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1.
OBJECTIVES: To assess the accuracy of reconstructed computed tomography for imaging canine elbow joint spaces. METHODS: Computed tomography scans of eight cadaveric elbows were obtained and reconstructed computed tomography images were formatted in the dorsal and sagittal planes. Humeroradial and humeroulnar joint space measurements were obtained from these images. Intra-observer and inter-observer variations in joint space measurements were assessed, as was the effect of specimen positioning (inter-image variation). After freezing, four elbows were sectioned in the dorsal plane and four in the sagittal plane. In addition to visual comparison of the frozen sections with reconstructed computed tomography images, joint space measurements were obtained from frozen sections and compared with those from reconstructed computed tomography images. Variation was assessed using statistical calculations and graphical techniques. RESULTS: Both inter-image and intra-observer analyses revealed good agreement and low variation between data sets. Inter-observer correlation was only moderate, though variation was low. Visually, the reconstructed computed tomography images accurately reflected the frozen section anatomy. Agreement between frozen section and reconstructed computed tomography joint space measurements was good, with minimal variation. CLINICAL SIGNIFICANCE: These results indicate that reconstructed computed tomography is capable of accurately imaging elbow joint spaces and precise joint space measurements can be obtained. Reconstructed computed tomography may be useful for determining joint space measurements and detecting elbow incongruencies in dogs with elbow dysplasia.  相似文献   

2.
Objectives— To describe computed tomographic (CT) features of canine elbows with incomplete ossification of the humeral condyle (IOHC) and investigate co-existing incongruence in the elbow joint.
Study Design— Case control study.
Animals— Dogs with IOHC (n=20; 38 elbows) and 25 normal elbows.
Methods— Elbows with IOHC and normal elbows were assessed by CT. Standardized dorsal and sagittal reconstructions were created at 3 levels using image analysis software to obtain single measurements of the humero-radial and humero-ulnar joint spaces. On dorsal plane reconstructions, joint space measurements were obtained at the center point of the humero-radial and humero-ulnar articulations. Joint incongruity was defined as the difference between the humero-radial and the humero-ulnar joint spaces.
Results— Nineteen dogs (95%), all Spaniel breeds, had either bilateral IOHC demonstrable as a saw-toothed intercondylar complete or incomplete hypoattenuating defect with hyperattenuating margins, or IOHC with contralateral humeral condylar fracture (HCF). Joint incongruity values for IOHC were compared with those of normal elbows. Significant differences were noted at the levels of the medial coronoid apex ( P <.0001) and base ( P <.004) indicative of humero-ulnar incongruence. Evidence of medial coronoid disease in 10 elbows (26%) and degenerative joint disease in 30 elbows (79%) was also found.
Conclusions— Presence of elbow incongruence may be an underlying factor in failure of ossification centers to fuse leading to IOHC.
Clinical Relevance— IOHC is clearly defined by CT, and it should be considered in larger Spaniel breeds, with a chronic forelimb lameness or HCF.  相似文献   

3.
Medial compartment erosion is an advanced stage of medial coronoid disease, an important cause of elbow lameness in dogs, with treatment and the expected prognosis depending on the extent of the cartilage lesions. The identification of specific computed tomographic (CT) findings might facilitate the nonsurgical diagnosis and add to treatment decision making. Aims of this retrospective, analytical, method comparison study were to describe CT findings in elbows of dogs arthroscopically diagnosed with medial compartment erosion and to compare CT vs. arthroscopic findings. A total of 56 elbows met inclusion criteria. Elbows with focal (n = 13), diffuse (n = 11), and complete (n = 32) erosion were compared. Prevalence findings for CT lesions were as follows: periarticular osteophytosis (100%), abnormal shape of the medial coronoid process of the ulna (96.4%), and subchondral bone defect of the medial part of the humeral condyle (MHC; 96.4%). The three groups significantly differed for presence of medial coronoid process fragmentation, radial head subchondral bone sclerosis, and widening of the humeroulnar joint space. No significant agreement was found between CT and arthroscopy for presence of a subchondral bone defect of the MHC. A significant agreement was found between CT and arthroscopy for presence of fragmentation of the medial coronoid process. However, some of the calcified body/fragment(s) visualized on CT in the region of the medial coronoid process could not be identified via arthroscopy. Findings indicated that an accurate estimation of the extent of the elbow cartilage lesions still requires arthroscopic joint inspection.  相似文献   

4.
Four skeletally immature, small breed dogs (five elbows) with elbow incongruency were evaluated for forelimb lameness. Findings on clinical examination included pain, effusion and decreased range of motion of the affected elbow. Radiography, computed tomography and arthroscopy demonstrated elbow incongruency in all dogs. Fragmented medial coronoid process was diagnosed arthroscopically in three dogs (four elbows). Arthroscopic subtotal coronoidectomy was performed in all cases of fragmented medial coronoid process. Incongruency was corrected with acute ulnar lengthening under arthroscopic visualisation. The ulna was stabilised with a plate following correction. In two elbows an ostectomy of the anconeal process was performed to prevent impingement against the olecranon fossa. All dogs demonstrated improvement in lameness scores and client‐scored visual analogue scale scores. Postoperative computed tomography showed significant improvement in elbow incongruency in all dogs. Arthroscopic‐guided ulnar lengthening may be considered as a valid treatment in severe cases of elbow incongruency .  相似文献   

5.
Five hundred and twenty German shepherd dogs were screened for elbow dysplasia. The following primary lesions were analysed: joint incongruity (JI), fragmented medial coronoid process (FCP), osteochondrosis or osteochondritis of the medial humeral condyle and ununited anconeal process (UAP). Three radiographic views were used for each joint to achieve a definitive diagnosis. The prevalence of elbow dysplasia was 19.4 per cent. The most frequent lesion was JI (16.3 per cent), followed by FCP (11.3 per cent). UAP was diagnosed rarely (1.1 per cent). Combinations of lesions were very frequent (42.2 per cent of the dysplastic elbows). Although these results may be biased due to prescreening of dogs with UAP, it should be highlighted that JI and FCP occur frequently in German shepherd dogs and are probably the most common primary lesions of elbow dysplasia, although they have been under-reported until now.  相似文献   

6.
OBJECTIVE: To compare radioulnar incongruence (RUI) of normal canine elbows and elbows with arthroscopically confirmed medial compartment disease in vivo using systematic computed tomography (CT) measurements. STUDY DESIGN: Prospective comparison of RUI measurements in normal and dysplastic canine elbows. SAMPLE POPULATION: Right elbows of 25 medium-large breed, adult dogs with medial compartment disease and 9 medium-large breed, adult dogs with no elbow disease. METHODS: Transverse CT images of proximal radioulnar articulation were reformatted to dorsal and sagittal planes. RUI in 3 locations of the forelimb's medial coronoid was measured. Arthroscopy confirmed diagnosis of medial compartment disease in the diseased group. RUI measurements of the diseased and normal elbows were compared. RESULTS: Cumulative statistical analysis of RUI in all planes revealed no significant difference between the normal and abnormal elbows (P = .61). The abnormal elbows had negative mean RUI at the mid (P = .56) and cranial (P = .24) coronoid regions that were not significantly different from normal elbows and mean positive RUI at the base coronoid that was significantly greater than in normal elbows (P = .00082). CONCLUSION: Canine elbows with established medial compartment disease do not have significant RUI at the medial coronoid region at the time of diagnosis when compared with normal elbows. CLINICAL RELEVANCE: If RUI is a significant factor in the pathophysiology of medial compartment elbow disease in the dog, it does not appear to be present at the time of diagnosis of disease. Ulnar or radial osteotomies do not appear to be indicated for restoration of normal radioulnar articular surface alignment.  相似文献   

7.
Jean K.  Reichle  DVM  MS  Richard D.  Park  DVM  PhD  Anne M.  Bahr  DVM  MS 《Veterinary radiology & ultrasound》2000,41(2):125-130
The purpose of this study was to identify the incidence of abnormal computed tomography (CT) findings in dogs with lameness of one or both elbows. CT examinations of 102 elbows in 51 dogs were reviewed individually and by group consensus by 3 examiners and graded for various abnormalities. Frequently encountered abnormalities included abnormal shape and sclerosis of the medial coronoid process of the ulna, irregularity of the radial incisure of the ulna, and ulnar trochlear notch sclerosis. Other abnormalities included distinct/separate or fissure/in situ fragmentation of the medial coronoid; lucency of the radial incisure; ununited anconeal process; sclerosis, lucency, or flattening of the medial aspect of the humeral condyle; osteophyte formation; and joint incongruity. In conclusion, CT of the canine cubital joint is useful in identification of various lesions beyond simple fragmentation of the medial coronoid process of the ulna.  相似文献   

8.
O bjective : To describe in detail the computed tomographic findings in elbows of dogs with fragmentation of the medial coronoid process of the ulna.
M ethods : Retrospective review of computed tomographic images of 58 elbows that had displaced medial coronoid process fragment(s), non-displaced medial coronoid process fragment or a stable fissure in the articular cartilage of the medial coronoid process at arthroscopy.
R esults : Bone fragments were observed in 85 per cent elbows with a displaced fragment at arthroscopy, in 18 per cent elbows with a non-displaced fragment and in 29 per cent elbows with a stable fissure. Fissures in the subchondral bone were observed in computed tomographic images of 43 per cent elbows that had a stable fissure at arthroscopy. Abnormal shape, sclerosis and lucency affecting the medial coronoid process, subchondral sclerosis of the ulna and humerus, irregular radial incisure of the ulna and periarticular osteophytes were observed in a similar proportion in dogs regardless of the arthroscopic findings. Kissing lesions affecting the medial aspect of the humeral condyle were mainly associated with displaced fragments. Signs of joint incongruity were observed in dorsal and sagittal reconstructed computed tomographic images in 24 per cent elbows.
C linical S ignificance : A wide range of abnormalities may be observed in computed tomographic images of dogs with fragmented medial coronoid process. Computed tomographic is moderately sensitive for detection of fragments.  相似文献   

9.
A 20-week-old male golden retriever, which was not lame and showed no clinical signs of a fragmented medial coronoid process (FCP), was euthanased for another study and perfused intravenously with formaldehyde. Gross dissection revealed no abnormalities within the right elbow joint. The medial coronoid process was excised, embedded in methylmethacrylate, scanned in a microcomputed tomography (microCT) scanner and sectioned for histology. The microCT scans revealed a dense trabecular bone structure, much denser than in other dogs of similar age, which was considered to be responsible for the sclerosis visible at the base of the coronoid process in radiographs. Three-dimensional reconstructions indicated that there was a small step within the subchondral bone, extending from the apex towards the radial notch. Histology revealed a necrotic lesion between locally thickened articular cartilage and the subchondral bone, characteristic of osteochondrosis.  相似文献   

10.
A caudomedial approach that allows the removal of an ununited anconeal process (UAP) is described. Intraoperative examination of the medial part of the joint to diagnose a fragmented coronoid process (FCP) is also possible using the same approach. Sixty-two joints (53 dogs) with UAP and various degrees of arthrosis were included in the study. In all joints the UAP could be removed via the caudomedial approach and the medial coronoid process could be inspected after extending the incision of the joint capsule distally. In eight cases a FCP was diagnosed and removed either by the caudomedial or by a medial approach. The results of the present study show that an UAP can occur simultaneously with a FCP in the same joint and that inspection of the medial part of the joint is useful.  相似文献   

11.
George G.  Keller  DVM.  MS  John M.  Kreeger  DVM.  PH.D  Fred A.  Mann  DVM.  MS  Jimmy C.  Lattimer  DVM.  MS 《Veterinary radiology & ultrasound》1997,38(4):272-276
Elbow dysplasia is osteoarthrosis/degenerative joint disease due to abnormal development of the elbow joint. The abnormaldevelopment is the result of specific inherited etiologies alone or in combination. This paper attempts to clarify the diagnosis of elbow dysplasia based on the presence of degenerative joint disease by correlating rediographic necropsy, necropsy, and histopathologic results using elbows from 8 German Shepherd dogs. All elbows had radiographic changes consistent with osteoarthrosis/degenerativejoint disease which were identified best on the flexedmedial-lateral projection. Radiographically, a specific diagnosis was made inseven elbows; ununited anconeal process(6) and osteochondrosis (1). At necropsy these lesions were confirmed plus 14 elbows were identified that had fragmented medial coronoid process (6), abnormally shaped medial coronoid processes of fissures in the articualr cartilage of the medial coronoid process (8). additionally, histopathologically there was proliferative synovitis at the radial notch of the ulna and degenerative changes on the proximal, nonarticualr surface of the anconeal process at the site of insertion of the olecranon ligament and joint capsule.Therefore, for screening the elbow joint to identify elbow dysplasia, the recognition of osteoarthrosis/degenerative joint disease on an extreme flexed mediolateral rediograph appears to be sufficient.  相似文献   

12.
OBJECTIVE: To evaluate subchondral bone density patterns in elbow joints of clinically normal dogs by use of computed tomographic (CT) osteoabsorptiometry. SAMPLE POPULATION: 20 cadaver forelimbs from 10 clinically normal dogs. PROCEDURE: Each elbow joint was imaged in parasagittal and transverse planes of 1.5-mm thickness. Slice data were converted to dipotassium phosphate equivalent density (PPED) values. Sagittal, parasagittal, and transverse medial coronoid process topographic maps were constructed. Defined zones were created for each of the 3 CT planes, and confluence and peak PPED values were determined. RESULTS: The lowest PPED value was 340 mg/ml (articular and subchondral confluence), and the highest was 1780 mg/ml (peak subchondral density). Detectable effects of joint laterality were not found in the confluence or peak PPED measurements or in the peak-to-confluence PPED ratio for all 3 CT planes. Significant differences were found among zones in all 3 planes for confluence and peak PPED measurements and between sagittal and transverse planes for peak-to-confluence PPED ratios. Subjectively, the pattern of density distribution among dogs was fairly consistent for the sagittal and parasagittal slices. Three specific patterns of density distribution were apparent on the transverse topographic maps of the medial coronoid process that corresponded to conformational differences. CONCLUSIONS AND CLINICAL RELEVANCE: The use of CT osteoabsorptiometry provides a repeatable technique that can be used to noninvasively examine bone density and the effects of stress acting on joints in vivo. Variability in density values for any of the CT planes was not identified among clinically normal dogs.  相似文献   

13.
OBJECTIVE: To evaluate areas of articular contact of the proximal portions of the radius and ulna in normal elbow joints of dogs and the effects of axial load on size and location of these areas. SAMPLE POPULATION: Forelimbs obtained from cadavers of 5 adult mixed-breed dogs. PROCEDURE: After forelimbs were removed, liquid-phase polymethyl methacrylate was applied to articular surfaces of the elbow joint, and limbs were axially loaded. Articular regions void of casting material were stained with water-soluble paint. Relative articular contact areas were determined by computer-assisted image analyses of stained specimens. Repeatability of the technique was evaluated by analyses of casts from bilateral forelimbs of 1 cadaver. Incremental axial loads were applied to left forelimbs from 4 cadavers to determine effects of load on articular contact. RESULTS: Specific areas of articular contact were identified on the radius, the craniolateral aspect of the anconeus, and the medial coronoid process. The medial coronoid and radial contact areas were continuous across the radioulnar articulation. There was no articular contact of the medial aspect of the anconeus with the central trochlear notch. Coefficients of variation of contact areas between repeated tests and between contralateral limbs was < 20%. Significant overall effects of axial load on contact area or location were not identified. CONCLUSIONS: Three distinct contact areas were evident in the elbow joint of dogs. Two ulnar contact areas were detected, suggesting there may be physiologic incongruity of the humeroulnar joint. There was no evidence of surface incongruity between the medial edge of the radial head and the lateral edge of the medial coronoid process.  相似文献   

14.
The diagnosis of fragmented (ununited) medial coronoid process was made in 21 dogs, with 10 dogs having bilateral lesions. Ten of these dogs were presented to surgery. The diagnosis of fragmented medial coronoid process was made in young and middle-aged large- and giant-breed dogs with a history of intermittent or persistent lameness. Diagnosis was based on history as well as results of clinical examination and radiographic study of both elbows. Concomitant elbow lesions seen with fragmented medial coronoid processes were ununited anconeal process and osteochondritis dissecans of the medial humeral condyle. Avulsion of the medial epicondyle and posteromedial supracondylar ridge of the humerus were thought not to have occurred in these cases. Instead, dystrophic ossification of the synovial membrane and periosteal proliferation on the medial epicondyle and posteromedial supracondylar ridge had taken place. It was concluded that, with a questionable radiographic diagnosis of fragmented medial coronoid process, exploratory arthrotomy may be necessary to confirm the diagnosis. Without surgery, the eventual outcome of fragmented coronoid process is degenerative joint disease. Even with degenerative joint disease, however, clinical improvement was seen following removal of the fragment of the medial coronoid process.  相似文献   

15.
Fragmented coronoid process in the dog: is there a role for incongruency?   总被引:1,自引:1,他引:0  
Fragmented coronoid process in the dog is a common yet frustrating and poorly understood condition. Elbow joint incongruency, which refers to malalignment of the joint surfaces of the elbow, has been proposed as a key factor in the pathogenesis of fragmented coronoid process, and various surgical procedures have been devised to treat the proposed incongruency. However, precise characterisation of incongruency present in cases of fragmented coronoid process has not been reported consistently. In this article, the literature relating to the pathogenesis of fragmented coronoid process, the role of incongruency and its implications are reviewed.  相似文献   

16.
OBJECTIVE: To determine if fatigue microdamage is associated with fragmented medial coronoid process (FMCP). STUDY DESIGN: Prospective study. ANIMALS: Thirty-eight dogs were admitted for subtotal coronoid ostectomy as treatment for FMCP. Surgical specimens of medial coronoid process (MCP) were retrieved from treated dogs. Normal MCP were collected from 5 age- and breed-matched dogs and 2 age-matched research beagles that were euthanatized for reasons other than elbow disease. METHODS: MCP specimens from affected elbows were classified into 4 groups based on disease severity. Specimens were bulk-stained for microdamage using 1% basic fuchsin, embedded in polymethylmethacrylate and sectioned at 130 microm. Specimens were evaluated using epifluorescent microscopy (425-440 excitation, 475 nm barrier filter) for diffuse damage (D.DX), osteocyte loss, and porosity. Cartilage thickness was evaluated using bright field microscopy. Qualitative observations were also made. RESULTS: MCP specimens from affected elbows had increased D.Dx, increased osteocyte loss, and greater porosity than normal groups. Specimens classified as severe FMCP (Classes 3, 4) had the most fatigue microdamage. Some Class 1 specimens, defined as having no visible fissuring of the articular cartilage (AC), had large microcracks in trabecular bone. CONCLUSIONS: Accumulation of subchondral fatigue microdamage, is associated with MCP fragmentation. Fissuring occurs in the subchondral bone before gross fibrillation of articular cartilage develops. CLINICAL RELEVANCE: Accumulation of fatigue microdamage in the MCP is important in the pathogenesis of FMCP. The underlying cause of this microdamage accumulation must be identified before treatment plans that will prevent further osteoarthritis of the elbow joint can be designed.  相似文献   

17.
The results of a combined retrospective and prospective study of 130 cases of fragmented coronoid process (FCP) in 109 dogs are presented. Sixty-eight cases were treated surgically by medial elbow arthrotomy and 62 were treated medically (rest and anti-inflammatories). Case records were searched with the emphasis on the severity of lameness, physical abnormalities and in surgical cases, the appearance of the coronoid process lesion. Long term follow-up was obtained by a telephone survey. Analysis of case histories and physical data revealed no correlation between severity of lameness before treatment, severity of radiographic changes in the elbow joint and the type of lesion found at surgery. Surgical treatment did not decrease the incidence of post treatment lameness, but the surgically treated dogs were more active and less severely lame than those treated without surgery. It was concluded that young dogs with mild lameness due to FCP in the elbow probably do not benefit from surgical treatment but dogs with chronic, moderate to severe lameness have a better prognosis if treated surgically.  相似文献   

18.
Few reports have been published regarding the use of scintigraphy in the diagnosis of elbow joint lameness in dogs. Some authors have speculated about the potential use of bone scintigraphy and its suspected high sensitivity for the early diagnosis of abnormalities of the medial coronoid process (MCP) in dogs. Scintigraphy is used routinely in our institution in dogs presented for thoracic limb lameness and/or suspected of abnormalities of the MCP when radiographic findings were equivocal. Radiographic, scintigraphic, and surgical findings of the elbow joints of 17 dogs with elbow joint lameness were compared with radiographic, scintigraphic, and necropsy findings of the elbow joints of 12 clinically healthy Labrador Retrievers. Quantitative evaluation of scintigraphic images was performed to determine relative radiopharmaceutical uptake in the region of the MCP. Maximum relative uptake of the coronoid process in the normal dogs was taken as a threshold value to classify elbows as positive or negative for an abnormal MCP after all 24 elbows of the 12 healthy dogs were confirmed as being normal at necropsy. All 17 elbows from lame dogs were positive on scintigraphy and confirmed as having chondromalacia, a fissure, or fragmentation of the MCP. Based on our results, bone scintigraphy may be a valuable diagnostic tool for the diagnosis of abnormalities of the MCP in dogs, and particularly in older dogs where clinical and radiographic changes may be ambiguous.  相似文献   

19.
Medial coronoid process disease is a common leading cause of thoracic limb lameness in dogs. Computed tomography and arthroscopy are superior to radiography to diagnose medial coronoid process disease, however, radiography remains the most available diagnostic imaging modality in veterinary practice. Objectives of this retrospective observational study were to describe the prevalence of medial coronoid process disease in lame large breed dogs and apply a novel method for quantifying the radiographic changes associated with medial coronoid process and subtrochlear‐ulnar region in Labrador and Golden Retrievers with confirmed medial coronoid process disease. Purebred Labrador and Golden Retrievers (n = 143, 206 elbows) without and with confirmed medial coronoid process disease were included. The prevalence of medial coronoid process disease in lame large breed dogs was calculated. Mediolateral and craniocaudal radiographs of elbows were analyzed to assess the medial coronoid process length and morphology, and subtrochlear‐ulnar width. Mean grayscale value was calculated for radial and subtrochlear‐ulnar zones. The prevalence of medial coronoid process disease was 20.8%. Labrador and Golden Retrievers were the most affected purebred dogs (29.6%). Elbows with confirmed medial coronoid process disease had short (P < 0.0001) and deformed (~95%) medial coronoid process, with associated medial coronoid process osteophytosis (7.5%). Subtrochlear‐ulnar sclerosis was evidenced in ~96% of diseased elbows, with a significant increase (P < 0.0001) in subtrochlear‐ulnar width and standardized grayscale value. Radial grayscale value did not differ between groups. Periarticular osteophytosis was identified in 51.4% of elbows with medial coronoid process disease. Medial coronoid process length and morphology, and subtrochlear‐ulnar width and standardized grayscale value varied significantly in dogs with confirmed medial coronoid process disease compared to controls. Findings indicated that medial coronoid process disease has a high prevalence in lame large breed dogs and that quantitative radiographic assessments can contribute to the diagnosis.  相似文献   

20.
Elbow joint incongruity is recognized as an important factor in the development, treatment, and prognosis of canine elbow dysplasia. Elbow incongruity has been measured based on radiographic joint space widths, however these values can be affected by the degree of elbow joint flexion. Recent studies have reported radiographic curvature radii as more precise measures of humeroulnar congruity in dogs. The aim of this prospective observational study was to describe radiographic curvature radii measured from flexed and extended elbow radiographs for a sample of dogs representing a medium breed (Portuguese Pointing Dog) and a large breed (Estrela Mountain Dog). The curvature radii from the ulnar trochlear notch and humeral trochlea were measured in 114 mediolateral elbow extended radiographic views (30 Portuguese Pointing Dog and 27 Estrela Mountain Dog), and 84 mediolateral flexed views (22 Portuguese Pointing Dog and 20 Estrela Mountain Dog). The sampled animals' ages ranged from 12 to 84 months (34.6 ± 17.8 months). Good agreement was observed between curvature radii measurements for flexed vs. extended views in both breed groups. Ulnar trochlear notch curvature radii measurements were greater than humeral trochlea curvature radii measurements in both breed groups. Both curvature radii were greater in the large‐breed dog group vs. the medium‐breed dog group. Both breed groups had ulnar and humeral curves with similar typology. However, the large breed group had greater intermediate differences between the humeroulnar surface curvature radii. Results from this study supported the use of curvature radii as measures of humeroulnar congruity in mediolateral flexed elbow radiographs of medium and large breed dogs.  相似文献   

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