Panosteitis?

Re: Panosteitis?

John Flynn — Sat, 13 Apr 2013 00:12:06 GMT

This GSD bitch had the following radiographs taken at 6mths old for "elbow pain" and "acute non-weigh-bearing lameness", apparently there wasn't anything to see

Having said that, I assume the lameness resolved within the time-frame of the 10ml bottle of meloxicam prescribed.

Got me thinking:

Does 'missing' a diagnosis of panosteitis on initial presentation have any bearing on clinical treatment? (Assuming most people don't reach for the benzopyron when they see an xray like this, http://www.ncbi.nlm.nih.gov/pubmed/11980379 )
What are the chances that radiographing a 6 month old GSD with acute forelimb lameness localized to the vicinity of the elbow will lead to a change in treatment (e.g. anything other than NSAIDs and lead restriction until lameness resolves); i.e. how would you convince me to part with a hundred quid for some xrays in such a case?

PS - I clearly am under the impression that the xrays posted above demonstrate panosteitis; please can someone set me straight if I'm wrong or there's other pathology there I'm missing

Re: Panosteitis?

ruths — Thu, 04 Apr 2013 23:46:01 GMT

I had one that had panosteitis and an ununited anconeal process. That was a nice X-ray

Re: Panosteitis?

Rob Davis — Tue, 02 Apr 2013 16:45:39 GMT

[quote user="Rob Davis"]

I have seen one suspected case recently, 10 month old GSD with typical history and clinical findings, though has not been confirmed radiographically. It is the first one I've seen for years.

[/quote]

Finally managed to radiograph this dog after a couple of episodes of lameness in different limbs, happy to confirm panosteitis. Thought I'd post the radiographs for interest.

Re: Panosteitis?

Charlotte Marshall — Fri, 14 Dec 2012 21:11:00 GMT

I agree that cases seem less common. I have not seen a definate case for a while though I did have one this year where it was a bit suspicious. However it settled down and was never radiographed.

Re: Panosteitis?

ashvetenry — Fri, 14 Dec 2012 17:52:34 GMT

I saw a case in a similarly aged GSD some months ago, confirmed on xray- seen at least 2 other suspected cases also, but do see a lot of young GSD's thorugh the police breeding scheme.

Re: Panosteitis?

Mark Holmes — Fri, 14 Dec 2012 16:52:36 GMT

I saw one a couple of months ago, they reported that its litter mate had been diagnosed with metaphyseal osteopathy. I had always assumed they were related but affecting different regions of bone...are they?

Re: Panosteitis?

Rob Davis — Fri, 14 Dec 2012 16:07:28 GMT

I have seen one suspected case recently, 10 month old GSD with typical history and clinical findings, though has not been confirmed radiographically. It is the first one I've seen for years.

Re: Panosteitis?

Malcolm Ness — Thu, 13 Dec 2012 08:41:51 GMT

History and rads are entirely consistent with your diagnosis of panosteitis.

We still see cases from time to time but I agree that it does seem less common than in the olden days. As you know, most dogs "grow out" of this diseaseand though you might expect one or two more episodes, it should be gone by 15mths or so. The biggest problem with panosteitis in my experience is that it occurs in the same dogs that are at risk of other developmental problems like elbow dysplasia, shoulder OCD etc etc.so it can be tempting to dismiss subsequent episodes and overlook another concurrent problem.

Without wanting to sound like a veterinary "grumpy old man" I would suggest that recent graduates read JHLs post very carefully and note that the diagnosis was effectively made on detailed history taking and careful clinical examination - the precise localisation of the pain not to the elbow but to the nearby bone - the rads merely confirmed the diagnosis established by "talking and laying on of hands" - essential skills that seem to becoming less used/developed/respected.