Ingrid Gielen

Medial humeral epicondylar lesions in the canine elbow: a review of the literature

A calcified fragment near the medial epicondyle of the humerus was originally described as an ununited medial epicondyle in 1966. Since then several papers reported similar lesions as a cause of elbow lameness. The aetiology and clinical significance of those lesions is poorly known. This paper gives an overview of the veterinary and human literature in an attempt to explain the aetiology and to suggest a diagnostic protocol and treatment plan.

Computed tomography findings in 32 joints affected with severe elbow incongruity and fragmented medial coronoid process.

OBJECTIVE To describe the computed tomography (CT) findings in dogs with severe elbow incongruity combined with a fragmented medial coronoid process (FCP) and compare these with normal joints and congruent joints affected by FCP. STUDY DESIGN Clinical study. ANIMALS Client-owned dogs with elbow lameness (n = 40) and purpose bred dogs (n = 5; controls). METHODS The CT features of 32 severely incongruent joints with concomitant FCP were compared with those of 32 congruent elbow joints affected with FCP and 10 normal joints. RESULTS In severely incongruent elbow joints, a radioulnar step and widened joint spaces were visible on each CT plane. Additional features typically seen in severely incongruent elbows were a cyst at the radioulnar transition and fragmentation of the axial border of the medial coronoid incisure. None of these features appeared in normal or in congruent FCP joints. CONCLUSION On CT, several features associated with severe elbow incongruity and concomitant FCP were detected, which were not found in normal joints or congruent joints affected by FCP.Objective To describe the computed tomography (CT) findings in dogs with severe elbow incongruity combined with a fragmented medial coronoid process (FCP) and compare these with normal joints and congruent joints affected by FCP. Study Design Clinical study. Animals Client-owned dogs with elbow lameness (n = 40) and purpose bred dogs (n = 5; controls). Methods The CT features of 32 severely incongruent joints with concomitant FCP were compared with those of 32 congruent elbow joints affected with FCP and 10 normal joints. Results In severely incongruent elbow joints, a radioulnar step and widened joint spaces were visible on each CT plane. Additional features typically seen in severely incongruent elbows were a cyst at the radioulnar transition and fragmentation of the axial border of the medial coronoid incisure. None of these features appeared in normal or in congruent FCP joints. Conclusion On CT, several features associated with severe elbow incongruity and concomitant FCP were detected, which were not found in normal joints or congruent joints affected by FCP.

Agreement and repeatability of linear vertebral body and canal measurements using computed tomography (CT) and low field magnetic resonance imaging (MRI).

OBJECTIVE To evaluate agreement and repeatability of vertebral column measurements using computed tomography (CT) and magnetic resonance imaging (MRI). STUDY DESIGN Retrospective observational study. ANIMALS; Dogs (n=18) with disc associated wobbler syndrome; Dog cadavers (n=3). METHODS Five measurements of the 5th cervical vertebra were performed: vertebral body length (VBL), vertebral canal height (VCH), vertebral body height (VBH), vertebral canal width (VCW), and vertebral body width (VBW). Measurements were performed independently twice by 2 observers. Bland-Altman plots were created to evaluate agreement. Cadaveric vertebrae with soft tissue removed had the same variables and actual dimensions measured. RESULTS The largest discrepancy between CT and MRI measurement was for VBL (mean difference+/-SD=1.262 mm+/-1.245; P<.001), with the difference for all the other variables being acceptable. The 1st measurement was significantly higher than the 2nd only for VBL using CT (mean difference=0.476 mm+/-1.120; P=.009), with all other variables having acceptable differences. Mean difference for all measurements between 2 observers was small, except for VBL using CT (mean difference=0.762 mm+/-1.042; P<.001). Only the difference for VBL between CT and cadaver specimens was statistically significant. CONCLUSIONS Our results suggest high repeatability and good agreement for most vertebral measurements of interest. VBL measurement using CT was considered problematic. CLINICAL RELEVANCE Provided limitations are understood, linear measurements of vertebral dimensions from CT and MRI images can be used clinically.

Anatomic study of the canine stifle using low-field magnetic resonance imaging (MRI) and MRI arthrography.

OBJECTIVE To investigate the use of low-field magnetic resonance imaging (MRI) and MR arthrography in normal canine stifles and to compare MRI images to gross dissection. STUDY DESIGN Descriptive study. SAMPLE POPULATION Adult canine pelvic limbs (n=17). METHODS Stifle joints from 12 dogs were examined by orthopedic and radiographic examination, synovial fluid analysis, and MRI performed using a 0.2 T system. Limbs 1 to 7 were used to develop the MR and MR arthrography imaging protocol. Limbs 8-17 were studied with the developed MR and MR arthrography protocol and by gross dissection. Three sequences were obtained: T1-weighted spin echo (SE) in sagittal, dorsal, and transverse plane; T2-weighted SE in sagittal plane and T1-gradient echo in sagittal plane. RESULTS Specific bony and soft tissue structures were easily identifiable with the exception of articular cartilage. The cranial and caudal cruciate ligaments were identified. Medial and lateral menisci were seen as wedge-shaped hypointense areas. MR arthrography permitted further delineation of specific structures. MR images corresponded with gross dissection morphology. CONCLUSIONS With the exception of poor delineation of articular cartilage, a low-field MRI and MR arthrography protocol provides images of adequate quality to assess the normal canine stifle joint.

Radiographic, computed tomographic and arthroscopic findings in 23 dogs with osteochondrosis of the tarsocrural joint

Twenty-three dogs with osteochondrosis of the tarsocrural joint were evaluated by radiography, computed tomography (Cr) and arthroscopy. The radiographic examination included an extended and flexed mediolateral, a plantarodorsal, a flexed dorsoplantar skyline view, and a plantaromedial-dorsolateral and a plantarolateral-dorsomedial view (two oblique views). The cT examination was carried out in ventral recumbency and 1 mm slices were taken with a bone window setting; 31 lesions were identified in the 46 joints examined. The arthroscopic exploration used either a plantar or a dorsal puncture, depending on the site of the lesion. In six cases the lateral, and in 17 cases the medial trochlear ridge was involved. Although the survey radiographs were sufficient to make a diagnosis, the cT examination helped to determine the exact site, and the number and size of the fragments of bone. A four-stage classification system comparable to the one used in man was established. Arthroscopy provided information about synovial inflammation and damage to the joint cartilage, and made it possible to remove fragments of bone from one-third of the cases.

Arthroscopic findings in 32 joints affected by severe elbow incongruity with concomitant fragmented medial coronoid process.

Objective To report arthroscopic findings in dogs with severe elbow incongruity combined with fragmented medial coronoid process (FCP) and compare these findings in normal joints and congruent joints affected by FCP. Study design Clinical study. Animals Dogs with elbow lameness (n = 40) and purpose bred dogs (5; controls). Materials and Methods Arthroscopic features of 32 severely incongruent joints with concomitant FCP were compared with 32 congruent elbow joints affected with FCP and 10 normal joints. A radioulnar step of ≥3 mm on radiographs and computed tomography (CT) scans was the selection criterion for a severely incongruent joint. Intraarticular structures were visually assessed at various sites within the joint. Regions of interest were: the radioulnar transition, humeroradial and humeroulnar joint space, trochlear notch, primary and secondary lesions of the medial coronoid process, and radial head. Results Incongruent joints had a radioulnar step and changes at the cartilage in the center of the trochlear notch, an irregular radioulnar transition, and an abnormal surface of the radial head. Coronoid pathology was present in every pathologic joint. Conclusion Arthroscopy allowed detection of several features that were signs or consequences of severe elbow incongruity or accompanying inflammation. After a prominent radioulnar step, cartilage changes involving the radial head and trochlear notch were most frequently seen.OBJECTIVE To report arthroscopic findings in dogs with severe elbow incongruity combined with fragmented medial coronoid process (FCP) and compare these findings in normal joints and congruent joints affected by FCP. STUDY DESIGN Clinical study. ANIMALS Dogs with elbow lameness (n = 40) and purpose bred dogs (5; controls). MATERIALS AND METHODS Arthroscopic features of 32 severely incongruent joints with concomitant FCP were compared with 32 congruent elbow joints affected with FCP and 10 normal joints. A radioulnar step of ≥ 3 mm on radiographs and computed tomography (CT) scans was the selection criterion for a severely incongruent joint. Intraarticular structures were visually assessed at various sites within the joint. Regions of interest were: the radioulnar transition, humeroradial and humeroulnar joint space, trochlear notch, primary and secondary lesions of the medial coronoid process, and radial head. RESULTS Incongruent joints had a radioulnar step and changes at the cartilage in the center of the trochlear notch, an irregular radioulnar transition, and an abnormal surface of the radial head. Coronoid pathology was present in every pathologic joint. CONCLUSION Arthroscopy allowed detection of several features that were signs or consequences of severe elbow incongruity or accompanying inflammation. After a prominent radioulnar step, cartilage changes involving the radial head and trochlear notch were most frequently seen.

Morphometric dimensions of the caudal cervical vertebral column in clinically normal Doberman Pinschers, English Foxhounds and Doberman Pinschers with clinical signs of disk-associated cervical spondylomyelopathy

Client-owned, clinically normal Doberman Pinschers (n=20), English Foxhounds (n=17), and Doberman Pinschers with clinical signs of disk-associated cervical spondylomyelopathy (DA-CSM) (n=17) were prospectively studied. All dogs underwent magnetic resonance imaging (MRI) of the cervical vertebral column. To evaluate vertebral canal stenosis, the canal occupying ratios of the spinal cord and cerebrospinal fluid (CSF)-column were calculated from C5 to C7. To evaluate the degree of spinal cord compression and the amount of canal compromise, the compression ratio, remaining spinal cord and CSF-column area, and vertebral canal and dorsoventral vertebral canal compromise ratios were calculated at the site of most severe compression. For each canal occupying ratio, there was a significant higher value (implicating less space available for the spinal cord in the vertebral canal) at the level of C7 for clinically affected Doberman Pinschers compared with clinically normal English Foxhounds. The remaining spinal cord area was significantly smaller in dogs with clinically relevant spinal cord compression compared to dogs with clinically irrelevant spinal cord compression. Relative stenosis of the caudal cervical vertebral canal occurred more often in Doberman Pinschers with DA-CSM compared to English Foxhounds and a critical degree of spinal cord compression should be reached to result in clinical signs.

Signalment, Clinical Presentation, and Diagnostic Findings in 122 Dogs with Spinal Arachnoid Diverticula

Background Most information about spinal arachnoid diverticula (SADs) in dogs has been retrieved from relatively small case series. The aim of this study was to describe this disease in a larger number of dogs. Objectives Description of the signalment, clinical presentation, and imaging findings of a large number of dogs with SADs. Animals One hundred and twenty‐two dogs with SADs. Methods Retrospective case series study. All medical records were searched for a diagnosis of SAD. The diagnosis was made based on myelography, computed tomography myelography (CT‐m), or magnetic resonance imaging (MRI). Results In the 122 dogs, 125 SADs were identified. Sixty‐five were located in the cervical region and 60 in the thoracolumbar region. A higher body weight was significantly associated with a cervical localization of the SAD (P < .001). Ninety‐five dogs were male and 27 dogs were female. Male dogs were significantly overrepresented (P < .0001). The most commonly affected breed was the Pug dog. Previous or concurrent spinal disorders, in the near proximity of the diagnosed SAD, were seen in 26 dogs. Eight of 13 French Bulldogs and 7 of 21 Pug dogs with SADs had a previous or concurrent spinal disease, whereas other spinal disorders occurred in only 1 of 17 Rottweilers with SADs. Conclusions and Clinical Importance Pug dogs and French Bulldogs might have a predisposition for SAD development. In a large percentage of these dogs, a concurrent spinal disorder, which might predispose to SAD formation, was diagnosed. The high prevalence in male dogs warrants further investigation.

Intraobserver and interobserver agreement for results of low-field magnetic resonance imaging in dogs with and without clinical signs of disk-associated wobbler syndrome.

OBJECTIVE To determine interobserver and intraobserver agreement for results of low-field magnetic resonance imaging (MRI) in dogs with and without disk-associated wobbler syndrome (DAWS). DESIGN Validation study. ANIMALS 21 dogs with and 23 dogs without clinical signs of DAWS. PROCEDURES For each dog, MRI of the cervical vertebral column was performed. The MRI studies were presented in a randomized sequence to 4 board-certified radiologists blinded to clinical status. Observers assessed degree of disk degeneration, disk-associated and dorsal compression, alterations in intraspinal signal intensity (ISI), vertebral body abnormalities, and new bone formation and categorized each study as originating from a clinically affected or clinically normal dog. Interobserver agreement was calculated for 44 initial measurements for each observer. Intraobserver agreement was calculated for 11 replicate measurements for each observer. RESULTS There was good interobserver agreement for ratings of disk degeneration and vertebral body abnormalities and moderate interobserver agreement for ratings of disk-associated compression, dorsal compression, alterations in ISI, new bone formation, and suspected clinical status. There was very good intraobserver agreement for ratings of disk degeneration, disk-associated compression, alterations in ISI, vertebral body abnormalities, and suspected clinical status. There was good intraobserver agreement for ratings of dorsal compression and new bone formation. Two of 21 clinically affected dogs were erroneously categorized as clinically normal, and 4 of 23 clinically normal dogs were erroneously categorized as clinically affected. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that variability exists among observers with regard to results of MRI in dogs with DAWS and that MRI could lead to false-positive and false-negative assessments.

Magnetic resonance imaging of the canine elbow: an anatomic study

OBJECTIVES To describe the normal anatomy of the soft tissues stabilizing the canine elbow observed by magnetic resonance (MR) imaging. STUDY DESIGN Descriptive study. ANIMALS Cadavers of large breed dogs (n=3). METHODS Immediately after euthanasia, T1- and T2-weighted MR images of both elbows of each dog were made in sagittal, transverse, and dorsal planes. Elbows were removed from the cadavers, embedded in a water bath, and frozen. Slab sections of the frozen elbows were obtained and matched with the MR images. RESULTS On anatomic sections, all musculoskeletal structures could be identified. T1-weighted MR images provided the best anatomic detail, whereas T2-weighted MR images were best for synovial cavities. All musculoskeletal structures identified on the anatomic sections were visible on the MR images. The flexor tendons were best seen on the images in the sagittal and dorsal planes, whereas the flexor carpi ulnaris tendon was best seen on the transverse images. The extensor tendons and the lateral collateral ligament were visible on the images in transverse and dorsal planes. The biceps brachii and triceps muscles and tendons were best seen on the sagittal MR images. CONCLUSIONS MR is a useful imaging technique to observe the soft tissues of the canine elbow. CLINICAL RELEVANCE This anatomic atlas could be used as a guide for interpretation of MR images of elbow disorders such as tendon, ligament, or muscle injuries.