Tendon and ligament conditions of the shoulder

Question 1

What is the most common cause of shoulder lameness in adult dogs?

Answer 1

Tendon and ligament conditions

Question 2

What injuries are often seen, which is the most common?

Answer 2

Most common: rupture of medial glenohumeral ligament
ligament rupture (partial, complete), inflammation, mineralization/ossification
Intra or extraarticular, both

Question 3

Why is it difficult to diagnose?

Answer 3

often unnoticed
difficult to asses during clinical exam
image modalities often find accidental subclinical findings
no mineralization of tendon

Question 4

Aetiopathogenesis?

Answer 4

Mechanical overloading, chronic repetitive strian injuries, vascular compromize, shoulder instability due to failure of passive or active restraints, trauma

Unknown/poorly understood

Question 5

Signalement?

Answer 5

Medium to large breeds, middle aged
Labrador retriever

Question 6

History?

Answer 6

insidous onset, progress, weightbearing lameness - improves with rest, pronounced with activity
Can become non-weightbearing after i.e. a jump

Question 7

Clinical examination?

Answer 7

Subtle findinger
muscle atrophy
pain on shoulder manipulation (inconsistent)
Cranial drawer test
Shoulder instability test (abduction, adduction)

Question 8

Radiography?

Answer 8

can sometimes see mineralization of tendons (can be accidental)

Question 9

Ultrasonography

Answer 9

can be very useful - increased fluid, synovia, steatitis

Question 10

Gold standard?

Answer 10

Arthroscopy

Question 11

CT?

Answer 11

can be used, but does not show instability or degree of tendon damage