Elbow rads

Re: Elbow rads

Mark Rowland — Thu, 16 Feb 2012 15:59:47 GMT

Bump, no further comments then?

If not I will go with exercise, NSAIDs and rexray unless I hear different.

Many thanks.

Re: Elbow rads

Mark Rowland — Tue, 14 Feb 2012 17:20:45 GMT

OK any more thoughts (the second is the original that I zoomed in on to show the sesamoid bone)

Thank-you

Re: Elbow rads

Mark Rowland — Tue, 14 Feb 2012 17:19:32 GMT

Re: Elbow rads

Mark Rowland — Tue, 14 Feb 2012 17:18:36 GMT

Re: Elbow rads

Rob Davis — Tue, 14 Feb 2012 17:11:41 GMT

[quote user="Malcolm Ness"]I think so. Nobody has convinced me that any benefit can come from rest whereas if you keep the pup active, they enjoy life a lot more, they are able to get properly fit, they are easier to keep slim and what's more you can get a much better idea of how much of a problem any orthopaedic abnormality actually is and you need that information to guide treatment. We have access to some pretty safe, effective NSAIDs so I like to use them. [/quote]

Having tried to rest my own labrador when he had an elbow lameness at 8 months old, I know how difficult it can be to achieve. If allowing them to exercise normally is unilkely to do any harm, I'm sure that owners (and patients!) will be much happier with this advice!

Re: Elbow rads

Malcolm Ness — Tue, 14 Feb 2012 16:34:54 GMT

[quote user="Rob Davis"]I've always thought activity should be restricted with these.....am I wrong?[/quote]

I think so. Nobody has convinced me that any benefit can come from rest whereas if you keep the pup active, they enjoy life a lot more, they are able to get properly fit, they are easier to keep slim and what's more you can get a much better idea of how much of a problem any orthopaedic abnormality actually is and you need that information to guide treatment. We have access to some pretty safe, effective NSAIDs so I like to use them.

If this turns out to be an elbow dysplasia/coronoid case then it is not unusual in developing lameness before any obvious radiographic changes. Bear in mind that even dogs with quite significant elbow OA on rads can appear sound and capable of normal pain free activity. Many clinicians lose sight of the fact that it is a dog with a problematic elbow that is being treated and not merely an abnormal radiograph.

Bear in mind that these comments are made in general and that a diagnosis of ED/coronoid disease has not been made on the rads in the OP.

Re: Elbow rads

Rob Davis — Tue, 14 Feb 2012 12:26:42 GMT

[quote user="Malcolm Ness"]I would advise normal activity and NSAIDs[/quote]

I've always thought activity should be restricted with these.....am I wrong?

Re: Elbow rads

Mark Rowland — Tue, 14 Feb 2012 09:23:13 GMT

Thank-you, I will try to get the other rads up today.

Re: Elbow rads

Malcolm Ness — Tue, 14 Feb 2012 09:00:17 GMT

[quote user="Mark Rowland"]Yep thats the one, many thanks. So with medial coranoid disease, are we resting with cartrophen?[/quote]

I would advise normal activity and NSAIDs with frequent clinical (every 2 weeks initially) and radiographic reviews (every four weeks initially) bearing in mind that we are, as yet, a long way from a definitive diagnosis.

Re: Elbow rads

Mark Rowland — Tue, 14 Feb 2012 08:38:23 GMT

[quote user="David Beattie"]

Is the fragment you're talking about where the red arrow is pointing? If so, I think this is the lateral aspect of the radiograph and looks like the sesamoid in the tendon of origin of the supinator muscle - it's present in about a third of elbow radiographs:

Anatomic and radiographic appearance of a sesamoid bone in the tendon of origin of the supinator muscle of dogs (1985). Wood, McCarthy, Howlett Am J Vet Res. 1985;46(10):2043-7.

Abstract:

"Radiologic and anatomic studies of the elbow of 100 dogs of 17 different breeds showed that a sesamoid bone may be located in a constantly present sesamoid cartilage associated with the tendon of origin of the supinator muscle. The sesamoid was observed in 31% of the radiographs of 100 supinator tendons dissected from 50 of the dogs. The bone was usually bilateral and was best demonstrated in craniocaudal medial-to-lateral oblique radiographs of the elbow where it articulated with the craniolateral aspect of the head of the radius."

I'd agree with other posts that medial coronoid disease pretty likely given signalment, but no cause of lameness visible on radiographs posted. I find sometimes that when I don't get a pain reaction with forced elbow extension, I do with flexion+pronation.

[/quote]

Yep thats the one, many thanks. So with medial coranoid disease, are we resting with cartrophen?

Re: Elbow rads

argyro koukouseli — Mon, 13 Feb 2012 22:44:52 GMT

[quote user="argyro koukouseli"]

[quote user="Malcolm Ness"]

[quote user="David Beattie"]Is the fragment you're talking about where the red arrow is pointing?[/quote]

I still can't see it on my screen but if that is where the bit is, then David is almost certainly correct.

[/quote]

it is a radiolucent line longuitually the compact bone,not the site David is talking about.

could it be a vessel?

[/quote]oops sorry,David,It IS what you are talking about.Sorry,it is a nutrient forament.I didnt read the posts correctly....waiting for more x-rays

Re: Elbow rads

argyro koukouseli — Mon, 13 Feb 2012 22:36:27 GMT

[quote user="Malcolm Ness"]

[quote user="David Beattie"]Is the fragment you're talking about where the red arrow is pointing?[/quote]

I still can't see it on my screen but if that is where the bit is, then David is almost certainly correct.

[/quote]

it is a radiolucent line longuitually the compact bone,not the site David is talking about.

could it be a vessel?

Re: Elbow rads

Laurence Webb — Mon, 13 Feb 2012 22:22:05 GMT

[quote user="argyro koukouseli"]

could that be of any scignificance?

also could we see femur diaphysis for any signs of panosteitis?

a non orphopod non radiologist, x-ray junkie!

....waiting for next images

[/quote] I assume that's a nutrient foramen so not significant.

Re: Elbow rads

Malcolm Ness — Mon, 13 Feb 2012 22:18:53 GMT

[quote user="David Beattie"]Is the fragment you're talking about where the red arrow is pointing?[/quote]

I still can't see it on my screen but if that is where the bit is, then David is almost certainly correct.

Re: Elbow rads

argyro koukouseli — Mon, 13 Feb 2012 22:03:56 GMT

also should check at what age coronoid is fully united in that breed

Re: Elbow rads

argyro koukouseli — Mon, 13 Feb 2012 22:00:37 GMT

could that be of any scignificance?

also could we see femur diaphysis for any signs of panosteitis?

a non orphopod non radiologist, x-ray junkie!

....waiting for next images

Re: Elbow rads

Anonymous — Mon, 13 Feb 2012 21:44:09 GMT

Anatomic and radiographic appearance of a sesamoid bone in the tendon of origin of the supinator muscle of dogs (1985). Wood, McCarthy, Howlett Am J Vet Res. 1985;46(10):2043-7.

Abstract:

Re: Elbow rads

jose targa — Mon, 13 Feb 2012 21:26:03 GMT

Hi there!.

Well i´m not a specialist, but i can see that small fragment you´re talking about. Is it possible that a partially avulsioned lateral elbow ligament took this piece away??? Is there any pain in the elbow?

Regards.

Re: Elbow rads

Mark Rowland — Mon, 13 Feb 2012 20:56:03 GMT

Ok thanks guys I'll adjust the contrast and repost it tomorrow :-)

Re: Elbow rads

Malcolm Ness — Mon, 13 Feb 2012 20:29:36 GMT

I can't see anything significant on these rads (I don't see the bit you are referring to - I am using a very small screen!) but that doesn't rule out elbow dysplasia/coronoid process disease or IOHC. On the basis that common things occur commonly, the former is most likely. Is there elbow pain or any other signs?

Re: Elbow rads

Utlendigur — Mon, 13 Feb 2012 20:06:10 GMT

Not claiming to be an orthopod, but do you mean the small fragment/s overlying the intercondylar area on the craniocaudal view? Fragmented coronoid process???

Re: Elbow rads

Michael Woodhouse — Mon, 13 Feb 2012 19:14:40 GMT

I think the little hand may be significant?

Back to the top for you!

Re: Elbow rads

Mark Rowland — Mon, 13 Feb 2012 18:58:18 GMT

Nope? Ok then....... *****logs onto VIN****** :-)

Re: Elbow rads

Mark Rowland — Mon, 13 Feb 2012 12:11:30 GMT

Heres the lateral