Elbow Dysplasia

Question 1

What are 5 possible components to canine elbow dysplasia?

Answer 1

1. ununited anconeal process
2. osteochondrosis dissecans of the humeral condyle
3. fragmentation of the humeral condyle
4. fragmentation of the medial coronoid process
5. elbow incongruity

Question 2

What dogs most commonly develop elbow dysplasia? What does it typically develop into?

Answer 2

young dogs

degenerative osteoarthritis –> even with treatment, sometimes the best we can do is slow down development

Question 3

What changes are indicative of elbow dysplasia on radiographs?

Answer 3

• ulna sclerosis
• degenerative changes above the anconeal process

Question 4

What is the most common breed associated with ununited anconeal processes? When do signs typically arise? What is seen?

Answer 4

GSDs - other large breeds

4-12 months

forelimb lameness with pain on flexion and extension of elbow, may be bilateral (screen for development)

Question 5

How is an ununited anconeal process diagnosed?

Answer 5

radiographs +/- CT - anconeal center of officiation fails to fuse to the ulna

(best seen on flexed lateral projection)

Question 6

What are 3 options for treating an ununited anconeal process?

Answer 6

1. medical management with NSAIDs (unrewarding)
2. excision of anconeal process (most consistent)
3. lag screw fixation and proximal ulnar ostectomy

Question 7

What is OCD of the humeral condyle? What are 4 potential factors?

Answer 7

abnormal endochondral ossification resulting in thickening of the articular cartilage

1. growth rate
2. genetics
3. hormonal imbalance
4. diet

Question 8

When do signs of OCD of the humeral condyle typically develop? What is seen?

Answer 8

4-7 months

forelimb lameness with pain on flexion and extension of the elbow joint (50% bilateral)

Question 9

What are 4 signs of OCD of the humeral condyle on radiographs?

Answer 9

1. lesion on medial aspect on the humeral trochlea
2. flattening
3. subchondral bone defect and surrounding sclerosis
4. osteophytosis

Question 10

What is the best treatment option for OCD of the humeral condyle?

Answer 10

surgical removal of flap and debridement of subchondral bone, typically done arthroscopically

Question 11

What are 5 signs on radiographs indicative of medial fragmented coronoid processes?

Answer 11

hard to visualize fragment, but secondary changes can be indicative (also view other elbow for comparison)

1. sclerosis of subchondral bone along trochlear notch of the ulna and adjacent to the proximal radioulnar articulation near the lateral coronoid process
2. large, blunted medial coronoid process or osteophyte development
3. proliferative bone on proximal anconeus
4. degenerative joint disease
5. elbow incongruity

Question 12

What is the best treatment option for medical coronoid process fragmentation?

Answer 12

surgical removal of fragment

Question 13

What is elbow incongruity? What are the 2 major features?

Answer 13

poor alignment of the joint surfaces of the elbow

1. abnormal shape of the ulnar trochlear notch
2. step between radius and ulna, either cause by a short radius or short ulna

Question 14

How is elbow incongruity treated?

Answer 14

ulnar ostectomy