Displasia do cotovelo: diagnóstico imagiológico da displasia do cotovelo
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2015
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A displasia do cotovelo (DC) é uma síndrome, comum em cães de raça grande e gigante, que causa artrite e claudicação.
Existem quatro doenças reconhecidas que podem fazer parte do grupo das “displasias do cotovelo”: doença do coronóide medial (DCM), osteocondrose (OC), não união do processo ancóneo (NUPA) e incongruência (INC) articular. Independentemente da entidade, todas elas causam osteoartrite irreversível da articulação do cotovelo. A sua etiopatogenia ainda não está bem reconhecida, mas tem sido sugerido que a OC, várias incongruências articulares e uma incompatibilidade de forças biomecânicas desempenham um papel importante. Todas estas causas ocorrem com uma predisposição genética, em conjunto com fatores ambientais secundários, tais como: dietas energéticas, taxas de crescimento rápidas, trauma e isquémia. O diagnóstico é baseado essencialmente no exame ortopédico, e em exames imagiológicos, como a radiografia, tomografia computorizada (TC), artroscopia, ressonância magnética, cintigrafia e ecografia.
O principal objetivo deste estudo é demonstrar qual o método de diagnóstico mais adequado para cada caso clínico.
No presente trabalho são descritos quatro casos clínicos de displasia que foram acompanhados ao longo do período de estágio no hospital veterinário da Universidade de Gante. Destes quatro casos, o primeiro apresentava DCM e INC articular. O segundo NUPA e INC articular. O terceiro DCM e panosteíte, e o último, DCM, NUPA e ainda INC articular. Nestes quatro casos é descrito o exame clínico/ortopédico e exames complementares para o diagnóstico da displasia, tais como radiografia, TC e artroscopia.
Com base nos casos clínicos é possível concluir que ocorreu uma predominância de 100% machos em relação a fêmeas. A idade média dos animais afetados é de 15 meses. O Pastor alemão apresenta-se como uma raça predisposta para a DC. A TC revela um grande detalhe para as estruturas ósseas e elimina problemas de sobreposição associados à radiografia. A artroscopia permite uma avaliação da cartilagem articular e, além de ser um método de diagnóstico preciso e definitivo, apresenta em simultâneo uma elevada capacidade terapêutica.
In large-to-giant breed dogs, elbow dysplasia (ED) is a common syndrome that causes arthritis and lameness. Elbow dysplasia is defined by four diseases: medial coronoid disease (MCD), osteochondrosis (OC), ununited anconeal process (UAP) and incongruity (INC) of the elbow joint. Regardless of the disease, all of them cause irreversible osteoarthritis of elbow articulation. The etiopathogenesis is not well known yet, but three mechanisms have been suggested for the development of elbow dysplasia including OC, various joint incongruities, and a biomechanical force mismatch across the elbow joint. Environmental factors and a complex genetic heritability play a role in predisposing dogs to elbow dysplasia. In addition, factors such as energetic diets, fast growth rates, trauma and ischaemia, could also be responsible for this disease. The diagnosis of the ED is primarily based on orthopedic examination, supported by imaging, namely radiography, computerize tomography (CT), arthroscopy, magnetic resonance imaging, scintigraphy and ultrasound. The main goal of my study is to show which diagnostic method was the best for each clinical case. During my stay in Belgium, I studied four cases of animals at the veterinary hospital of Gent University, which will then be exhibited. The first one, showed MCD and joint INC. The second was affected by UAP and joint INC. The third showed MCD and panosteitis, and the last one, MCD, UAP and still joint INC. In each case, it is described the clinical/orthopedic examination, as well as the imaging tests for the diagnosis of the disease (i.e. radiography, CT and arthroscopy). Data showed that it can be concluded there was a prevalence of 100% males compared to females. The mean age of the animals affected was 15 months. The German shepherd is presented as a breed prone to ED. The CT scan provides a high detailed view of the bone structures and eliminates overlapping problems associated with radiography. Arthroscopy allows an evaluation of the articular cartilage and, besides being a precise and definitive diagnostic method, exhibits a high therapeutic capacity.
In large-to-giant breed dogs, elbow dysplasia (ED) is a common syndrome that causes arthritis and lameness. Elbow dysplasia is defined by four diseases: medial coronoid disease (MCD), osteochondrosis (OC), ununited anconeal process (UAP) and incongruity (INC) of the elbow joint. Regardless of the disease, all of them cause irreversible osteoarthritis of elbow articulation. The etiopathogenesis is not well known yet, but three mechanisms have been suggested for the development of elbow dysplasia including OC, various joint incongruities, and a biomechanical force mismatch across the elbow joint. Environmental factors and a complex genetic heritability play a role in predisposing dogs to elbow dysplasia. In addition, factors such as energetic diets, fast growth rates, trauma and ischaemia, could also be responsible for this disease. The diagnosis of the ED is primarily based on orthopedic examination, supported by imaging, namely radiography, computerize tomography (CT), arthroscopy, magnetic resonance imaging, scintigraphy and ultrasound. The main goal of my study is to show which diagnostic method was the best for each clinical case. During my stay in Belgium, I studied four cases of animals at the veterinary hospital of Gent University, which will then be exhibited. The first one, showed MCD and joint INC. The second was affected by UAP and joint INC. The third showed MCD and panosteitis, and the last one, MCD, UAP and still joint INC. In each case, it is described the clinical/orthopedic examination, as well as the imaging tests for the diagnosis of the disease (i.e. radiography, CT and arthroscopy). Data showed that it can be concluded there was a prevalence of 100% males compared to females. The mean age of the animals affected was 15 months. The German shepherd is presented as a breed prone to ED. The CT scan provides a high detailed view of the bone structures and eliminates overlapping problems associated with radiography. Arthroscopy allows an evaluation of the articular cartilage and, besides being a precise and definitive diagnostic method, exhibits a high therapeutic capacity.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Osteoartrite , Articulação do cotovelo , Diagnóstico radiográfico , Tomografia computadorizada por raios X , Artroscopia , Displasia do cotovelo