Nelson and Couto > Joint Disorders > Flashcards

Joint Disorders Flashcards

(165 cards)

Study These Flashcards
1
Q

What are the two main categories of joint disorders?

A

Noninflammatory and inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most common type of polyarthritis recognized in dogs?

A

Immune-mediated nonerosive polyarthritis (IMPA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What causes immune-mediated nonerosive polyarthritis (IMPA) in dogs?

A

Immune-complex deposition within the synovial membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the classifications of immune-mediated polyarthritis based on physical examination and radiographic findings?

A

Erosive or nonerosive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What type of lameness is commonly observed in dogs with polyarthritis?

A

Shifting-leg lameness or ‘walking on egg shells’ gait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some clinical signs that may indicate polyarthritis in dogs?

A
  • Decreased appetite
  • Fever
  • Weakness
  • Stiffness
  • Exercise intolerance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What should be evaluated in animals with nonspecific pain and a stiff gait?

A

A careful physical examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the typical pain response during joint manipulation in animals with joint inflammation?

A

Obvious discomfort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does synovial fluid analysis help to differentiate?

A

Inflammatory from noninflammatory joint disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some infectious causes of arthritis?

A
  • Bacteria
  • Mycoplasma spp.
  • Spirochetes
  • Rickettsial agents
  • Protozoa
  • Fungi
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the minimum database required for diagnosing noninflammatory joint disease?

A

CBC, serum biochemistry profile, and urinalysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does cloudiness or turbidity in synovial fluid indicate?

A

Presence of red blood cells (RBCs) or white blood cells (WBCs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the normal appearance of synovial fluid?

A

Clear and colorless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the typical cell count in normal synovial fluid?

A

Fewer than 3000 WBCs/µL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What indicates an increase in neutrophils within joint fluid?

A

Inflammation of the synovial lining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the role of arthrocentesis in joint disease diagnosis?

A

To collect and analyze synovial fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the recommended joints to sample for synovial fluid analysis in suspected polyarthritis?

A
  • At least one carpus
  • One hock
  • One stifle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the significance of a thin or watery consistency of synovial fluid?

A

Deficiency in polymerized hyaluronic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the two types of immune-mediated polyarthritis recognized in cats?

A
  • Idiopathic/primary IMPA
  • Reactive polyarthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

True or False: Polyarthritis is more common in dogs than in cats.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is an important diagnostic test for assessing immune-mediated conditions in dogs?

A

Serologic testing for rheumatoid factor (RF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What should be done if synovial fluid appears grossly abnormal during collection?

A

Perform a second arthrocentesis on the most abnormal joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What can the presence of platelets in synovial fluid indicate?

A

Recent intra-articular hemorrhage or significant blood contamination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the role of cytologic evaluation in synovial fluid analysis?

A

To estimate cell numbers and identify inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the cell count in DJD?
Slightly increased cell count (<6000 cells/µL) with mononuclear cells predominating ## Footnote DJD stands for degenerative joint disease
26
What indicates inflammation of the synovial lining?
An increase in the number of neutrophils within a joint ## Footnote Neutrophils are a type of white blood cell involved in inflammation
27
What is important for the cytologic evaluation of joint fluid?
Actual or estimated WBC count and WBC differential ## Footnote WBC stands for white blood cells
28
What appearance should neutrophils have in cases of immune-mediated disease in dogs and cats?
Normal appearance ## Footnote Immune-mediated diseases can lead to various joint issues
29
What may be observed in acute or severe cases of septic arthritis?
Bacteria within neutrophils, which may be toxic, ruptured, or degenerate ## Footnote Septic arthritis is a joint infection that can lead to severe inflammation
30
What organisms may be observed in synovial fluid of animals with polyarthritis caused by rickettsial infections?
Ehrlichia canis, Ehrlichia ewingii, Anaplasma phagocytophilum ## Footnote Rickettsial infections are caused by bacteria transmitted by arthropods
31
What cells may be seen in dogs with SLE-induced polyarthritis?
Lupus erythematosus (LE) cells or ragocytes ## Footnote SLE stands for systemic lupus erythematosus
32
What is the most common cause of joint infection?
Bacteria ## Footnote Bacterial infections are a frequent cause of septic arthritis
33
True or False: Direct bacterial culture of synovial fluid is positive in more than half of all cases of septic arthritis.
False ## Footnote Direct culture is positive in less than half of cases
34
What can improve the diagnostic yield of infected synovial fluid?
Inoculation into broth-enrichment media and incubation for 24 hours prior to culture ## Footnote This method increases the likelihood of bacterial recovery
35
What are the methods for obtaining synovial membrane biopsies?
Needle biopsy or surgical arthrotomy ## Footnote Surgical excision allows for better visualization and selection of biopsy site
36
When is radiography particularly important?
When only one joint is clinically affected or when palpation reveals crepitation, instability, or restricted range of motion ## Footnote Radiography helps in assessing joint conditions
37
What are common radiographic findings in dogs with erosive polyarthritis?
Abnormalities in up to 75% of dogs at first evaluation ## Footnote Erosive polyarthritis can lead to significant joint changes visible on radiographs
38
What is the role of serologic testing in Lyme disease diagnosis?
Detects antibody response to Borrelia burgdorferi ## Footnote Lyme disease is caused by the tick-borne spirochete Borrelia burgdorferi
39
What does a positive Lyme disease antibody titer indicate?
Exposure to the organism, not necessarily active disease ## Footnote Antibody tests can show past exposure but not current infection
40
What tests are used to diagnose systemic lupus erythematosus (SLE)?
ANA titer and LE cell test ## Footnote These tests assess the presence of autoantibodies in the blood
41
What does a positive ANA titer indicate?
Circulating antibodies to nuclear material are present ## Footnote The ANA test is sensitive for SLE but not specific
42
What is the reliability of the rheumatoid factor (RF) test?
Increases with the severity and chronicity of the disease ## Footnote RF can be positive in various autoimmune conditions
43
What are the two main categories of joint disorders based on synovial fluid analysis?
Inflammatory and noninflammatory
44
What is the most common noninflammatory joint disease?
Degenerative joint disease (DJD)
45
What causes inflammatory joint disorders?
Infectious or immune-mediated causes
46
What is a common characteristic of immune-mediated polyarthritis (IMPA)?
Most IMPA syndromes are nonerosive
47
What is the etiology of Degenerative Joint Disease (DJD)?
Chronic progressive disorder resulting in articular cartilage loss, osteophyte formation, and periarticular fibrosis
48
What types of joints can be affected by DJD?
Any joint, including smaller joints like vertebral facets and metacarpophalangeal joints
49
What percentage of the adult canine population in North America is affected by DJD?
Approximately 20%
50
What are some clinical signs of DJD?
* Lameness * Stiffness * Decreased exercise tolerance * Muscular atrophy
51
How is DJD diagnosed?
Based on history, physical examination, and characteristic radiographic features
52
What are some radiographic changes characteristic of DJD?
* Joint effusion * Periarticular osteophyte formation * Subchondral bone sclerosis * Joint space narrowing
53
What is a common predisposing condition for DJD?
Trauma or congenital deformity
54
What is the goal of treatment for DJD in dogs?
To alleviate discomfort and prevent further joint degeneration
55
What type of exercise is recommended for dogs with DJD?
Low-impact exercise like swimming and leash walking
56
What dietary supplements may help with DJD?
* Omega-3 polyunsaturated fatty acids (PUFAs) * Antioxidants (vitamin E, vitamin C, beta carotene, zinc, selenium)
57
What are commonly prescribed nonsteroidal antiinflammatory drugs (NSAIDs) for DJD?
NSAIDs are often recommended for their antiinflammatory and analgesic effects
58
What is the primary action of most NSAIDs?
Reversible inhibition of cyclooxygenase (COX)
59
What should be monitored in dogs receiving NSAIDs?
* Renal function * Inappetence * Vomiting * Melena
60
What are chondroprotective agents used for in dogs with DJD?
To improve cartilage biosynthetic activity and decrease synovial inflammation
61
What is a common chondroprotective medication mentioned?
Glucosamine and chondroitin sulfate
62
What is a significant risk factor for administering NSAIDs in cats?
Deficient glucuronidation pathways leading to prolonged duration of effect
63
What is the recommended dose of meloxicam for cats with DJD?
0.1 mg/kg/day PO for 4 days, then 0.1 mg/cat/day
64
What is the most common cause of septic arthritis in cats?
Pasteurella spp.
65
What are the common clinical features of septic polyarthritis?
* Systemically ill * Febrile * Depressed * Very painful joints
66
What is required to confirm a diagnosis of septic arthritis?
Identification of bacteria in synovial fluid or cultures
67
What are the initial treatment goals for septic arthritis?
* Resolve bacterial infection * Remove intra-articular debris
68
What type of antibiotic is often used for septic arthritis?
Broad-spectrum, β-lactamase-resistant antibiotics like first-generation cephalosporins
69
What is the prognosis for septic arthritis dependent on?
Severity of damage to articular cartilage at the time of infection control
70
What are Mycoplasma spp. considered in most species?
Generally considered nonpathogenic ## Footnote Mycoplasma spp. are normal inhabitants of the conjunctival membranes, pharynx, upper respiratory, and urogenital tracts.
71
Which Mycoplasma species are associated with polyarthritis in cats?
Mycoplasma gatea and Mycoplasma felis ## Footnote These species are linked to erosive and nonerosive polyarthritis and tenosynovitis.
72
What is the primary condition under which Mycoplasma polyarthritis occurs in cats?
Immunosuppressed or debilitated states ## Footnote It has rarely been reported in immunocompetent cats.
73
What are common clinical signs of Mycoplasma polyarthritis in cats?
* Lameness * Joint pain * Depression * Fever
74
What is typically found in synovial fluid analysis of cats with Mycoplasma polyarthritis?
Increase in nondegenerate neutrophils with no visible organisms ## Footnote Routine cultures of joint fluid are negative.
75
What empirical treatment is recommended for Mycoplasma polyarthritis in cats?
Oral doxycycline (5-10 mg/kg q12h) for 3 weeks ## Footnote This is recommended before administering immunosuppressant drugs.
76
Which viruses should cats with polyarthritis be tested for?
* Feline leukemia virus (FeLV) * Feline immunodeficiency virus (FIV)
77
What is the treatment duration for Mycoplasma arthritis to prevent relapse?
6 to 8 weeks
78
What tick-borne diseases are associated with nonerosive polyarthritis in dogs?
* Rocky Mountain spotted fever (RMSF) * Ehrlichia canis * Ehrlichia ewingii * Anaplasma phagocytophilum
79
What causes the polyarthritis in rickettsial diseases?
Immune complex deposition in the joints (reactive polyarthritis) ## Footnote Most infected dogs exhibit systemic signs of illness.
80
What are common hematologic abnormalities in dogs with ehrlichiosis and anaplasmosis?
* Thrombocytopenia * Anemia
81
What is the treatment of choice for acute rickettsial infections causing polyarthritis?
Oral doxycycline (5 mg/kg q12h)
82
What is the primary vector for Lyme disease in dogs?
Ticks of the genus Ixodes
83
What is the most common clinical feature of Lyme borreliosis?
Acute polyarthritis
84
What are the clinical signs of Lyme polyarthritis in dogs?
* Shifting leg lameness * Joint swelling * Fever * Lymphadenopathy * Anorexia
85
What is Lyme nephritis associated with?
Immune-mediated glomerulonephritis, tubular necrosis, and lymphocytic-plasmacytic interstitial nephritis ## Footnote It is most common in Labrador and Golden Retrievers and Shetland Sheepdogs.
86
What should raise suspicion for Lyme disease in dogs?
Fever, lameness, and anorexia in endemic areas
87
What is the recommended treatment duration for Lyme disease?
At least 4 weeks
88
What is Leishmaniasis caused by?
A protozoan parasite
89
What are common clinical abnormalities of Leishmaniasis?
* Weight loss * Lymphadenopathy * Splenomegaly * Hyperglobulinemia * Hypoalbuminemia * Proteinuria
90
What is a rare occurrence with fungal arthritis?
Fungal infection of the joints ## Footnote Usually as an extension of fungal osteomyelitis.
91
What viral infection is associated with transient polyarthritis in kittens?
Calicivirus
92
What is the classification of immune-mediated nonerosive polyarthritis (IMPA)?
Erosive or nonerosive based on joint destruction
93
What accounts for about 25% of all nonerosive IMPA cases?
Reactive polyarthritis
94
What conditions can lead to reactive polyarthritis?
* Chronic bacterial infections * Fungal infections * Rickettsial infections * Neoplasia * Drug administration
95
What is the most common form of polyarthritis diagnosed in dogs?
Idiopathic immune-mediated nonerosive polyarthritis
96
What is the typical age range for dogs affected by idiopathic IMPA?
2.5 to 4.5 years
97
What are common clinical signs of idiopathic IMPA?
* Cyclic fever * Stiffness * Lameness
98
What is typically found in synovial fluid analysis of idiopathic IMPA?
* Increased nucleated cell counts * Nondegenerate neutrophils predominating (>80%)
99
What are the common treatments for reactive polyarthritis?
* Short-term low-dose glucocorticoids * NSAIDs
100
What is demonstrated by joint and periarticular swelling in the absence of bone or cartilage abnormalities?
Idiopathic immune-mediated polyarthritis (IMPA) ## Footnote IMPA is characterized by inflammation of the synovial membrane and increased synovial fluid production.
101
What is the typical viscosity of synovial fluid in cases of idiopathic IMPA?
Decreased viscosity and may be turbid
102
What is the range of nucleated cell counts in synovial fluid for idiopathic IMPA?
4000-370,000 cells/µL
103
What type of cells predominates in the synovial fluid of dogs with idiopathic IMPA?
Nondegenerate neutrophils (>80%)
104
True or False: Blood, urine, and synovial fluid cultures are positive for bacteria and Mycoplasma spp. in idiopathic IMPA.
False
105
What empirical treatment is usually initiated while awaiting diagnostic testing results for infectious causes of polyarthritis?
Doxycycline
106
What is the initial treatment of choice for dogs with idiopathic IMPA?
Glucocorticoids
107
What percentage of cases may achieve remission with prednisone treatment alone?
50%
108
How often should the dosage of glucocorticoids be decreased if the animal is clinically normal?
Every 3 to 4 weeks
109
What is the gold standard for response to therapy in idiopathic IMPA?
Resolution of synovial inflammation
110
What additional immunosuppressive drug is often used for dogs with persistent synovial fluid inflammation despite prednisone therapy?
Azathioprine (Imuran)
111
What is the initial dosage of azathioprine for dogs?
2.2 mg/kg PO once daily for 4 to 6 weeks
112
What is the most common adverse effect of azathioprine?
Myelosuppression
113
How often should a CBC and platelet count be performed during azathioprine treatment?
Initially every 2 weeks, then every 4 to 8 weeks
114
Which additional drugs have been shown to be effective add-on treatments for idiopathic IMPA in dogs?
* Leflunomide * Mycophenolate mofetil * Cyclosporine * Cyclophosphamide
115
What is the prognosis for animals with idiopathic immune-mediated nonerosive polyarthritis?
Good in most cases
116
What percentage of dogs respond well to initial treatment for idiopathic IMPA?
Approximately 80%
117
What should be considered if a dog with polyarthritis is refractory to treatment?
Reevaluation for infectious disease, reactive polyarthritis, and erosive disease
118
What is Systemic Lupus Erythematosus (SLE)?
A multisystemic immune-mediated disorder
119
What are the common clinical manifestations of SLE in dogs?
* Intermittent fever * Polyarthritis * Glomerulonephritis * Skin lesions * Hemolytic anemia * Immune-mediated thrombocytopenia * Myositis * Polyneuritis
120
What percentage of dogs diagnosed with SLE exhibit polyarthritis?
70% to 90%
121
What is the typical synovial fluid WBC count in SLE polyarthritis?
5000-350,000/mL
122
What tests may aid in the diagnosis of SLE polyarthritis?
* LE cell test * Antinuclear antibody (ANA) test
123
What is the prognosis for dogs with SLE?
Guarded to poor
124
What type of polyarthritis is associated with certain dog breeds like Akitas and Newfoundlands?
Heritable polyarthritis
125
What is Familial Chinese Shar-Pei Fever also known as?
Shar-Pei Autoinflammatory Disease (SPAID)
126
What genetic mutation is associated with Familial Chinese Shar-Pei Fever?
A missense mutation promoting proinflammatory reactions
127
What is a common treatment for Familial Chinese Shar-Pei Fever?
Oral colchicine (0.03 mg/kg q24h)
128
What is lymphoplasmacytic synovitis associated with?
Partial and complete tears of the cranial cruciate ligament
129
What is the predominant cell type in synovial fluid of dogs with lymphoplasmacytic synovitis?
Lymphocytes and plasma cells (60%-90%)
130
What is the recommended treatment for dogs diagnosed with lymphoplasmacytic synovitis?
Surgical stabilization of the stifle and treatment with NSAIDs
131
What is canine rheumatoid-like polyarthritis?
A disorder resembling human rheumatoid arthritis, causing erosive polyarthritis and progressive joint destruction in dogs, particularly small and toy breeds.
132
Which dog breeds are commonly affected by canine rheumatoid-like polyarthritis?
* Cocker Spaniels * Shetland Sheepdogs
133
What is the age of onset for canine rheumatoid-like polyarthritis?
Variable, from 9 months to 13 years, but most cases are in young or middle-aged dogs.
134
What are the initial clinical signs of canine rheumatoid-like polyarthritis?
Signs indistinguishable from other forms of polyarthritis, including low-grade fever, depression, anorexia, and reluctance to exercise.
135
What joints are most commonly affected in canine rheumatoid-like polyarthritis?
* Carpi * Hocks * Phalanges * Stifles * Elbows * Shoulders
136
What is the significance of rheumatoid factors (RFs) in canine rheumatoid-like polyarthritis?
Antibodies against IgG form and complex with IgG in the synovium, leading to inflammation and joint destruction.
137
What is the typical synovial fluid appearance in affected dogs?
Thin, cloudy, and hypercellular with increased total nucleated cell count (TNCC).
138
What is the treatment regimen for canine rheumatoid-like polyarthritis?
* Oral prednisone * Azathioprine * Chondroprotective agents
139
What is a common radiographic finding in dogs with rheumatoid-like polyarthritis?
Focal, irregular, radiolucent, cyst-like areas of subchondral bone destruction.
140
True or False: Erosive changes are common in the carpus at the time of diagnosis.
True
141
What is a key diagnostic method for canine rheumatoid-like polyarthritis?
Synovial fluid analysis showing neutrophils as the predominant cell type.
142
What is the role of Leflunomide in treatment?
It has been reported to be effective as monotherapy in some dogs with idiopathic polyarthritis.
143
What is the age range for erosive immune-mediated polyarthritis in Greyhounds?
3 to 30 months of age.
144
What are common clinical signs of erosive polyarthritis in Greyhounds?
* Generalized stiffness * Joint pain or swelling * Intermittent lameness
145
What are the two uncommon immune-mediated disorders affecting cats?
* Periosteal proliferative polyarthritis * Deforming arthritis resembling RA
146
What are the initial clinical signs of feline periosteal proliferative polyarthritis?
* Fever * Stiff gait * Joint pain * Lymphadenopathy * Edema of skin and soft tissues
147
What is the treatment for feline periosteal proliferative polyarthritis?
* Glucocorticoids (prednisolone or prednisone) * Analgesics
148
What is the typical radiographic finding in feline periosteal proliferative polyarthritis?
Mild periarticular soft tissue swelling and periosteal proliferation initially, worsening over time.
149
Fill in the blank: The pathogenesis of canine rheumatoid-like polyarthritis is _______.
[poorly understood]
150
What is the common outcome of rheumatoid arthritis treatment in dogs?
Most dogs show deterioration with time despite appropriate therapy.
151
What is a common surgical procedure used to improve joint stability in dogs with RA?
* Synovectomy * Arthroplasty * Joint replacement * Arthrodesis
152
What is the onset of feline rheumatoid-like arthritis?
Insidious onset with slow development of lameness, stiffness, and joint deformity over weeks to months.
153
Which age group of cats is primarily affected by feline rheumatoid-like arthritis?
Middle-aged and older cats.
154
Which breed of cats may be predisposed to feline rheumatoid-like arthritis?
Siamese cats.
155
Do systemic illness and fever usually occur in feline rheumatoid-like arthritis?
No, they do not usually occur.
156
What does synovial fluid analysis reveal in cases of feline rheumatoid-like arthritis?
Mild to moderate mixed inflammation.
157
What are the radiographic findings in feline rheumatoid-like arthritis?
Severe subchondral central and marginal erosions, and periarticular swelling that progresses to extensive bone destruction and gross joint deformities.
158
When should rheumatoid-like arthritis be suspected in cats?
Once infectious causes have been eliminated and a treatment trial with doxycycline has been ineffective.
159
What serologic tests are commonly positive in cats with rheumatoid-like arthritis?
Tests for circulating RF using the canine Rose-Waaler or ELISA test.
160
Is a positive serologic test essential for the diagnosis of feline rheumatoid-like arthritis?
No, a positive test is not essential for diagnosis.
161
Is feline rheumatoid-like arthritis a reversible disease?
No, it is aggressive, destructive, and irreversible.
162
What is the typical response of cats to treatment with NSAIDs or glucocorticoids?
Most cats have only a minimal response.
163
What combination of medications has shown remarkable improvement in some cats with rheumatoid-like arthritis?
Methotrexate in combination with leflunomide.
164
What other treatment options should be considered for feline rheumatoid-like arthritis?
Other potent immunosuppressive agents.
165
Which analgesics may be used concurrently to make affected cats more comfortable?
* Amantadine (3 mg/kg PO q24h) * Amitriptyline (0.5-2 mg/kg PO q24h) * Gabapentin (2-10 mg/kg PO q24h)
Nelson and Couto
flashcards
Decks in class (14)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions