Small Animal Radiology and Ultrasound: A Diagnostic Atlas and Text

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Chapter Four The Appendicular Skeleton 581 Mucopolysaccharidosis. Bilateral subluxation of the coxofemoral joints with valgus deformity of the femoral heads and shallow acetabula has been described in association with mucopolysaccharidosis VI in cats. Other skeletal deformities may include epiphyseal dysplasia, fusion of cervical vertebrae, flaring of the ribs at the costochondral junctions, osteoarthrosis of the vertebral articulations, and sternal deformities. 603-605 These findings are an aid in distinguishing this disease from other causes of secondary degenerative joint disease. Mucopolysaccharidosis I also has been described, and it appears similar to mucopolysaccharidosis VI, except that epiphyseal dysplasia of long bones is not seen. 606 Mucopolysaccharidosis II (Hunter’s disease) has been reported in a Labrador Retriever. 607 Hypervitaminosis A. Ankylosis of joints associated with extensive periarticular softtissue mineralization has been associated with hypervitaminosis A in cats. 338,339,608 Lesions occur at points of ligamentous and tendinous attachment to the bone, especially in the periarticular areas (see Fig. 4-82). Periarticular osteophytes are observed most often around the elbow and shoulder, while involvement of the stifle, hip, and carpal and tarsal joints is rare. The periarticular osteophytes are smooth and evenly mineralized and tend to coalesce and bridge the affected joint. The dietary history and presence of lesions in the vertebral column will help to confirm the diagnosis. Hypothyroidism. Congenital hypothyroidism has been described in dogs and cats. Although the retarded bone development that has been observed could result in limb deformity and subsequent secondary degenerative joint disease, this has not been described. Hyperparathyroidism. Hyperparathyroidism, either primary or secondary, may produce secondary degenerative joint disease as a result of limb deformity. Degenerative joint disease has not been reported as a direct result of hyperparathyroidism. Neoplastic Arthropathy. Although rare, tumors may originate from the periarticular soft tissues and invade the joint. Synovial sarcoma is the most common tumor of this type, although chondrosarcoma, fibrosarcoma, lymphosarcoma, undifferentiated sarcomas, and others are observed. 219-223 The stifle or elbow is involved more frequently, although any joint may be affected. Soft-tissue swelling will be identified in all cases. This frequently extends beyond the anatomical limits of the joint. Soft-tissue mineralization is uncommon. A small amount of periosteal proliferation may be present at the margins of the lesion. The predominant radiographic finding usually is destruction of the bones of the affected joint. Bony destruction begins at the sites of periosteal and ligamentous attachment, but eventually the subchondral bone will be involved also. Because joint neoplasms occur in older dogs, they may be superimposed on preexisting degenerative joint disease and some difficulty may be encountered in recognizing the presence of a tumor. The irregularly shaped, localized soft-tissue swelling and bony destruction should not be overlooked if the joint is evaluated carefully, despite the presence of degenerative joint disease (see Figs. 4-60 and 4-61). Infectious Arthritis. Joint infection is uncommon in dogs and cats. It may result from hematogenous spread to the synovial membrane or synovial fluid or direct joint penetration from a contiguous soft-tissue or bone infection, external wound, surgical procedure, or intraarticular injection. 609-614 Bacterial infection is encountered most often, although fungal, viral, mycoplasmal, and protozoal infections have been described. 615-633 Infectious arthritis is characterized radiographically by soft-tissue swelling, subchondral bone destruction and sclerosis, and periarticular periosteal proliferation (see Figs. 4-73 and 4-76). The radiographic changes are minimal early in the disease, usually limited to soft-tissue swelling. By the time bony changes become evident there will be considerable cartilage destruction. The soft-tissue swelling with infectious arthritis is usually more extensive than that seen with other joint diseases. Poorly defined or faintly mineralized bony proliferation may be observed at the points of ligamentous or joint capsule attachment. Subchondral bone destruction and sclerosis will occur later in the disease and indicates extensive destruction of articular cartilage (Fig. 4-135). Although the radiographic changes observed with infectious arthritis are similar to those of secondary degenerative joint disease or some immune joint diseases, the radiographic changes generally are more severe and extensive in infectious arthritis when compared with other arthritides.
582 Small Animal Radiolo g y and Ultrasono graphy Fig. 4-135 A 3-year-old spayed female Labrador Retriever was brought in for left hind limb lameness 1 month after a femoral head and neck resection. A, Radiographic findings include a mixture of demineralization and surface irregularity in the left acetabulum. B, Progression of the left acetabular changes is apparent on the follow-up view performed 1 month later. Diagnosis: Septic arthritis. A B
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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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100 Small Animal Radiolo g y and Ul
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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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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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