Elbow lameness in dogs of six years and older

Summary

Objectives: To report on the frequency and distribution of lesions of the medial coronoid process in dogs of six years of age and older, and to describe the arthroscopic findings in the affected joints. To compare those lesions seen in ‘old’ dogs with those seen in ‘young’ dogs between the ages of five and 18 months.

Methods: A retrospective study of dogs six-years-old and older admitted for elbow lameness and subsequent elbow arthroscopy. The dogs were divided into groups according to the lesions of the medial coronoid process diagnosed during arthroscopic examination and computed tomography (CT). The radio-graphic degree of osteoarthritis (OA) and arthroscopically diagnosed lesions on the medial humeral condyle are described.

Results: In 51 ‘old’ dogs, five types of lesions could be identified on arthroscopy and CT: chondromalacia-like lesions (2%), fissures (27.5%), non-displaced fragments (12%), displaced fragments (27.5%), and erosions within the medial compartment without fragmentation (31%). A significantly different distribution of lesions was seen in ‘young’ dogs: fissures (23%), non-displaced fragments (45%), displaced fragments (29%), and erosions within the medial compartment without fragmentation (3%). No difference in radio-graphic degree of OA was seen between the two groups.

Clinical significance: This study demonstrates the relatively high incidence of medial coronoid disease in dogs older than six years of age, and it highlights one particular problem in ‘old’ dogs: the complete erosion of the medial compartment.

Keywords

Elbow joint - arthroscopy - medial coronoid process - old dogs

• Reference List

• 1 Hazewinkel HAW.. Clinical investigation and treatment of elbow problems in the dog. Proceedings of the 14th annual meeting of the International Elbow Working Group. 2003. May 22 Estoril, Portugal:
• 2 Grondalen J.. Arthrosis with special reference to the elbow joint of young rapidly growing dogs. II. Occurrence, clinical and radiographical findings. Nord Vet Med 1979; 31: 69-75.
• 3 Grondalen J, Grondalen T.. Arthrosis in the elbow joint of young rapidly growing dogs. V. A pathoanatomical investigation. Nord Vet Med 1981; 33: 1-16.
• 4 Olsson SE.. The early diagnosis of fragmented coronoid process and osteochondritis dissecans of the canine elbow joint. J Am Anim Hosp Assoc 1983; 19: 616-626.
• 5 Wind AP, Packard ME.. Elbow incongruity and developmental elbow diseases in the dog .2. J Am Anim Hosp Assoc 1986; 22: 725-730.
• 6 Meyer-Lindenberg A, Fehr M, Nolte I.. Co-existence of ununited anconeal process and fragmented medial coronoid process of the ulna in the dog. J Small Anim Pract 2006; 47: 61-65.
• 7 Van Ryssen B, Van Bree H.. Arthroscopic findings in 100 dogs with elbow lameness. Vet Rec 1997; 140: 360-362.
• 8 Mason DR, Schulz KS, Fujita Y. et al. Measurement of humeroradial and humeroulnar transarticular joint forces in the canine elbow joint after humeral wedge and humeral slide osteotomies. Vet Surg 2008; 37: 63-70.
• 9 Schulz KS, Krotscheck U.. Canine elbow dysplasia. In: Textbook of Small Animal Surgery (3rd ed.) Douglas Slatter (editor). W. B. Saunders; Philadelphia: 2009: 1927-1952.
• 10 Fitzpatrick N, Smith TJ, Evans RB. et al. Radio-graphic and arthroscopic findings in the elbow joints of 263 dogs with medial coronoid disease. Vet Surg 2009; 38: 213-223.
• 11 Hazewinkel HA.. Elbow dysplasia; clinical aspects and screening programs. Proceedings of the 28^th World Congress of the World Small Animal Veterinary Association; 2003 Oct 24; Bangkok, Thailand 2003
• 12 Fitzpatrick N, Smith TJ, Evans RB. et al. Subtotal coronoid ostectomy for treatment of medial coronoid disease in 263 dogs. Vet Surg 2009; Feb 38: 233-245.
• 13 Meyer-Lindenberg A, Langhann A, Fehr M. et al. Prevalence of fragmented medial coronoid process of the ulna in lame adult dogs. Vet Rec 2002; 151: 230-234.
• 14 Flo GL.. Surgical removal of fragmented coronoid processes and fractured anconeal process in an older dog with evidence of severe degenerative joint disease. J Am Vet Med Assoc 1998; 213: 1780-1782.
• 15 Samoy Y, Van Ryssen B, Van Caelenberg A. et al. An atypical case of fragmented medial coronoid process in a dog. Vlaams Diergeneesk Tijdschr 2005; 74: 154-161.
• 16 Henry Jr. WB. Radiographic diagnosis and surgical management of fragmented medial coronoid process in dogs. J Am Vet Med Assoc 1984; 184: 799-805.
• 17 Lewis DD, Parker RB, Hager DA.. Fragmented medial coronoid process of the canine elbow. Compend Contin Educ Veterinarian Pract Vet 1989; 11: 703.
• 18 De Rycke LM, Gielen IM, van Bree H. et al. Computed tomography of the elbow joint in clinically normal dogs. Am J Vet Res 2002; Oct 63: 1400-1407.
• 19 Reichle JK, Park RD, Bahr AM.. Computed tomo-graphic findings of dogs with cubital joint lameness. Vet Radiol Ultrasound 2000; 41: 125-130.
• 20 Snaps FR, Balligand MH, Saunders JH. et al. Comparison of radiography, magnetic resonance imaging, and surgical findings in dogs with elbow dysplasia. Am J Vet Res 1997; 58: 1367-1370.
• 21 Carpenter LG, Schwarz PD, Lowry JE. et al. Comparison of radiologic imaging techniques for diagnosis of fragmented medial coronoid process of the cubital joint in dogs. J Am Vet Med Assoc 1993; 203: 78-83.
• 22 Van Ryssen B, Van Bree H, Missinne S.. A Survey of 200 Arthroscopies in 150 Dogs and Cats. Vlaams Diergeneesk Tijdschr 1993; 62: 87-94.
• 23 Meyer-Lindenberg A, Langhann A, Fehr M. et al. Arthrotomy versus arthroscopy in the treatment of the fragmented medial coronoid process of the ulna (FCP) in 421 dogs. Vet Comp Orthop Traumatol 2003; 16: 204-210.
• 24 Van Ryssen B, Van Bree H, Simoens P.. Elbow Arthroscopy in Clinically Normal Dogs. Am J Vet Res 1993; 54: 191-198.
• 25 Moores AP, Benigni L, Lamb CR.. Computed tomography versus arthroscopy for detection of canine elbow dysplasia lesions. Vet Surg 2008; 37: 390-398.
• 26 International Elbow Working Group. Guidelines for radiographic examination and interpretation of the elbow joint. Proceedings of the 2nd Annual Meeting San Francisco, California, USA. 1990; Mar 29; 1990.
• 27 Fox SM, Roberts RE.. Linear tomography in diagnosing fragmented coronoid processes in canine elbows. Compend Contin Educ Veterinarian Pract Vet 1987; Jan 9: 60-65.
• 28 Mason TA, Lavelle RB, Skipper SC. et al. Osteochondrosis of the elbow joint in young-dogs. J Small Anim Pract 1980; 21: 641-656.
• 29 Everts RE, Hazewinkel HAW, Rothuizen J. et al. Bone disorders in the dog: A review of modern genetic strategies to find the underlying causes. Vet Q 2000; 22: 63-70.
• 30 Berzon JL, Quick CB.. Fragmented coronoid process – anatomical, clinical, and radiographic considerations with case analyses. J Am Anim Hosp Assoc 1980; 16: 241-251.
• 31 Boulay JP.. Fragmented medial coronoid process of the ulna in the dog. Vet Clin North Am Small Anim Pract 1998; 28: 51-74.
• 32 Hazewinkel HAW, Ubbink GJ.. Elbow dysplasia in the Dutch Bernese Mountain dog population. Proceedings of the International Elbow Working Group. 1999. Jan 8 Orlando, Florida, USA:
• 33 Read A, Armstrong SJ, Black AP. et al. Relationship between physical signs of elbow dysplasia and radiographic score in growing Rottweilers. J Am Vet Med Assoc 1996; 209: 1427-1430.
• 34 Fitzpatrick N, Yeadon R, Smith T. et al. Techniques of application and initial clinical experience with sliding humeral osteotomy for treatment of medial compartment disease of the canine elbow. Vet Surg 2009; 38: 261-278.
• 35 Meyer-Lindenberg A, Heinen V.. Therapy and results of chondromalacia like lesions and cartilage abrasions in the canine elbow joint. Proceedings of the 47th BSAVA Congress. 2004. April 1-4 Birmingham, UK:
• 36 Danielson KC, Fitzpatrick N, Muir P. et al. Histomorphometry of fragmented medial coronoid process in dogs: A comparison of affected and normal coronoid processes. Vet Surg 2006; 35: 501-509.
• 37 Kirberger RM, Fourie SL.. Elbow dysplasia in the dog: pathophysiology, diagnosis and control. J S Afr Vet Assoc 1998; 69: 43-54.
• 38 Walde I, Tellhelm B.. Fragmented medial coronoid process of the ulna (Fcp) and osteochondritisdDissecans (Ocd) of the canine elbow-joint and hock-joint – literature-review, diagnosis and therapy. Wien Tierarztl Monatsschr 1991; 78: 414-424.
• 39 Punke JP, Hulse DA, Kerwin SC. et al. Arthroscopic documentation of elbow cartilage pathology in dogs with clinical lameness without changes on standard radiographic projections. Vet Surg 2009; 38: 209-212.