IMAGING DIAGNOSIS—NUCLEAR SCINTIGRAPHIC,RADIOLOGICAL, AND PATHOLOGIC CHARACTERISTICS OF METASTATIC PILOMATRICOMA IN A DOG

A 6‐year‐old castrated Goldendoodle dog was presented for left‐sided lameness of 3 weeks’ duration. Focal, moderate to marked increased ^99mTc‐methylene diphosphonate (^99mTc‐MDP) uptake was detected in the right caudal lung lobe, caudal angle of the left scapula, and the distal aspect of the left femur with whole body bone phase scintigraphy. Radiographs identified a well‐circumscribed, oval‐shaped soft tissue opaque mass in the right caudal lung lobe; a suspect oval‐shaped osteolytic lesion in the proximal third of the left scapula; and an osteolytic lesion in the distal aspect of the left femur. Metastatic pilomatricoma was confirmed histologically at all three sites.     

Advanced imaging of a histologically confirmed bone infarction of the distal tibia in a Warmblood mare

An 8-year-old Warmblood-cross mare presented for investigation of acute onset left hindlimb lameness. Nuclear scintigraphy identified a marked, focal, increase in radiopharmaceutical uptake in the distal aspect of the left tibia. Radiography revealed a large, oval, multi-loculated radiolucent area within the medulla of the distal metaphysis of the left tibia. The mare was treated conservatively for 6 months but showed little improvement in the lameness so the owner elected for euthanasia. Post-mortem computed tomographic imaging revealed a large, oval, hypoattenuating area within the distal tibia, surrounded by a thick, irregular, sclerotic border. The lesion occupied the majority of the medullary cavity but the cortical bone was unaffected. Gross and histopathological examination confirmed a diagnosis of a bone infarction in the medullary cavity of the distal tibia.     

Open reduction and internal fixation with a locking plate for the treatment of a femoral fracture in a ferret (Mustela putorius furo)

Long bone fractures in ferrets (Mustela putorius furo) are usually traumatic in etiology, and the femur is commonly affected [1]. A 4-year-old, castrated male ferret was examined for acute, non-weight-bearing lameness of the left pelvic limb after presumably falling from its elevated enclosure. Clinical and radiographic evaluation showed a complete, comminuted fracture of the proximal diaphyseal third of the left femur. Open reduction and internal fixation (ORIF) of the left femoral fracture was performed with cerclage wires and a 1.5 mm locking compression plate with associated locking screws. Anatomic reconstruction was achieved, and postoperative radiographs confirmed appropriate fracture fragment apposition, limb alignment, and implant placement. At 9 weeks postoperatively, the ferret was ambulatory with no evidence of lameness, and complete radiographic union was noted. This is the first published report of the use of a bone plate for femoral fracture stabilization in a ferret. Bone plates, including locking plates, could be considered for long bone fracture stabilization in ferrets as an alternative to other methods.     

Meningeal sarcoma mimicking a sciatic neuropathy in a dog

A 5-year-old Golden Retriever presented for lameness evaluation and removal of a dynamic compression plate on the left femur exhibited neurologic signs compatible with a left sciatic peripheral neuropathy. Radiographs revealed a healed fracture of the left femur and a slightly narrowed intervertebral disc space with ventral spondylosis at T_12–13. An EMG demonstrated fibrillation potentials and positive sharp waves in the left hind limb muscles innervated by the peroneal nerve. Surgery was performed to remove the bone plate and explore the left sciatic nerve. The proximal 3 cm of the left peroneal nerve was surrounded by thick fibrous connective tissue and its diameter was smaller than the more distal segment. The dog's condition remained static for 4 weeks and then gradually progressed to paraparesis in 2 weeks. A neurologic examination at that time indicated a caudal lumbar spinal cord lesion and a myelogram confirmed an intradural mass at the level of the 4th lumbar vertebra. The dog was destroyed and a necropsy performed. The histologic diagnosis was meningeal sarcoma.     

Can distal border fragments of the navicular bone be a primary cause of lameness?

A horse with unilateral forelimb lameness and pain localised to the palmar aspect of the foot was evaluated using radiography and low field magnetic resonance (MR) imaging. A distal border fragment of the navicular bone, an osseous cyst‐like lesion (OCLL) in the distal third of the navicular bone and focal distal sesamoidean impar desmitis were identified as the most likely causes of pain and lameness. No other lesions likely to contribute to pain and lameness were identified on MR images or gross post mortem examination. The OCLL was characterised histologically by enlarged bone lacunae containing proliferative fibrovascular tissue. Focal lesions of the distal aspect of the navicular bone are rarely found in isolation but can be causes of pain and lameness in horses.     

Subchondral bone cyst of the apical portion of the proximal sesamoid bone as a cause of severe lameness in a Warmblood filly

A 20‐month‐old Warmblood filly was evaluated for acute onset of a nonweightbearing lameness and swelling of the left hindlimb. Clinical and lameness evaluation and diagnostic intrasynovial anaesthesia isolated the lameness to the left hind metatarsophalangeal region. Radiography and ultrasonography revealed a subchondral cystic lesion of the apical portion of the lateral proximal sesamoid bone associated with oedema and synovial effusion of the metatarsophalangeal joint. Arthroscopic surgical debridement of the subchondral cystic lesion resulted in immediate post operative improvement in the lameness score. Rest and controlled exercise achieved complete resolution of the lameness with the filly being able to start training without apparent lameness. Subchondral cystic lesions of the proximal sesamoid bones can be a cause of nonweightbearing lameness. Surgical debridement resulted in complete resolution of the lameness with a favourable outcome in this case.     

Multiloculated solitary (unicameral) bone cyst in a young dog

A 20‐month‐old female spayed Staffordshire Terrier (22.3 kg) presented to the Orthopedic Surgery Service at North Carolina State University Veterinary Teaching Hospital for evaluation of a 6‐week history of toe‐touching to nonweight‐bearing lameness in the right hind limb. Radiographs of the right stifle revealed a multiloculated lytic lesion of the distal femur, with a large open lytic zone centrally, numerous osseous septations peripherally, and focal areas of cortical thinning and loss. An aspirate of the right distal femoral lesion yielded mildly cloudy serosanguineous fluid. Cytologic examination of the fluid revealed a pleomorphic population of discrete cells that exhibited marked anisocytosis and anisokaryosis and a variable nuclear‐to‐cytoplasmic (N:C) ratio, which were interpreted as probable neoplastic cells, with few macrophages, and evidence of hemorrhage. Given the clinical signs of pain, lesion size, and concern for malignant neoplasia, amputation of the right hind limb was performed. Histologically, the lesion had undulating walls 1‐3 mm thick with a continuous outer layer of dense fibrous tissue and an inner layer composed of reactive cancellous bone with no cortical compacta remaining. Remnants of thin fibrous or fibro‐osseous septa projected from the bony wall into the cyst lumen. The final histologic diagnosis was a benign multiloculated solitary (unicameral) bone cyst of the distal right femur. Based on the histopathologic findings, it was speculated that the cells identified on cytology were a mixture of developing osteoclasts, osteoblasts, endothelial, and stromal cells. This is the first report describing the cytologic examination of a solitary bone cyst in veterinary medicine.     

A large cyst in the distal femur of a horse

A 10-year-old Warmblood gelding presented with a left hindlimb lameness. Diagnostic analgesia located the lameness to the stifle. Radiography showed an unusually large cyst in the distal femur. Diagnostic arthroscopy of the stifle did not reveal any significant abnormalities. An extra-articular transcortical approach to the cyst was performed for drainage, curettage, and provision of an autologous, cancellous bone graft, gentamicin-impregnated collagen fleeces and injectable steroid. The horse returned to a higher level of competitive dressage than prior to surgery. This report describes a large cyst in the distal femur of a horse.     

Retrospective study of scintigraphic and radiological findings in 21 cases of enostosis-like lesions in horses

Records of horses admitted to a veterinary surgery in the UK for lameness investigation during 2000 to 2008 were reviewed. Twenty-one horses were identified with both scintigraphic and radiological evidence of enostosis-like lesions (ELLs), in which 68 individual foci of increased radiopharmaceutical uptake were confirmed in 57 long bones. The presenting lameness was attributed to ELLs in 15 of 21 (71 per cent) horses; the remainder were thought to be incidental findings. Five horses were subjected to a repeat examination, four of which showed the occurrence of new lesions in the same or different limbs. Hindlimbs had significantly more lesions than forelimbs, but there was no difference between the right and left limbs. All 18 horses for which follow-up information was available were treated conservatively and returned to soundness after a variable period of time. Following ELL resolution, thoroughbred horses performed at a similar level to that before investigation and diagnosis.     

Pathological fracture of the femur secondary to haematogenous osteomyelitis in a weimaraner

A seven-year-old male weimaraner developed an acute-onset non-weightbearing pelvic limb lameness without a history of significant trauma. Radiographs demonstrated an oblique fracture of the femur associated with a lytic bone lesion, while cytology and histopathology of the lesion were consistent with osteomyelitis. A pure growth of Streptococcus intermedius was obtained from culture of affected tissue samples. The fracture healed without complication after rigid internal fixation and antibiotic therapy.     

Osteochondritis dissecans-like lesion of the intercondylar fossa of the femur in a dog.

An 11-month-old neutered female crossbreed dog was admitted with left pelvic limb lameness. Radiographs and computed tomography identified an osteochondritis dissecans- (OCD) like lesion in the intercondylar fossa of the femur originating from the axial aspect of the medial femoral condyle. Stifle arthrotomy was performed in order to remove the bony fragment. It was concluded that the clinical features and location of this lesion indicate an osteochondritis dessicans-like lesion. Fragment removal was associated with an excellent outcome.     

Radiographic appearance and clinical progress after excision arthroplasty of the canine hip

This paper describes the radiographic appearance of the proximal femur and acetabulum after excision arthroplasty for chronic hip lameness in the dog. An attempt has been made to correlate the various radiographic appearances with the clinical findings. The fate of spurs of bone left at the site of resection has been investigated. A constant finding was remodelling of the acetabulum and proximal femur; the results of this remodelling are described.     

Polyostotic cystic bone lesions in a dog

The clinical, radiological, and pathological features of a polyostotic cystic bone lesion in a 9-month-old Doberman Pinscher are described. The patient was diagnosed as having nutritional secondary hyperparathyroidism at 6 weeks of age and after dietary correction it remained clinically normal until 9 months when there was sudden left hind-limb lameness due to a pathological fracture through a cystic lesion in the distal femur. Radiography revealed additional cystic structures in the metaphyses of the left radius, and left and right tibia. Pseudofractures were associated with two of the cystic lesions.
In some areas the cysts were crossed by trabeculae and in others there were bony ridges on the inner cystic wall. The cavities were lined with flesh-coloured fibrillar material which formed a lacy network extending into cavities. Histologically, multiple small cysts were present adjacent to the larger cavities noted radiographically. The secondary spongiosa and the metaphyseal periosteum were the major abnormal tissue sites. The small cysts appeared to arise in an oedematous and congested metaphyseal spongiosa. The cysts were accompanied by small foci of intense osteoclasis but unattended by compensatory bone production, and the consequent possibility of pseudofractures is an important clinical consideration. Earlier reports demonstrated that resolution of the lesions will follow surgical drainage and curettage of the cystic cavity. Of six cases of polyostotic cystic bone lesions observed in the dog, five were in the Doberman Pinscher breed.     

Long-term survival after surgical excision of a schwannoma of the sixth cervical spinal nerve in a dog

A schwannoma of the sixth cervical spinal nerve in a 5-year-old Shetland Sheepdog was surgically excised, sparing the thoracic limb and resulting in long-term survival. The dog had been referred because of slowly progressive left thoracic limb lameness. The lesion was localized to the left suprascapular and musculocutaneous nerves or the C6 and C7 spinal nerves on the basis of neurologic examination, electrodiagnostic examination, and myelography. Surgical exploration revealed a mass, which was excised and identified histologically as a schwannoma. Three and a half years later, the dog was normal except for mild gait abnormality, focal muscle atrophy, and a focal area of decreased cutaneous sensation of the left thoracic limb.     

HEMANGIOMA OF THE DISTAL PHALANX IN A COLT

A yearling Thoroughbred colt was admitted to the University of Florida College of Veterinary Medicine with severe, progressive lameness of the left forelimb. A centrally located expansile lytic lesion involving approximately 40% of the distal phalanx with a large associated vascular channel was identified by radiography. Increased vascular phase pooling, increased soft tissue phase uptake, and a photopenic area on bone phase images corresponding to the lytic lesion within the left distal phalanx were identified by vascular, soft tissue, and bone phases of a three phase bone scan, respectively. Contrast medium accumulation and disappearance in dilated vessels within the lesion was apparent angiographically. The colt was euthanized and the histologic diagnosis was hemangioma of the distal phalanx with a pathologic fracture.     

Bilateral stifle osteochondritis dissecans in a cat

A 9-month-old, castrated male, domestic shorthaired cat was presented for progressive right hind-limb lameness. A diagnosis of osteochondritis dissecans of the lateral femoral condyle was made based on radiographs and physical examination, and was confirmed by right lateral stifle arthrotomy. The cartilage flap was removed, and the underlying bone was curetted. Seven months later, the cat was sound on the right leg but developed a left hind-limb lameness. A similar lesion was found in the left leg and was treated identically. Fourteen months after presentation, the cat was sound on both hind limbs.     

MRI and CT diagnosis of acute desmopathy of the lateral collateral sesmoidean (navicular) ligament and long-term outcome in a horse

Clinical, magnetic resonance imaging (MRI) and computed tomography (CT) findings of acute desmopathy of the lateral collateral sesmoidean (navicular) ligament (CSL) in a 13-year-old Hanoverian mare are presented. On admission to the clinic the horse showed a grade 5/6 left front-limb lameness at the walk, pain on coffin joint manipulation, and coffin joint effusion. Despite a positive palmar digital nerve block, radiographs and ultrasonography did not indicate reasons for the severe clinical signs. However, MRI revealed damage to the CSL and bone marrow oedema of the navicular bone (NB), whereas a focal bone defect of the NB at the CSL insertion zone was demonstrated best by CT. The horse was managed with complete box rest and a fibreglass cast for four weeks followed by a controlled exercise program. Follow-up examination revealed no lameness at the trot three months later and the patient had fully recovered within six months.     

Diagnostic investigation of an unusually large osseous cyst-like lesion of the radial carpal bone

A 10-year-old Irish Sports Horse presented for intermittent, fluctuating lameness of the left forelimb. Nuclear scintigraphy, radiography and computed tomography identified a large osseous cyst-like lesion (OCLL) occupying approximately 50% of the radial carpal bone with an articular communication to the antebrachiocarpal joint. A transcortical surgical approach was used to curette the lining of the lesion prior to injection with triamcinolone acetonide. This imaging report describes the detailed diagnostic findings of an unusually extensive OCLL in the radial carpal bone.     

Delayed diagnosis of fungal osteomyelitis with early scintigraphic lesions in a dog

A 4-year-old neutered male golden retriever was diagnosed with osseous blastomycosis of the distal left forelimb by means of radiographs and histopathology. Presumptive bacterial pneumonia and left forelimb lameness had been diagnosed 2 y previously, at which time bone scintigraphy revealed increased uptake in the distal left forelimb, but radiographs showed no detectable lesion. Though not specific, bone scintigraphy appears more sensitive than radiography in identifying early lesions of fungal osteomyelitis in dogs.     

Primary ossifying fibroma of the proximal phalanx in a horse

A primary ossifying fibroma was found at necropsy in a 5-year-old Welsh pony cross mare that was humanely subjected to euthanasia for an intractable severe left hindlimb lameness. Antemortem radiographs of the left hind pastern were characterised by articular, subchondral and cortical areas of lysis. Primary ossifying fibroma is a rare lesion of the distal limb but should be considered when there is extensive lysis extending into the medulla and proximal cortical bone.