COMPARISON OF THE ULTRASONOGRAPHIC APPEARANCE OF OSTEOCHONDROSIS LESIONS IN THE CANINE SHOULDER WITH RADIOGRAPHY, ARTHROGRAPHY, AND ARTHROSCOPY

Osteochondrosis lesions in 29 shoulder joints (from 20 dogs) were evaluated with ultrasound (US) and the results were compared with survey radiography, arthrography, and arthroscopy. US was performed with a 7-12 MHz linear matrix transducer which was placed in cranio-caudal direction just distally to the acromion while the joint was adducted and maximally endorotated to visualize the caudal aspect of the humeral head. With US, the subchondral defect was completely visible in 21 joints and partially visible in 8 joints. The length of the subchondral defect measured on US was comparable with the length measured on survey radiographs. In two joints, the cartilage flap was mineralized and thus already visible on survey radiographs. The mineralized flap was visible on US as a straight hyperechoic line above the subchondral defect. In the other joints, survey radiographs could not assess the status of the articular cartilage. In 17 joints, the presence of a cartilage flap or cartilage fissuring was suspected based on the presence of a second hyperechoic line at the base of the subchondral defect, and this suspicion was confirmed by arthroscopic examination in 16 joints and also by arthrographic examination in 15 joints. One joint that was suspected of having a cartilage flap on US was normal on arthroscopy and arthrography. When US revealed only focal thickening of the anechoic cartilage layer (5 joints), the joints appeared normal on arthroscopic and arthrographic examination. Of the four joints where the subchondral defect was irregular and covered by heteroechogeneous material on US, arthroseopy revealed the presence of a lesion resembling chondromalacia in two joints, the presence of a small cartilage flap in one joint and the presence of scar tissue underneath the flap at the level of the subchondral defect in one joint. In conclusion, US is a helpful imaging modality in the identification of osteochondritic lesions in the canine shoulder joint. US also appears to be a satisfactory imaging tool for identifying lesions such as joint mice, joint effusion, and distinct new bone formation.     

Comparison of two caudolateral approaches to the scapulohumeral joint for treatment of osteochondritis dissecans in dogs

Two caudolateral approaches to the canine scapulohumeral joint that do not require myotomy, tenotomy, or osteotomy were used to expose the humeral heads of both scapulohumeral joints in 10 clinically normal dogs. One approach (method 1) was used on the left shoulder of 5 dogs and on the right shoulder of the other 5 dogs. The other approach (method 2) was used on the opposite joints. The amount of humeral head articular cartilage that could be exposed with each approach was measured. The amount of articular cartilage exposed with method 1 was significantly greater than that exposed with method 2 (P less than 0.0001). Method 1 also provided for exposure of the caudomedial aspect of the scapulohumeral joint. Method 1 was used unilaterally in 20 dogs with osteochondritis dissecans. This approach provided excellent exposure of the humeral head and osteochondritis dissecans lesion. Of the 16 dogs that were available for follow-up evaluation, 1 developed a seroma after surgery. Other complications were not observed or reported.     

Osteochondritis dissecans of the canine stifle joint

In fourteen dogs with osteochondritis dissecans of the stifle joint the lesion was found in the articular cartilage of the medial condyle of the femur in six and the lateral condyle in eight. Both stifle joints were affected in eight dogs and in two of these, both Wolfhounds, the shoulder joints were also affected. Ten dogs were treated surgically and three by conservative means. The results of treatment are discussed.     

Evaluation of a method for experimental induction of osteoarthritis of the hip joints in dogs

OBJECTIVE: To evaluate a method for experimental induction of osteoarthritis in the hip joints of dogs. ANIMALS: 12 mixed-breed dogs. PROCEDURE: A unilateral triple pelvic osteotomy was performed. In 6 dogs, the iliac osteotomy was repaired with 45 degrees of internal rotation, reducing coverage of the femoral head by the acetabulum. In the other 6 dogs, the fragments were repaired in anatomic alignment. Radiography, force plate evaluations, and subjective lameness evaluations were performed before and after surgery. Dogs were euthanatized 7 months after surgery, and samples of cartilage and joint capsule were examined histologically. RESULTS: Subjective lameness scores, radiographic appearance of the hip joints, and Norberg angles were not significantly different between groups; however, force plate evaluations did reveal significant differences in vertical ground reaction forces. Femoral head coverage was significantly decreased with rotation of the acetabulum. Mild inflammatory changes were discernible in the joint capsule and articular cartilage of some dogs in both groups. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that 45 degrees internal rotation of the acetabulum does not consistently induce biologically important osteoarthritic changes in the hip joints of dogs.     

OSTEOCHONDROSIS LESIONS OF THE CANINE SHOULDER: CORRELATION OF POSITIVE CONTRAST ARTHROGRAPHY AND ARTHROSCOPY

In this study the correlation between positive contrast arthrography and arthroscopy was evaluated in a series of 20 shoulder joints (12 dogs) with radiographic and clinical evidence of osteochondrosis. The joints were consecutively examined by arthrography and arthroscopy. In 12 joints arthrography revealed the presence of a cartilage flap, and this finding was confirmed by arthroscopy. In 3 out of 8 joints where arthrography failed to demonstrate rupture of the cartilage, arthroscopy revealed the presence of a distinct fissure line. In 2 joints arthroscopy demonstrated a lesion comparable with chondromalacia and in 3 only a dimple in the articular cartilage was found. In 2 joints arthroscopy revealed the presence of small joint mice not detected by arthrography. Kissing lesions on the surface of the glenoid cavity opposite to cartilage flaps could be demonstrated as well. Evaluation of synovial inflammation, judged by the aspect and pattern of the synovial villi, correlated well with histologic findings. These results indicate that arthroscopy is a complementary examination in painful joints where arthrography fails to demonstrate rupture of the articular cartilage. It could be the procedure of choice if diagnostic and surgical arthroscopy can be combined. However, arthrography remains the technique of choice to demonstrate joint mice within the bicipital tendon sheath.     

Primary degenerative joint disease of the shoulder in a colony of beagles

Shoulder joints of 149 Beagles over 8 years old at the time of death (mean age, 13.8 years +/- 3.21), were examined radiographically throughout their life-times for the frequency of degenerative joint disease (DJD). Clinical histories revealed no underlying cause for DJD. The shoulder joints of a subgroup of 18 dogs were examined at necropsy, and thin sections of the joints were evaluated radiographically and histologically. Serial clinical radiographic studies indicated that normal shoulder joint development during the first year of life was followed by the appearance of subchondral bone sclerosis and bony remodeling of normal joint contour, and by the formation of periarticular osteophytes and enthesiophytes. All changes were progressive with age and typical for DJD in dogs. Bilateral involvement was common. Evaluation of specimens obtained at necropsy revealed: articular cartilage change with roughening of the surface layer, degeneration and death of superficial chondrocytes, exposure of deeper layers of chondrocytes that had proliferated with fissuring of the damaged cartilage, total cartilage loss with polishing of the exposed subchondral bone, mixed patterns of subchondral bone sclerosis and osteoporosis, change in contour of the articular surfaces, and formation of periarticular osteophytes and enthesiophytes. Joint capsule thickening, synovitis, pannus formation, and synovial chondroma formation were observed. Because of the available clinical information, in addition to the typical changes of DJD, it was thought that the changes were primary. Instability appeared to play a role in the pathogenesis of the joint disease described; however, it was not clear whether the instability caused abnormal forces on healthy cartilage or whether the primary cartilage wear caused the instability.     

Vacuum phenomenon associated with osteochondrosis of the scapulohumeral joint in dogs: 100 cases (1985-1991).

The vacuum phenomenon was visualized in 20 of 100 scapulohumeral joints with osteochondritic lesions in 65 dogs. The phenomenon was associated with the finding of a cartilage flap, lack of joint effusion, and clinical signs of pain and lameness. The vacuum phenomenon was not observed on radiography of 30 clinically normal contralateral joints, and it could not be induced in 36 clinically normal scapulohumeral joints radiographed under stressed extension.     

Correlation of ultrasonographic observations with anatomic features and radiography of the elbow joint in dogs

OBJECTIVE: To define the ultrasonographic appearance of the elbow joint of dogs and to develop an ultrasonographic imaging protocol to reliably accomplish complete evaluation of that joint. ANIMALS: 11 clinically normal mixed-breed dogs. PROCEDURE: Ultrasonographic observations (by use of a 5 to 10 MHz linear array probe) were made of 22 elbow joints in cadaveric forelimbs from clinically normal dogs. Images in standard anatomic planes were recorded with a multi-image camera, on videotape, or onto a computer. The anatomic plane of the ultrasonographic beam and position of the ultrasonographic probe were also recorded. Dissection of each elbow joint was performed, and anatomic features were correlated with ultrasonographic images. RESULTS: Structures clearly identified ultrasonographically included the lateral and medial humeral epicondyles, the humeroradial and humeroulnar joints, anconeal process, medial coronoid process, hyaline cartilage covering the proximal articular surface of the radius, collateral ligaments, tendons of triceps brachii and supinator muscles, and the supinator tendon and sesamoid in the supinator cartilage. An ultrasonographic imaging protocol for examination of the elbow joint was developed. CONCLUSIONS AND CLINICAL RELEVANCE: Precise correlations were established between the gross anatomic appearance of the elbow joint and the ultrasonographic images of its component structures. The ultrasonographic imaging protocol will enable complete examination of all regions of the joint for detection of pathologic lesions.     

Evaluation of Experimental Transection and Partial Excision of the Caudal Cruciate Ligament in Dogs

The caudal cruciate ligament (CaCL) of one stifle joint in seven dogs was transected and a 2 to 4 mm section was removed. Six months after surgery, none of the dogs were lame. Thigh muscle circumference, stifle range of motion, and internal tibial rotation in the operated limb were not significantly different from the preoperative measurements or the contralateral, unoperated limb. A caudal drawer motion was consistently present in the stifle joints with a transected CaCL. A radiographic evaluation of the operated stifle joints did not reveal osteoarthritic changes; four of seven stifle joints had an irregular fat pad 6 months after surgery. Results of a joint fluid analysis revealed a slight increase in synovial cells within treated stifle joints; inflammatory cells were not observed. The only gross morphologic change in stifle joints with a severed ligament was enlarged knobby remnants of the CaCL. Articular cartilage defects or osteophytes were not observed. Results of a histologic examination of the CaCL remnants revealed synovial cellular capping and intraligamentous fibroplasia. Based on a limited number of dogs, it was concluded that isolated transection of the CaCL produced minimal clinical and pathologic changes in the stifle joint during a 6 month period.     

Distribution of beta-endorphin and substance P in the shoulder joint of the dog before and after a low impact exercise programme

Beta-endorphin and substance P were immunolocalized in the articular cartilage, synovial membrane and fibrous joint capsule of dogs. Twelve adult greyhounds were randomly assigned to one of three groups: control, limited exercise, or regimented exercise. On day 0, biopsies of articular cartilage and joint capsule were obtained from the left shoulder joints of dogs receiving limited and regimented exercise. On day 72, biopsies of joint capsule from right and left shoulders and articular cartilage from the right shoulder joint were analysed for the presence of glycosaminoglycans (GAG) and for immunolocalization of substance P and beta-endorphin. Regimented exercise increased the presence of GAGs and immunolocalization of substance P and beta-endorphin in articular cartilage and synovial membrane compared to day 0 biopsies and untreated controls. Localization of beta-endorphin became prominent in and around the chondrocytes. Substance P was increased in chondrocytes and extracellular matrix. Concomitant changes in localization of beta-endorphin and substance P may have a role in the modulation of the microphysiological environment, metabolism, or function of joint tissues in response to low-impact exercise.     

Evaluation of multiple radiographic predictors of cartilage lesions in the hip joints of eight-month-old dogs

OBJECTIVE: To determine the radiographic methods that best predict the development of osteoarthritis in the hip joints of a cohort of dogs with hip dysplasia and unaffected dogs. ANIMALS: 205 Labrador Retrievers, Greyhounds, and Labrador Retriever-Greyhound crossbred dogs. PROCEDURE: Pelvic radiography was performed when the dogs were 8 months old. Ventrodorsal extended-hip, distraction, and dorsolateral subluxation (DLS) radiographs were obtained. An Orthopedic Foundation for Animals-like hip score, distraction index, dorsolateral subluxation score, and Norberg angle were derived from examination of radiographs. Osteoarthritis was diagnosed at the time of necropsy in dogs > or = 8 months of age on the basis of detection of articular cartilage lesions. Multiple logistic regression was used to determine the radiographic technique or techniques that best predicted development of osteoarthritis. RESULTS: A combination of 2 radiographic methods was better than any single method in predicting a cartilage lesion or a normal joint, but adding a third radiographic method did not improve that prediction. A combination of the DLS score and Norberg angle best predicted osteoarthritis of the hip joint or an unaffected hip joint. All models that excluded the DLS score were inferior to those that included it. CONCLUSIONS AND CLINICAL RELEVANCE: A combination of the DLS score and Norberg angle was the best predictor of radiographic measures in 8-month-old dogs to determine whether a dog would have normal or osteoarthritic hip joints.     

Demonstration of the articular cartilage of the canine ulnar trochlear notch using high-field magnetic resonance imaging

The articular cartilage covering the ulnar trochlear notch (UTN) of both elbow joints from 25 adult canine cadavers was demonstrated by the use of high-field magnetic resonance imaging (MRI) with a fat-suppressed, three-dimensional, spoiled gradient echo sequence. The dogs used for this study were divided into five groups: giant, large, mid-sized, small, and chondrodystrophic breeds. The distribution of articular cartilage of the UTN was assessed on MR images. The joints were then opened, and the distribution of the articular cartilage of the UTN was verified. In 29/50 joints, there was good agreement between gross findings of the distribution of the articular cartilage of the UTN and MRI interpretation. Reasons for the poor results in small and chondrodystrophic breeds were decreased thickness of the articular cartilage, small size of the articular surface and of its structural features, and the frequent inability to visualize the joint space.     

Arthrosis in the elbow joint of young rapidly growing dogs. III. Ununited medical coronoid process of the ulna and osteochondritis dissecans of the humeral condyle. Surgical procedure for correction and postoperative investigation

A surgical procedure for medial arthrotomy in the elbow joint is described. Surgery was performed in an endeavour to remove an ununited coronoid process and/or a loose piece of cartilage from the humeral condyle. A long term follow up investigation of 58 operated and 20 unoperated dogs was undertaken. The prognosis of dogs operated upon because of osteochondritis dissecans of the humeral condyle, was fairly good; 11 of 15 dogs (73.3%) being reported as showing no signs of lameness. When dogs with the both diagnoses were judged together, the percentage of dogs reported not to be lame was 48.3 among operated dogs and 45 among unoperated dogs. However, dogs operated upon, recovered somewhat sooner than unoperated dogs. Of 38 dogs (58 joints) which were clinically and radiographically re-examined by the author, it was found that severe arthrosis (degree 3) developed in about 60% of the joints, no matter whether surgical treatment was carried out or not. However, 19 of these dogs were not lame, or only revealed lameness occasionally.     

Hyaluronic acid in synovial fluid. VI. Effect of intra-articular injection of hyaluronic acid on the clinical symptoms of arthritis in track horses

Twelve horses with traumatic arthritis were treated with intraarticular injection of hyaluronic acid mixed with cortisone and the results compared with 6 horses treated only with cortisone. There was a significantly better improvement in the group injected with a mixture of hyaluronic acid and cortisone. Further studies have given the same results in traumatic arthritis in horses if hyaluronic acid alone is injected.After injection of hyaluronic acid a large number of granulated monocytes appeared in the synovial fluid, but no inflammatory signs were observed. It is possible that this macrophage invasion is instrumental in producing improvement in the condition of the joint. The injected hyaluronic acid may also adhere to the surface of articular cartilage producing an “clastic cushion” protecting the cartilage surface.Experimental mechanical damage was also inflicted on the surface of articular cartilage in dogs and monkeys, and smoother healing was achieved if hyaluronic acid was injected into the joints after the damage.Injections of hyaluronic acid seem to be of value in treating traumatic arthritis or similar conditions.     

Molecular monitoring of equine joint homeostasis

Diseases affecting synovial joints are a major cause of chronic disability both in humans and in companion animal species, most notably dogs and horses. As progressive deterioration of the articular cartilage is the hallmark of degenerative joint disease or osteoarthritis, research efforts traditionally tended to focus primarily on cartilage pathology. However, in recent years it has become clear that synovial joints should be considered intricate organs in their own right, with each of the constituent tissues (cartilage, bone, and synovial membrane) interacting with each other both in health and disease. Moreover, with the advent of modern molecular biology techniques, the importance of synovial inflammation in disease development and progression has become increasingly recognized. These realizations have spurred the need for tools that allow a more comprehensive, integral study of synovial joint homeostasis. This review provides a brief overview of synovial joint biology and the concept of joint homeostasis, followed by a discussion of methods that may be used to study joint homeostasis (varying from in?vitro tissue culture to in?vivo imaging) including specific advantages and limitations of each approach. It then zooms in on one such approach, synovial fluid biomarker analysis, as a promising avenue in synovial joint research, highlighting some results from equine studies performed in the author's own laboratory that illustrate how such studies may help shed light on in?vivo joint homeostasis and therapeutic modulation thereof. The review concludes with some future perspectives and promising developments in the field.     

Clinical, radiographical and pathological aspects of ununited medial coronoid process of the elbow joint in dogs

An ununited medial coronoid process was found in the region of the medial ulnar articular rim of seven elbow joints in four Persian stray dogs in a survey of joint disease in dogs. The clinical, radiographical and pathological aspects of this condition are described and discussed.     

RADIOGRAPHIC EVALUATION OF FELINE APPENDICULAR DEGENERATIVE JOINT DISEASE VS. MACROSCOPIC APPEARANCE OF ARTICULAR CARTILAGE

Degenerative joint disease (DJD) is common in domesticated cats. Our purpose was to describe how radiographic findings thought to indicate feline DJD relate to macroscopic cartilage degeneration in appendicular joints. Thirty adult cats euthanized for reasons unrelated to this study were evaluated. Orthogonal digital radiographs of the elbow, tarsus, stifle, and coxofemoral joints were evaluated for the presence of DJD. The same joints were dissected for visual inspection of changes indicative of DJD and macroscopic cartilage damage was graded using a Total Cartilage Damage Score. When considering all joints, there was statistically significant fair correlation between cartilage damage and the presence of osteophytes and joint‐associated mineralizations, and the subjective radiographic DJD score. Most correlations were statistically significant when looking at the different joints individually, but only the correlation between the presence of osteophytes and the subjective radiographic DJD score with the presence of cartilage damage in the elbow and coxofemoral joints had a value above 0.4 (moderate correlation). The joints most likely to have cartilage damage without radiographic evidence of DJD are the stifle (71% of radiographically normal joints) followed by the coxofemoral joint (57%), elbow (57%), and tarsal joint (46%). Our data support radiographic findings not relating well to cartilage degeneration, and that other modalities should be evaluated to aid in making a diagnosis of feline DJD.     

Bacterial endocarditis and inflammatory joint disease in the dog

The main clinical features of 12 cases of bacterial endocarditis were lameness, pyrexia, lethargy, anorexia and systolic cardiac murmurs. The lameness varied from generalised stiffness to an inability to stand and walk. Multiple joint involvement was typical. Two types of joint pathology were identified. A marked synovitis with granulation tissue sometimes covering the articular cartilage was present in some joints associated with the presence of bacterial organisms. Other joints proved sterile and showed a milder synovial pathology. In many dogs both an infective arthritis and a non-infective arthritis co-existed. Bilaterally symmetrical joint involvement was typical of the non-infective arthritis. The pathogenesis of the latter was likely to involve the deposition of circulating immune complexes (bacterial antigens, antibody and complement) in the synovium. The infective arthritis was presumed to be secondary to embolic disease, ie, the spread of infected emboli from the heart valve to the joints. Treatment was unsuccessful in all cases.     

European veterinary dissertations

Diseases affecting synovial joints are a major cause of chronic disability both in humans and in companion animal species, most notably dogs and horses. As progressive deterioration of the articular cartilage is the hallmark of degenerative joint disease or osteoarthritis, research efforts traditionally tended to focus primarily on cartilage pathology. However, in recent years it has become clear that synovial joints should be considered intricate organs in their own right, with each of the constituent tissues (cartilage, bone, and synovial membrane) interacting with each other both in health and disease. Moreover, with the advent of modern molecular biology techniques, the importance of synovial inflammation in disease development and progression has become increasingly recognized. These realizations have spurred the need for tools that allow a more comprehensive, integral study of synovial joint homeostasis. This review provides a brief overview of synovial joint biology and the concept of joint homeostasis, followed by a discussion of methods that may be used to study joint homeostasis (varying from in vitro tissue culture to in vivo imaging) including specific advantages and limitations of each approach. It then zooms in on one such approach, synovial fluid biomarker analysis, as a promising avenue in synovial joint research, highlighting some results from equine studies performed in the author's own laboratory that illustrate how such studies may help shed light on in vivo joint homeostasis and therapeutic modulation thereof. The review concludes with some future perspectives and promising developments in the field.     

Deposition of fibronectin in articular cartilage of canine osteoarthritic joints

Deposition of fibronectin was examined in articular cartilage of healthy and osteoarthritic joints of Labrador Retriever dogs. Abnormal cartilage from osteoarthritic joints contained up to 20 times more fibronectin than did disease-free cartilage. Compared with normal cartilage, the rate of fibronectin synthesis in osteoarthritic cartilage was increased and a greater proportion of the newly made fibronectin accumulated in the lesion cartilage matrix. The rate of release of endogenous prelabeled [3H]fibronectin from disease-free explants was similar to the rate of release from degenerated cartilage explants into incubation media. Concentrations of fibronectin were greater in synovial fluid from osteoarthritic joints than in synovial fluid from healthy joints, but both types of fluid had less fibronectin than in blood plasma.