Shoulder Disease

Question 1

what is the main shoulder condition in young, large breed dogs

Answer 1

OC / OCD

Question 2

what is the main shoulder condition in adult dogs and what causes it

Answer 2

joint instability (usually medial)

caused by tearing of the:
- medial glenohumeral ligament
- supscapularis muscle
- joint capsule

Question 3

shoulder OC/OCD

Answer 3

disruption of normal endochondral ossification on the caudomedial humeral head

often bilateral

Question 4

clinical signs of OC/OCD

Answer 4

thoracic limb lameness

can be subclinical

Question 5

shoulder OC/OCD treatment

Answer 5

conservative for OC only

surgical: flap removal and debridement arthroscopy
- good prognosis

Question 6

glenoid dysplasia

Answer 6

abnormal development of the medial glenoid leading to luxation

occurs in toy breed dogs

Question 7

clinical signs of glenoid dysplasia

Answer 7

lameness and muscle atrophy

can be subclinical then become clinical later in life

Question 8

treatment of glenoid dysplasia

Answer 8

surgical:
- stabilization: usually fails
- salvage: arthrodesis

Question 9

incomplete ossification of the caudal glenoid

Answer 9

caudal glenoid fails to completely ossify, leaving a mineralized piece of cartilage in the joint

Question 10

clinical signs of incomplete ossification of the caudal glenoid

Answer 10

usually incidental

may cause pain/lameness

Question 11

treatment for incomplete ossification of the caudal glenoid

Answer 11

usually none needed

can do arthroscopic removal of non-ossified cartilage

Question 12

what is the most common soft tissue injury in dogs

Answer 12

biceps brachii tendinopathy

Question 13

biceps brachii tendinopathy

Answer 13

acute or chronic repetitive trauma causing biceps tendon to tear

Question 14

signalment for biceps brachii tendinopathy

Answer 14

adult
large breed
active dogs

Question 15

clinical signs of biceps brachii tendinopathy

Answer 15

lameness
pain on abduction
muscle atrophy

Question 16

treatment for biceps brachii tendinopathy

Answer 16

conservative: first choice
- use shoulder hobbles, rest, rehab, NSAIDs

surgical:
- tenodesis (screw attaches tendon to bone)
- transection (only done if tendon is not salvageable)

Question 17

diagnosis of biceps brachii tendinopathy

Answer 17

positive biceps test: pain in response to pressing on the insertion of the biceps at the intertubercular groove

shoulder drawer test
biceps retraction test

radiographs: calcification of new bone production in bicipital groove

ultrasound: fluid within bursa, changes to tendon structure, hypoechoic ring around tendon

Question 18

supraspinatus tendinopathy

Answer 18

mineralization of the supraspinatus

common in large breed dogs

Question 19

treatment for supraspinatus tendinopathy

Answer 19

conservative: rest, NSAIDs

surgical: removal of calcification in the tendon (last resort; takes out entire tendon)

Question 20

diagnosis of supraspinatus tendinopathy

Answer 20

calcifications near the humeral head

Question 21

infraspinatus contracture

Answer 21

most common in active hunting/herding dogs

Question 22

diagnosis of infraspinatus contracture

Answer 22

observation:
dog holds thoracic limb in distal abduction with foot circumducted

Question 23

traumatic luxation

Answer 23

uncommon

glenoid is structured normally but trauma causes medial or lateral luxation

Question 24

treatment for traumatic luxation

Answer 24

medial: use a velpeau sling to keep shoulder in flexion

lateral: use a spica splint to keep shoulder in extension

Question 25

what is the most effective treatment for OA

Answer 25

weight loss

can also use low impact exercises, NSAIDs, and omega 3 FA supplements