1、Craniomandibular Osteopathy & Calvarial Hyperostosis,Christina Copple, DVM Radiology Resident NCSU CVM-VTH Accession #97223,Craniomandibular Osteopathy (CMO),Occurrence most commonly in young terrier breeds West Highland white autosomal recessive inheritance Scottish terriers Cairn terriers Boston t
2、erriers Nonterrier breeds include: Labrador Retriever & Doberman Pinscher Bullmastiffs Calvarial Hyperostosis,http:/ unknown Clinical signs seen at 3 8 months Mandibular swelling Difficulty prehending food Drooling Pain on opening of the mouth Physical exam- firm and often painful swelling of the ma
3、ndible and/or the temporomandibular region; pyrexia may be noted Rarely involves long bone, but in terriers lameness or limb swelling may precede changes in the skull If severe = restricted jaw movements (if fusion between the tympanic bullae & angular processes of the mandible) and masticatory musc
4、le atrophy,Craniomandibular Osteopathy (CMO),Proliferative bone disease increased bone opacity Non-neoplastic Bones of endochondral origin = occipital bone, tympanic bullae and mandibular rami Bilateral but asymmetric irregular new bone of mandible and tympanic bulla-petrous temporal bone May see co
5、nfinement to a specific region either mandible or tympanic bulla-petrous temporal area Calvarium and tentorium ossium are often thickened,Craniomandibular Osteopathy (CMO),http:/ 6th ed. Volume 2; pg 1977,(Note: also good radiographic images in Thrall 5th ed. 2007; pg 137),Diagnosis: signalment, cli
6、nical signs, radiographic or CT findings In atypical cases (rarely affected breeds or unilateral lesions) bone biopsy may be helpful Self-limiting abnormal bone proliferation slows, becoming static at skeletal maturity (1yr of age) Lesions may regress but radiographic abnormalities or prehensile dys
7、function may remain Guarded prognosis if changes to affected areas are severe with ankylosis and adhesions that permanently restrict jaw movement,Craniomandibular Osteopathy (CMO),CMO Literature Review,Computed Tomography of Craniomandibular Osteopathy in a Dog,Cites reports of CMO in Great Dane, Bo
8、xer, and English Bulldog Brief discussion of similarities between CMO and infantile cortical hyperostosis or Caffey-Silverman syndrome in humansCT to determine extent of osseous involvement of tympanic bullae and angular processes of the mandibleElevations in serum ALP may coincide with periods of a
9、ctive diseaseIn this case, lameness preceded involvement of skull. Presentation of a young Westie or Scottish terrier with periosteal involvement of the long bones may indicate future development of CMO. Recommend that these patients be monitored for changes consistent with CMO.,VetRadUS, Vol. 35:2,
10、 1994. pp 94-99,CMO Literature Review,Canine Craniomandibular Osteopathy Journal of the Veterinary Radiology Society 1967; 8:23-31. Good review of history, histopathologic changes, embryology of mandible, temporal bones, tympanic bullae and jaw Summary of observations in 18 dogs (all terrier breeds)
11、 with craniomandibular osteopathy Clinical signs Radiographic signs Laboratory findings Gross anatomical appearance of skull lesions Microscopic description of bone changes,A syndrome of young male & female Bullmastiffs 6 months of age Etiology unknown Benign hyperostosis of frontal and parietal bon
12、es lesion localization is characteristic of the disease Other findings may include: Painful boney swelling of skull Lymphadenopathy Eosinophilia Pyrexia,Calvarial Hyperostosis,http:/www.dog-breed- of CMO? Histologically calvarial hyperostosis is a primarily inflammatory subperiosteal or periosteal d
13、isease With CMO the inflammatory component is variable, shows primarily irregular deposition & resorption of bone Main differentiating feature of calvarial hyperostosis from CMO is the lack of mandibular involvement Like CMO, calvarial hyperostosis is a self-limiting condition with regression of the
14、 lesions by skeletal maturity,Calvarial Hyperostosis,Smooth thickening of mandibular cortices with increased medullary opacity in the caudal mandibles and poor corticomedullary distinction. Sclerotic thickening of the frontal and parietal bones. Accession #97223,Calvarial Hyperostosis Literature Rev
15、iew,Calvarial Hyperostosis Syndrome in Two Bullmastiffs,Calvarial Hyperostosis Syndrome is not a sex-linked syndromePurported association with osteomyelitis first case had limb involvement that rapidly improved after addition of antibioticsMRI of second case findings similar to radiographs; loss of
16、fat from bone marrow is a relatively nonspecific change = fibrosis, sclerosis, hemosiderosis, or marrow infiltrate/replacement,References,Ettinger, Stephen J. and Edward C. Feldman. Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat. 6th ed. Volume 2. Elsevier. St. Louis, MO:2005.
17、pp1976-1980. Thrall, Donald E., DVM, PhD. Textbook of Veterinary Diagnostic Radiology. 5th ed. Saunders. St. Louis, MO:2007. pp135-136. Hudson, Judith A., DVM, PhD, Ron D. Montgomery, DVM, MS, John T. Hathcock, DVM, MS, and Joli M. Jarboe, DVM. Computed Tomography Of Craniomandibular Osteopathy In A
18、 Dog. Veterinary Radiology & Ultrasound 35:2, 1994. pp94-99. Riser, Wayne H., D.V.M., M.S., Lincoln J. Parkes, D.V.M., and Jane F. Shirer, B.S., M.A. Canine Craniomandibular Osteopathy. Journal of the Veterinary Radiology Society 8, 1967. pp23-31. McConnell, J. F., A. Hayes, S. R. Platt, and K. C. S
19、mith. Calvarial Hyperostosis Syndrome In Two Bullmastiffs. Veterinary Radiology & Ultrasound 47:1, 2006. pp72-77. Fischetti, Anthony J., DVM, MS, DACVR, Ana Lara-Garcia, DVM, PhD, and Steven Gross, VMD. What Is Your Diagnosis? Journal of the American Veterinary Association 229:2, July 2006. pp211-212.,
