Small Animal Radiology and Ultrasound: A Diagnostic Atlas and Text

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Chapter Four The Appendicular Skeleton 569 A B Fig. 4-120 An 8-month-old male Saint Bernard with intermittent left rear leg lameness. Lateral (A), flexed lateral (B), and anteroposterior (C) radiographs of the right tarsus were obtained. There is a slight amount of swelling around the hock. The medial aspect of the tibiotarsal articulation is widened and a small bone density is noted within that joint space (open arrow). The medial trochlea of the talus appears small and the proximal aspect is flattened. Although this is evident on both the lateral and flexed lateral views (arrows), flexion of the leg demonstrates the lesion more clearly. Small calcified fragments can be seen caudal to the trochlea of the talus in the flexed lateral view. Diagnosis: Osteochondritis dissecans of the hock. C
570 Small Animal Radiolo g y and Ultrasono graphy A B Fig. 4-121 A 5-month-old female German Shepherd dog with a left foreleg lameness of 2 weeks duration. Lateral (A) and flexed lateral (B) radiographs of the left foreleg were obtained. A radiolucent line separates the anconeal process from the proximal ulna (arrows). This is most obvious in the flexed lateral radiograph. The radiolucent line is hidden by the medial epicondyle of the humerus in the straight lateral view. Diagnosis: Ununited anconeal process. Flexion of the elbow is extremely important in evaluating an animal for ununited anconeal process, because the lesion is more apparent when the joint is flexed. The ununited anconeal process is visible on the straight lateral projection. nose definitively on survey radiographs. 549-566 Fragmented coronoid process often affects both ulnas, although clinical signs may be unilateral. The flexed lateral view of the elbow is the most commonly used view in attempting to make the diagnosis. The medial coronoid process usually is viewed most clearly on a slightly supinated anteroposterior view. It also may be seen when viewed through the radial head on the lateral view. Frequently, the coronoid fragment will not be identified specifically. Compared with other radiographic techniques, CT has shown the highest accuracy, sensitivity, and negative predictive values in making the diagnosis. 564 Among the earliest radiographic signs that will be seen is mild osteophytosis on the horizontal, or proximal, aspect of the anconeal process. As the condition progresses, endosteal sclerosis of the ulna immediately deep to the coronoid processes just caudal and distal to the semilunar notch and a widened humeroulnar joint space may be seen. Finally, signs of degenerative joint disease may be seen, including osteophytes on the cranial proximal radius, medial humeral epicondyle, proximal margin of the anconeal process, or coronoid process, but typically not affecting the lateral surfaces. The degenerative changes, including the specific pattern of osteophytosis noted above, may be highly suggestive of the diagnosis and may be the only radiographic findings noted (Fig. 4-123). These usually will progress despite surgical intervention. 565-567 The separate coronoid fragment rarely is identified by radiography, because it usually occurs on the lateral aspect of the medial coronoid process (Fig. 4-124). The medial humeral condylar lesion of osteochondrosis may be observed concomitantly with fragmented coronoid process. RETAINED CARTILAGE CORE. Retention of endochondral cartilage occurs in young, large-breed, and giant-breed dogs. 397,568,569 Although any long bone may be involved, the distal ulna is affected most frequently. An inverted radiolucent cone is seen extending proximally from the distal ulnar physis into the metaphysis (Figs. 4-125 and 4-126). Irregular metaphyseal radiolucencies and physeal widening may be observed in other bones. Although the lesion usually is without clinical significance and disappears as normal bone modeling occurs, growth retardation and angular limb deformities may result. Irregular
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SAUNDERS An Imprint of Elsevier Sci
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C H A P T E R O N E Introduction GE
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Chapter One Introduction 3 Fig. 1-1
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metal. Soft tissues or organs surro
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A B C Fig. 2-63 A 10-year-old male
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Fig. 2-101 A 7-year-old male mixed
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Fig. 3-234 A 7-year-old female Brit
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Page 521 and 522: Fig. 4-59 A 9-year-old female Russi
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I N D E X A Abdomen, abnormal prese
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Index 729 Bone, cysts of, 525-527,
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Index 731 Ear, abscess of—cont’
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Index 733 Hydrocephalus—cont’d
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Index 735 Lungs. See also Pulmonary
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Index 737 Pregnancy, determination
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Index 739 S-shaped aortic deformity
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Small Animal Radiology and Ultrasound: A Diagnostic Atlas and Text

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