Active periods of disease may last for several days and '''relapses''' may occur at intervals of 1-6 weeks.
-Some severely suffering dogs may '''die''' or may be euthanised on owner's request.
-==Diagnosis==
-The clinical signs and presentation are suggestive.
-'''Radiography''' can confirm the diagnosis. Findings include:
-:irregular radiolucent line (double physeal line) in the metaphysis, parallel to the normal radiolucent physeal line
-:the physis may appear widened
-:subperiosteal new bone formation at the metaphysis forming a collar of bone, also known as bone cuffing
-:evidence of growth deformities
-Bone '''scintigraphy''' may reveal increased uptake of agent at the metaphysis.
-Haematology and biochemistry are usually unremarkable.
-'''Histology''' of the area would reveal: haemorrhage and necrosis of [[Bones - Anatomy & Physiology|osteoblasts]] in the growth plates and primary spongiosa, intense infiltration by [[Neutrophils|neutrophils]], periosteal reaction and formation of new bone on external surface above the lesion.
-==Treatment==
-HOD is usually '''self-limiting''' and mildly affected dogs '''recover within a few weeks'''.
-Treatment involves '''supportive care with proper nutrition, fluids and analgesia'''. Buffered aspirin is the preferred analgesic.
-In severe cases, '''corticosteroids and antibiotics''' may be indicated, depending on blood culture results. Recumbent puppies should be turned every 4 hours and placed in a well-padded cage.
-Correction of '''angular limb deformities''' may be necessary.
-==Prognosis==
-This is related to disease severity.
-'''Mildly affected dogs''' have a '''good prognosis''' and many recover spontaneously. Diaphyseal deformities can be severe but are usually not debilitating.
-'''Severely affected dogs''' have a '''poor prognosis''' and some dogs can succumb to '''hyperthermia or acidosis'''. Euthanasia may also be performed on the worst cases.
-{{Learning
-|flashcards = [[Small Animal Orthopaedics Q&A 04]]
-}}
-==References==
-Pasquini, C. (1999) '''Tschauner's Guide to Small Animal Clinics''' ''Sudz Publishing''
-Dunn, J. (1999) '''Textbook of small animal medicine''' ''Elsevier Health Sciences''
-Hosgood, G. (1998) '''Small animal paediatric medicine and surgery''' ''Elsevier Health Sciences''
-{{review}}
-{{OpenPages}}
-[[Category:Musculoskeletal Diseases - Dog]]
-[[Category:Expert Review - Small Animal]]
 [[Category:Bones - Hyperplastic Pathology]]

Difference between revisions of "Hypertrophic Osteodystrophy"

Revision as of 12:35, 3 March 2011

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