Strange shoulder xray

Re: Strange shoulder xray

Utlendigur — Tue, 04 Sep 2012 10:24:52 GMT

Thank you Malcom

Re: Strange shoulder xray

Malcolm Ness — Tue, 04 Sep 2012 09:11:30 GMT

This is a markedly dysplastic shoulder - the problem appears centred on the scapula but there is compensatory change in the humerus.

The primary cause of this anomaly is not obvious - an early injury to physes would be top of my list. Genetics is unlikely (why only one shoulder) and rickets is even more unlikely, first because it is about as common as hens' teeth and second because only one anatomical location is involved. Whatever the cause, we are left with a markedly abnormal joint.

Fortunately, the shoulder in dogs can tolerate a lot of abnormality without causing the patient a great problem and despite the fact that there is already evidence of OA (periarticular osteophytes) here, the account suggests that the dog is coping adequately.

I would try an extended (6-8 weeks) course of NSAID to see if the dog improves in which case discomfort/pain can be inferred.

If ongoing intermittent medical management is enough, then that is all I would do but if the problem progresses or if permanent medication is or becomes necessary then I would advise surgery. Shoulder arthrodesis will resolve pain completely and give the dog a permanently fully functional limb allowing him full, unrestricted activity albeit with a minor gait abnormality.

Re: Strange shoulder xray

Utlendigur — Sun, 02 Sep 2012 23:50:34 GMT

The scapula also looked smaller on L side than the R to me. There's a small mineralised area just cranial to the glenoid - I had wondered whether that was an ossification centre that hadn't developed, as the glenoid looks very small on the lateral view and without a supragenoid tubercle (or could just be a joint mouse or in the tendon).

Re: Strange shoulder xray

Rob Loxley — Sun, 02 Sep 2012 23:38:41 GMT

[quote user="Moira Hamilton"] wonder if this is a genetic problem, though could have been a feeding/growth issue[/quote]

If it's unilateral then maybe some kind of trauma that has affected the humeral growth at an early stage causing the ALD and poor development of the shoulder joint?

Re: Strange shoulder xray

Utlendigur — Sun, 02 Sep 2012 23:38:16 GMT

The growth plates looked normal and the other FL is normal (haven't put up the lower leg and RF xrays) so I hadn't considered rickets. It was seen by a colleague a few months ago with HL lameness (query hip dysplasia) but there was no mention of a foreleg problem then

[quote user="Mark Hedberg"]"goodness, never seen a leg like that come naturally!"[/quote]

That was pretty much my reaction...

Re: Strange shoulder xray

Moira Hamilton — Sun, 02 Sep 2012 23:32:06 GMT

Wow, that is truelly a bizarre x-ray, does make you wonder if this is a genetic problem, though could have been a feeding/growth issue??? Otherwise no really useful comments, sorry

Re: Strange shoulder xray

Mark Hedberg — Sun, 02 Sep 2012 20:59:36 GMT

I'm tempted to wonder about what genetic train wrecks the parents were, but aside from possible wondering about rickets or a horrible malunion of a puppy fracture, you've got me at plain old "goodness, never seen a leg like that come naturally!"