Canine developmental elbow disease part 1: aetiopathogenesis and diagnosis

2021 ◽  
Vol 12 (2) ◽  
pp. 74-79
Author(s):  
Rosanne Fernee-Hall ◽  
Jan Janovec
Keyword(s):  
Gold Standard ◽  
Elbow Joint ◽  
Advanced Stage ◽  
Restricted Movement ◽  
Multiple Modalities ◽  
Nonsurgical Management ◽  
Elbow Dysplasia ◽  
Arthroscopic Examination ◽  
Multiple Abnormalities ◽  
Extensive Damage

Elbow dysplasia or ‘developmental elbow disease’ as it is now known, is an umbrella term encompassing multiple abnormalities of the elbow joint. These include elbow incongruity, fragmented medial coronoid process, osteochondritis dissecans and ununited anconeal process. These problems may occur individually or in combination with each other and all may cause lameness, pain, reluctance to exercise and restricted movement as the disease progresses. The advanced stage of osteoarthritis associated with medial coronoid disease involving extensive damage to or loss of cartilage is known as medial compartment disease. There are multiple modalities available for imaging the elbow joint: radiography which is widely available in general practice can detect some changes but may miss others; computed tomography in conjunction with arthroscopic examination is considered the ‘gold standard’ in elbow imaging. Part 1 of this two part series of articles introduces the aetiopathogenesis of canine developmental elbow disease, and part 2 will cover the surgical and nonsurgical management.

Sensitivity and specificity of arthroscopic estimation of positive and negative radio-ulnar incongruence in dogs

2009 ◽  
Vol 22 (06) ◽  
pp. 437-441. ◽  
Author(s):  
H. Werner ◽  
V. Grevel ◽  
G. Oechtering ◽  
P. Böttcher ◽  
P. Winkels
Keyword(s):  
Sensitivity And Specificity ◽  
Elbow Joint ◽  
In Vitro Model ◽  
Treatment Plan ◽  
Accurate Estimation ◽  
Elbow Dysplasia ◽  
Random Manner ◽  
Vitro Model ◽  
Clinical Conditions

Summary Objectives: To determine the sensitivity and specificity of arthroscopic estimation of positive and negative radio-ulnar incongruence (RUI) in the canine elbow joint. Methods: Experimental radial shortening and lengthening by 1 and 2 mm increments were performed in nine right elbow joints, extending an established surgical in vitro model of RUI. Arthroscopic estimation of each artificially produced radio-ulnar joint conformation (RUJC) was done using a graduated hook probe. A total of 72 RUJC were blindly evaluated in a random manner by an independent investigator and estimated in 1 mm increments (-2, -1, 0, +1, +2). Results: The sensitivity for identification of an incongruent joint was 0.98 (95% CI: 0.90 to 0.99). The specificity for identification of a congruent joint was 0.89 (95% CI: 0.65 to 0.98). Analysing the data only in respect to a congruent joint versus one with a shortened radius (positive RUI) resulted in a sensitivity of 0.96 (95% CI: 0.80 to 0.99) and a specificity of 1.00 (95% CI: 0.92 to 1.00). Clinical significance: Accurate estimation of RUI in dogs affected by elbow dysplasia might improve functional outcome and prevent osteoarthritis when corrective or modifying osteotomies are being considered as part of the treatment plan. Arthroscopy has been shown to be highly accurate and precise in detecting both positive and negative RUI in vitro. However, its diagnostic strength under clinical conditions still has to be proven.

Arthroscopic features of primary and concomitant flexor enthesopathy in the canine elbow

2013 ◽  
Vol 26 (05) ◽  
pp. 340-347 ◽  
Author(s):  
Y. Samoy ◽  
E. Coppieters ◽  
L. Mosselmans ◽  
B. Van Ryssen ◽  
E. de Bakker
Keyword(s):  
Clinical Significance ◽  
Correct Diagnosis ◽  
Diagnostic Techniques ◽  
Coronoid Process ◽  
Sensitive Detection ◽  
Pathological Changes ◽  
Elbow Dysplasia ◽  
Arthroscopic Examination

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.

scholarly journals Nonsurgical management of advanced hepatocellular carcinoma: a clinical practice guideline

2019 ◽  
Vol 27 (2) ◽  
Author(s):  
B. M. Meyers ◽  
J. Knox ◽  
R. Cosby ◽  
J. R. Beecroft ◽  
K. K.W. Chan ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Practice Guideline ◽  
Hepatitis B Surface Antigen ◽  
Antiviral Treatment ◽  
Intermediate Stage ◽  
Cochrane Library ◽  
Advanced Hepatocellular Carcinoma ◽  
Advanced Stage ◽  
Nonsurgical Management

Background Practice guidelines based on a systematic review of the literature regarding the nonsurgical management of hepatocellular carcinoma (hcc) in North America are lacking. Resection and transplantation are the foundations for cure of hcc; however, most patients are diagnosed at an advanced stage, precluding those curative treatments. A number of local or regional therapies are used and are followed by systemic therapy for advanced or progressive disease. Other treatments are available, but their efficacy, compared with those standards, is not well known. Methods First, systematic review questions were developed. Literature searches of the medline, embase, and Cochrane library databases (January 2000 to July 2018 or January 2005 to July 2018 depending on the question) were conducted; in addition, abstracts from the 2018 annual meeting of the American Society of Clinical Oncology were reviewed. A practice guideline was drafted that was then scrutinized by internal and external reviewers. Results Seventy-seven studies were included in the guideline: no guidelines, two systematic reviews, and seventyfive primary studies published in full (including one pooled analysis). Five recommendations were developed. Conclusions There is no evidence for or against the use of local or regional interventions other than transarterial chemoembolization for the treatment of intermediate- or advanced-stage hcc. Furthermore, there is no evidence to support the addition of sorafenib to any local or regional therapy. Sorafenib or lenvatinib are recommended for firstline systemic treatment of intermediate-stage hcc. Regorafenib or cabozantinib provide survival benefits when given as second-line treatment. Antiviral treatment is recommended in individuals with advanced hcc who are positive for the hepatitis B surface antigen.

scholarly journals Medial compartment disease in a young Large Munsterlander

2012 ◽  
Vol 81 (2) ◽  
pp. 88-92
Author(s):  
E. Coppieters ◽  
Y. Samoy ◽  
P. Pey ◽  
T. Waelbers ◽  
B. Van Ryssen
Keyword(s):  
Elbow Joint ◽  
Substantial Improvement ◽  
Additional Treatment ◽  
Coronoid Process ◽  
Medial Compartment ◽  
Radiographic Examination ◽  
Arthroscopic Examination ◽  
The Right ◽  
Humeral Condyle ◽  
Strong Suspicion

Medial compartment disease (MCD) is a recently recognized elbow disorder in dogs and refers to extensive cartilage erosions of the medial compartment of the elbow joint. This report describes a case of MCD in a 10- month-old Large Munsterlander that was presented with right frontleg lameness. Based on signalement, history and radiographic examination, there was a strong suspicion of a fragmented coronoid process (FCP) of the right elbow. However, arthroscopic examination revealed extensive cartilage erosions of the medial part of the humeral condyle and the medial coronoid process in addition to a small coronoid fragment (FCP) and a small OCD-like lesion. After the arthroscopic treatment, the dog did not improve. Neither did additional treatment with autologous conditioned plasma (Arthrex ACP®) lead to a substantial improvement. Finally, the dog was euthanized because of persistent lameness.

Elbow dysplasia in a Basset Hound

2003 ◽  
Vol 16 (01) ◽  
pp. 11-15 ◽  
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.

Endovascular Treatment of Malignant Portomesenteric Venous Obstruction

2020 ◽  
Vol 04 (03) ◽  
pp. 267-272
Author(s):  
Nassir Rostambeigi ◽  
Michael D. Darcy
Keyword(s):  
Portal Hypertension ◽  
Rare Condition ◽  
Future Research ◽  
Advanced Stage ◽  
Venous Obstruction ◽  
Management Options ◽  
Factors Affecting ◽  
Vein Thrombosis ◽  
Nonsurgical Management ◽  
Neoplastic Process

AbstractPortal vein thrombosis (PVT) is a rare condition, and malignancies account for up to a quarter of cases. Malignant PVT is an advanced stage in the neoplastic process, which affects survival. In addition, portal venous obstruction can result in portal hypertension and associated complications. There are a few reports on the surgical and nonsurgical management of this condition. We herein aim to present an overview of these management options and discuss the factors affecting the outcomes after each. We will also discuss gaps in knowledge and the possible areas for future research.

Predicting Failure of Nonoperative Treatment for Insertional Achilles Tendinosis

2017 ◽  
Vol 11 (3) ◽  
pp. 252-255 ◽  
Author(s):  
James F. Stenson ◽  
Christopher W. Reb ◽  
Joseph N. Daniel ◽  
Sundeep S. Saini ◽  
Mohammed F. Albana
Keyword(s):  
Risk Factors ◽  
Standard Deviation ◽  
Corticosteroid Injection ◽  
Case Series ◽  
Nonoperative Treatment ◽  
Retrospective Case ◽  
Duration Of Symptoms ◽  
Multiple Modalities ◽  
Achilles Tendinosis ◽  
Nonsurgical Management

Nonoperative treatment for midportion Achilles tendinosis is well defined by the literature. Multiple modalities are described for the management of insertional Achilles pathology, but no consensus exists regarding efficacy. Surgical intervention for insertional Achilles tendinosis (IAT) is successful greater than 80% of the time. Our objective was to risk stratify patients who would fail nonsurgical management of IAT and thus benefit progressing to surgery. We reviewed the records of 664 patients with IAT. The cohort was 53% male and 80% obese. Mean age was 53.7 years (standard deviation 14.7 years). Average duration of symptoms was 10.4 months (standard deviation 28 months). Of the parameters collected, 4 were found to correlate with failing nonoperative treatment: visual analog scale, limited ankle range of motion, previous corticosteroid injection, and presence of Achilles tendon enthesophyte. We found that as the number of risk factors increased so did the chance of failing nonoperative treatment. With all 4 parameters, chance of failing conservative treatment was only 55%. Thus, nonoperative management should be exhausted until surgery is the only remaining option. However, the presence of one of the aforementioned risk factors can aid a surgeon in the decision to pursue surgery in the appropriate clinical scenario. Levels of Evidence: Level IV: Retrospective Case series

scholarly journals Recent Advances in Development of New Technology in Pre and Intra Operative Breast Cancer Diagnoses

2021 ◽  
Vol 5 (2) ◽  
pp. 1-17
Author(s):  
Justina A Ugwah ◽  
Martin O’Sullivan ◽  
Brian O’Donnell ◽  
Eric J. Moore
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Gold Standard ◽  
Malignant Disease ◽  
Review Paper ◽  
New Technology ◽  
Treatment Options ◽  
Detection Accuracy ◽  
Advanced Stage ◽  
Ongoing Research

Breast cancer is the second most occurring malignant disease in women. 1 in 9 women will be affected by this disease in their lifetime. The gold standard for breast cancer screening is the mammographic technique, which has its limitations especially for women aged below 40 as a result of breast density. Ongoing research are exploring techniques that can improve detection accuracy as well as reduce time and money spent in advanced stage treatment options. This review paper highlights the different technologies that have been developed for breast cancer diagnoses.

Computerized measurements of radiographic anatomical parameters of the elbow joint in Bernese Mountain Dogs

2012 ◽  
Vol 25 (03) ◽  
pp. 250-261 ◽  
Author(s):  
H. G. Schmoekel ◽  
H. Waibl ◽  
L. Brunnberg ◽  
S. Stein
Keyword(s):  
Elbow Joint ◽  
Elbow Flexion ◽  
Opening Angle ◽  
Radiographic Analysis ◽  
Kind Permission ◽  
Elbow Dysplasia ◽  
The Difference ◽  
Area X ◽  
Humeral Condyle ◽  
Anatomical Parameters

SummaryObjective: Comparison of two methods for evaluation of anatomical parameters of elbow joints in Bernese Mountain Dogs.Study design: Radiographic analysis.Animals: Nine hundred and thirty-one radiographs of elbow joints from 305 Bernese Mountain Dogs.Material and methods: The angles OL, PA, RA and UL were measured according to the Mues method and the Radius of the humeral condyle, Opening angle beta, Quotient Q and Ae, Area X, Step 1 and Step 2 according to the Viehmann method. The radiographs were divided according to their angle of flexion into five groups: 0–30°, 31–60°, 61–90°, 91–120° and >120°. The difference and the correlation between measured values and the elbow dysplasia (ED) score was calculated and compared.Results: The average values of angle OL, PA and RA, Area X, Step 1 and Step 2 were significantly different within the different elbow flexion angle groups. The values of Opening angle beta, Quotients Q and Ae as well as Radius of the humeral condyle varied independently from the degree of the elbow flexion on the radiograph. The angles OL, PA and RA and the Radius of the humeral condyle, the Opening angle beta, the Quotients Q and Ae, Step 1 and Step 2 correlated with the ED score.Conclusion: In contrast to the method of Mues, the majority of the measured parameters of the method of Viehmann were not influenced by the degree of flexion of the elbow joint and correlated with the ED score. Clinical relevance: The method of Viehmann warrants consideration for the evaluation of radiographs of elbow joints in the Bernese Mountain Dog for ED.This article is based on a study first reported in S. Stein's doctoral thesis, which was presented on 08.05.2007 and published thereafter in full by Mensch & Buch Verlag. This abridged and translated version is now being published with the kind permission of Mensch & Buch Verlag.

Bone dysplasias in the labrador retriever: a radiographic study

1999 ◽  
Vol 35 (4) ◽  
pp. 332-340 ◽  
Author(s):  
JP Morgan ◽  
A Wind ◽  
AP Davidson
Keyword(s):  
Humeral Head ◽  
Elbow Joint ◽  
Hip Dysplasia ◽  
Femoral Condyle ◽  
Radiographic Study ◽  
Stifle Joint ◽  
Elbow Dysplasia ◽  
Bone Dysplasias ◽  
One Year ◽  
Labrador Retrievers

A radiographic study of the humeral head, elbow joint, hip joint, stifle joint, tarsal joint, and lumbosacral (LS) junction was performed in 1,018 Labrador retrievers in search for humeral head, femoral condyle, and tarsal osteochondroses; elbow and hip dysplasias; and transitional LS vertebrae. The ages of all dogs reported were one year or older. Elbow dysplasia was detected as the most common lesion (17.8%), with a higher prevalence in the male dog. Hip dysplasia was the second most common lesion (12.6%) and was found equally in the male and female. Elbows and hips were often affected in the same dog (4.2%). Transitional vertebral segments were found more frequently in the female (4.2%) than in the male (1.0%), and the condition was thought to be inherited.

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