Primary and concomitant flexor enthesopathy of the canine elbow

E. de Bakker; I. Gielen; J.H. Saunders; I. Polis; S. Vermeire; K. Peremans; J. Dewulf; H. van Bree; B. Van Ryssen

doi:10.3415/VCOT-12-02-0025

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2013; 26(06): 425-434
DOI: 10.3415/VCOT-12-02-0025

Original Research

Schattauer GmbH

Primary and concomitant flexor enthesopathy of the canine elbow

A phantom study

Authors

E. de Bakker

¹Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Merelbeke, Belgium
I. Gielen

¹Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Merelbeke, Belgium
J.H. Saunders

¹Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Merelbeke, Belgium
I. Polis

²Department of Small Animal Medicine and Clinical Biology, Ghent University, Merelbeke, Belgium
S. Vermeire

¹Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Merelbeke, Belgium
K. Peremans

¹Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Merelbeke, Belgium
J. Dewulf

³Department of Reproduction, Obstetrics and Herd Health, Ghent University, Merelbeke, Belgium
H. van Bree

¹Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Merelbeke, Belgium
B. Van Ryssen

¹Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Merelbeke, Belgium

Abstract

Summary

Objectives: To report the characteristics of two types of flexor enthesopathy, primary and concomitant, based on different diagnostic techniques.

Materials and methods: Over a period of three years a prospective study was performed on dogs admitted for the complaint of elbow lameness. Based on the radiographic findings a selection of dogs underwent a complete series of different imaging modalities. With each technique, pathology of the medial epicondyle and the presence of other elbow disorders were recorded. All joints with signs of flexor pathology apparent with at least three techniques were selected. A distinction was made between primary and concomitant flexor enthesopathy based on the absence or presence of other elbow disorders.

Results: Primary flexor enthesopathy was diagnosed in 23 joints and concomitant flexor enthesopathy in 20 joints. In 43% of the joints with primary and in 75% of the joints with concomitant flexor enthesopathy, pathology at the medial epicondyle was demonstrated by all techniques. All joints with concomitant flexor enthesopathy had a diagnosis of medial coronoid disease, osteochondritis dissecans, or both.

Clinical significance: Pathology at the medial epicondyle is a sign of flexor enthesopathy. It may be present as the only sign in a joint with primary flexor enthesopathy or concomitant with other elbow pathology. In both groups flexor lesions can be demonstrated with different imaging techniques. The distinction between the primary and concomitant form is based on the presence or absence of other elbow pathology, mainly medial coronoid disease. Recognizing both types is important for a correct treatment decision.

Keywords

Flexor enthesopathy - primary - concomitant - elbow - dog

Full Text

References

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