Elbow dysplasia and lesions of the medial coronoid process: correlation between tomographic and arthroscopic findings in thirty cases

SummaryObjectives: To investigate the possibilities and limitations of arthroscopy to detect flexor enthesopathy in dogs and to distinguish the primary from the concomitant form.Materials and methods: Fifty dogs (n = 94 elbow joints) were prospectively studied: dogs with primary flexor enthesopathy (n = 29), concomitant flexor enthesopathy (n = 36), elbow dysplasia (n = 18), and normal elbow joints (n = 11). All dogs underwent an arthroscopic examination of one or both elbow joints. Presence or absence of arthroscopic characteristics of flexor enthesopathy and of other elbow disorders were recorded.Results: With arthroscopy, several pathological changes of the enthesis were observed in 100% of the joints of both flexor enthesopathy groups, but also in 72% of the joints with elbow dysplasia and 25% of the normal joints. No clear differences were seen between both flexor enthesopathy groups.Clinical significance: Arthroscopy allows a sensitive detection of flexor enthesopathy characteristics, although it is not very specific as these characteristics may also be found in joints without flexor enthesopathy. The similar aspect of both forms of flexor enthesopathy and the presence of mild irregularities at the medial coronoid process in joints with primary flexor enthesopathy impedes the arthroscopic differentiation between primary and concomitant forms, requiring additional diagnostic techniques to ensure a correct diagnosis.

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Canine Elbow Dysplasia: The Early Radiographic Detection of Fragmentation of the Coronoid Process

Veterinary Clinics of North America Small Animal Practice ◽

10.1016/s0195-5616(00)50021-7 ◽

2000 ◽

Vol 30 (2) ◽

pp. 257-266 ◽

Cited By ~ 32

Author(s):

J. Hornof William ◽

P. Wind Alida ◽

T. Wallack Seth ◽

S. Schulz Kurt

Keyword(s):

Coronoid Process ◽

Elbow Dysplasia

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Elbow dysplasia in a Basset Hound

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632748 ◽

2003 ◽

Vol 16 (01) ◽

pp. 11-15 ◽

Cited By ~ 4

Author(s):

S. W. Volk ◽

D. G. Keith ◽

R. C. McLear ◽

G. K. Smith ◽

A. S. Kapatkin

Keyword(s):

Ct Scan ◽

Elbow Joint ◽

Coronoid Process ◽

Surgical Interventions ◽

Computer Tomographic ◽

Left Elbow ◽

Elbow Dysplasia ◽

Highly Sensitive ◽

The Times ◽

The Right

SummaryA Basset Hound with elbow dysplasias (ununited anconeal process and elbow incongruity in the left elbow, fragmented medial coronoid process and elbow incongruity in the right elbow) was followed by serial radiography, computer tomographic (CT) scan and arthroscopy at eight,11,13,16 and 19 months of age. Radiographs were insensitive to progressive changes in the elbow dysplastic joints. CT and arthroscopy were both highly sensitive to subtle and severe changes occurring in the elbow joint over the times examined. Further studies evaluating the effect of multiple arthroscopic examinations itself on joints as well as age that CT will be sensitive to the earliest changes in the elbow joint need to be investigated. Hopefully, these studies will help evaluate early surgical interventions and help to eliminate elbow dysplasia in breeding dogs.

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Computed tomography of ununited anconeal process in the dog

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-11-10-0138 ◽

2012 ◽

Vol 25 (06) ◽

pp. 498-505 ◽

Cited By ~ 5

Author(s):

J. J. Labruyère ◽

J. F. Bardet ◽

E. G. Gasch

Keyword(s):

Computed Tomography ◽

Coronoid Process ◽

Tomographic Images ◽

Computed Tomographic ◽

Elbow Dysplasia ◽

Preoperative Ct ◽

Sclerotic Lesions ◽

Grade 3 ◽

Humeral Condyle ◽

Ct Features

SummaryObjective: The purpose of this study was to describe computed tomography (CT) features of the ununited anconeal process and relate them with the following elbow dysplasia signs: medial coronoid disease, medial humeral condyle changes, osteoarthritis (OA), and radioulnar incongruence.Methods: Computed tomographic images of dogs older than six months with an ununited anconeal process were evaluated (n = 13). Ununited anconeal process features were described as being complete or incomplete, and the degree of displacement, volume, and presence of cysts and sclerosis were also evaluated. Medial coronoid disease was defined as an irregular medial coronoid process shape, presence of sclerosis and fragmentation. Medial humeral condyle changes were defined as subchondral bone flattening, lucencies, and sclerosis. Osteoarthritis was graded depending on the osteophytes size. Radioulnar incongruence was measured on a sagittal view at the base of the medial coronoid process.Results: Eleven elbows had a complete and two had an incomplete ununited anconeal process. All ununited anconeal processes had cystic and sclerotic lesions. Seven ununited anconeal processes were displaced and six were non-displaced. Mean ununited anconeal process volume was 1.35 cm3 (0.61 cm3 – 2.08 cm3). Twelve elbows had signs of medial coronoid disease (4 of them with a fragmented medial coronoid process), and one elbow did not show any evidence of medial coronoid disease. Ten elbows had medial humeral condyle changes. One elbow had grade 1 OA, seven elbows had grade 2, and five elbows grade 3. All elbows had radioulnar incongruence: three elbows had a negative and 10 elbows had a positive radioulnar incongruence. Mean radioulnar incongruence was 1.49 mm (0.63 mm – 2.61 mm). Computed tomographic findings were similar in the majority of the elbows studied: complete ununited anconeal processes with signs of medial coronoid disease, positive radioulnar incongruence, high grade of OA, sclerotic medial humeral condyle changes, and large ununited anconeal process volumes.Clinical significance: Incomplete small ununited anconeal process volumes could be associated with a lower incidence of medial coronoid disease or medial humeral condyle changes. We recommend performing preoperative CT of elbows with an ununited anconeal process to evaluate concurrent lesions.

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Medial coronoid disease in an eleven-year-old Labrador retriever

Vlaams Diergeneeskundig Tijdschrift ◽

10.21825/vdt.v84i5.16586 ◽

2015 ◽

Vol 84 (5) ◽

pp. 257-263

Author(s):

M. Dallago ◽

E. De Bakker ◽

E. Coppieters ◽

J. Saunders ◽

I. Gielen ◽

...

Keyword(s):

Computed Tomography ◽

Treatment Outcome ◽

Case Report ◽

Subchondral Bone ◽

Developmental Disorder ◽

Coronoid Process ◽

Labrador Retriever ◽

Arthroscopic Removal ◽

Arthroscopic Findings ◽

Chronic Problem

In this case report, the occurrence of medial coronoid disease (MCD) is described in an elevenyear- old Labrador retriever. A left frontleg lameness had started six months before presentation. Radiographs showed minimal pathology and computed tomography (CT) demonstrated a discrete fissure of the medial coronoid process. Arthroscopy confirmed the presence of a coronoid lesion, visible as chondromalacia. Treatment was performed by arthroscopic removal of the diseased cartilage and subchondral bone. Despite the successful procedure, the dog needed continuous physiotherapy to maintain an acceptable gait. MCD is a developmental disorder mainly affecting young large breed dogs. However, the described dog was already eleven years old. Nevertheless, the duration of lameness was rather short and the imaging and arthroscopic findings could not demonstrate a chronic problem. In the literature, little information is available about the etiology, prevalence and treatment outcome of medial coronoid pathology in old dogs.

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Arthroscopic Findings in 32 Joints Affected by Severe Elbow Incongruity with Concomitant Fragmented Medial Coronoid Process

Veterinary Surgery ◽

10.1111/j.1532-950x.2012.00949.x ◽

2012 ◽

pp. n/a-n/a ◽

Cited By ~ 3

Author(s):

Yves Samoy ◽

Delphine Van Vynckt ◽

Ingrid Gielen ◽

Henri van Bree ◽

Luc Duchateau ◽

...

Keyword(s):

Coronoid Process ◽

Arthroscopic Findings

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Elbow lameness in dogs of six years and older

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-09-03-0032 ◽

2010 ◽

Vol 23 (01) ◽

pp. 43-50 ◽

Cited By ~ 26

Author(s):

A. L. R. Bergenhuyzen ◽

I. Gielen ◽

H. van Bree ◽

L. Duchateau ◽

B. Van Ryssen ◽

...

Keyword(s):

Computed Tomography ◽

Retrospective Study ◽

Clinical Significance ◽

Coronoid Process ◽

Medial Compartment ◽

Elbow Arthroscopy ◽

Arthroscopic Findings ◽

High Incidence ◽

Arthroscopic Examination ◽

Humeral Condyle

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.

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Traumatic fracture of the medial coronoid process in 24 dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-15-09-0154 ◽

2016 ◽

Vol 29 (04) ◽

pp. 325-329 ◽

Cited By ~ 4

Author(s):

Sherman Canapp ◽

Christopher Leasure ◽

David Dycus ◽

Erica O’Donnell ◽

Desmond Tan

Keyword(s):

Coronoid Process ◽

Radiographic Evidence ◽

Term Outcome ◽

Joint Pathology ◽

Elbow Dysplasia ◽

Traumatic Fracture ◽

Distinct Disease ◽

Clinical Records ◽

Displaced Fracture

SummaryObjective: To describe traumatic fracture of the medial coronoid process in dogs as a clinically distinct disease unrelated to congenital elbow dysplasia.Methods: Clinical records of dogs with acute, traumatic, unilateral lameness attributable to medial coronoid process disease were reviewed retrospectively. Clinical interpretation included findings on physical examination, orthopaedic examination, and subjective gait analysis. Radiographs of the affected and contralateral elbows were obtained and reviewed for pathology. Arthroscopy of the elbow joints was performed by one of three surgeons and findings were compared to preoperative diagnostics. Postoperative follow-up was continued for 16 weeks.Results: Twenty-four dogs were included in this study. All dogs in this study were free of radiographic evidence of medial coronoid pathology. All dogs were diagnosed with a single, large, displaced or non-displaced fracture of the medial coronoid process, with no other joint pathology. Dogs generally had an excellent short-term outcome following arthroscopic treatment of the fractured medial coronoid process.Clinical significance: Traumatic fracture of the medial coronoid process should be considered a clinical disease distinct from dysplasia-related fragmentation and should be considered as a differential diagnosis in dogs that are presented with the complaint of acute unilateral elbow discomfort or lameness, especially after concussive activities involving the forelimb.

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Spectrum of arthroscopic findings in 84 canine elbow joints diagnosed with medial compartment erosion

Vlaams Diergeneeskundig Tijdschrift ◽

10.21825/vdt.v87i2.16084 ◽

2018 ◽

Vol 87 (2) ◽

pp. 76-85

Author(s):

E. Coppieters ◽

E. De Bakker ◽

B. Broeckx ◽

Y. Samoy ◽

G. Verhoeven ◽

...

Keyword(s):

Pathological Finding ◽

Medial Compartment ◽

Lateral Part ◽

Age Difference ◽

Elbow Dysplasia ◽

Arthroscopic Findings ◽

Group 3 ◽

Group 2 ◽

Cartilage Erosion ◽

Group 1

Elbow dysplasia is an important cause of forelimb lameness in large breed dogs. The aim of this study was to report on the arthroscopic findings associated with medial compartment erosion (MCE) of the canine elbow joint. Retrospectively, records of 84 elbow joints from 66 dogs diagnosed arthroscopically with MCE were retrieved from a medical records database (2008 - 2012). The radiographic degree of osteoarthritis was determined. Arthroscopic images and videos were evaluated in detail. In nine joints (10.7%), MCE was the only pathological finding (= group 1). Group 2 (n = 50, 59.5%) consisted of elbows with MCE concomitant with medial coronoid process (MCP) pathology. In group 3 (n = 25 joints, 29.8%), MCE was diagnosed during a second- look arthroscopy in dogs presented with lameness after arthroscopic treatment for medial coronoid disease. There was a significant age difference (p < 0.001) between the groups, with dogs in group 1 being the oldest. Complete erosion of the medial compartment was most commonly found in group 1, whereas focal cartilage erosion was mostly identified in group 2. Overall, additional cartilage pathology of the lateral part of the humeral condyle and/or the radial head was recognized in 58.3% of the joints (49/84).

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Computed tomography findings in a cohort of 169 dogs with elbow dysplasia - a retrospective study

BMC Veterinary Research ◽

10.1186/s12917-021-02997-5 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Mateusz Hebel ◽

Wojciech K. Panek ◽

Jakub J. Ruszkowski ◽

Maria Nabzdyk ◽

Dariusz Niedzielski ◽

...

Keyword(s):

Retrospective Study ◽

Small Animal ◽

Coronoid Process ◽

German Shepherd ◽

Veterinary Clinic ◽

Elbow Dysplasia ◽

Mixed Breed ◽

Study Population ◽

The Mean ◽

Ct Data

Abstract Background Canine elbow dysplasia (CED) is a complex developmental skeletal disorder associated with a number of pathological conditions within the cubital joint. Because CED is a heritable disease, it is important to identify and remove the affected animals from breeding. The first objective of this study was to describe the prevalence of medial coronoid process disease (MCPD) without (MCD) or with (FMCP) fragmented medial coronoid process, osteochondrosis (OC) and/or osteochondritis dissecans (OCD), ununited anconeal process (UAP), radio-ulnar incongruence (INC R-U) and humero-ulnar incongruence (INC H-U) in dogs with the use of CT imaging. The second aim was to determine the influence of demographics on the prevalence of investigated pathologies in dogs with clinical evidence of elbow dysplasia. Results In this retrospective study, CT data records of 169 dogs of different breeds presented to the small animal veterinary clinic from 2012 to 2018 were included. 69.23% of dogs diagnosed with CED were young (≤ 2 years old). The mean age of dogs presented with INC R-U was 1.68 ± 1.82 years, while in dogs without INC R-U the mean age was 2.64 ± 2.59 years. The mean age of dogs with INC H-U was 1.94 ± 2.06 years, while without INC H-U 3.29 ± 2.09 years. Labrador Retrievers, German Shepherd and Bernese Mountain dogs were most frequently presented with CED-associated lameness. In 122 dogs OA of varying severity was found. Conclusion INC H-U, FMCP and MCD were among the most frequently found components of CED found in the present study. OCD and UAP were the least frequently diagnosed. Dogs presented with INC R-U and INC H-U were significantly younger than dogs without these CED components. Boxers, Dog de Bordeaux, American Staffordshire terriers and mixed-breed dogs were diagnosed later in life than the other breeds. OA of varying severity was found in 72.18% of dogs. Males accounted for more than 75% of the study population.

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