EJCAP Online 22(4), December 2012, English

5 FCP: arthroscopy vs. radiology

5 FCP: arthroscopy vs. radiology

SUMMARY

To establish the diagnosis of a fragmented coronoid process (FCP), radiographic and arthroscopic examinations were performed on 150 elbow joints (from 100 dogs with lameness referable to the elbow joint). In 122 joints, radiographic signs of degenerative joint disease (DJD) were present.

In 35 of these 122 joints, the presence of radiographic signs of DJD was not associated with the arthroscopic finding of a FCP, but only chondromalacia or severe synovitis could be detected arthroscopically. On the other hand, in 19 elbows, a FCP was arthroscopically diagnosed although no radiographic signs of DJD were present. It was concluded that arthroscopy is probably a more accurate diagnostic method for FCP than radiology. In addition; arthroscopy allows this diagnosis to be made before the development of radiographically detectable degenerative changes, thus probably improving the outcome after surgery.

In young large-breed dogs with clinical signs of elbow lameness, elbow arthroscopy can detect additional cases of FCP even if no degenerative lesions are visible radiographically. On the other hand, in elbow joints with radiographic signs of DJD, arthroscopic exploration could be advised as it is less traumatic than an exploratory arthrotomy.

First author

Henri van Bree

Department of Medical Imaging & Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University,

Salisburylaan 133,

B-9820, Merelbeke

Belgium

E-mail: Henri.VanBree@UGent.be

Henri van Bree graduated in 1974 at the Ghent University in Belgium. After graduation, he was appointed as assistant at the Small Animal Clinic of the Faculty of Veterinary Medicine in Ghent. From 1976 to 1978, during his civil duties, he worked as assistant professor at the Veterinary Faculty of El-Harrach, Algeria. In 1981, he became assistant professor at the Small Animal Clinic, Faculty of Veterinary Medicine, University of Ghent, Belgium. He obtained his PhD (“Comparative imaging in the canine shoulder”) at the University of Utrecht, the Netherlands. Since 1991, he is full professor in medical imaging and orthopaedic surgery at the Department of Medical Imaging and Small Animal Orthopaedics, and became head of this department in 2001. He is a Diplomate of both the European College of Veterinary Diagnostic Imaging (ECVDI) and the European College of Veterinary Surgeons (ECVS). Author of over 250 publications on medical imaging and orthopaedics, he has been invited speaker at some 150 international conferences on medical imaging and small animal arthroscopy.

Radiographic grading of arthrosis vs. arthroscopic findings in 150 elbows in 100 dogs with elbow lameness

This slideshow shows the various stages of FCP that may be encountered in the canine elbow by arthroscopy – often before radiographic changes are visible.

The fragmented coronoid process (FCP) is the most common developmental disorder of the canine elbow.

Although radiography is most commonly used to establish the diagnosis, young dogs will often present with lameness suggestive of FCP but without radiographic changes.

Arthroscopy is probably a more reliable diagnostic method for early FCP than radiology.

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Table: Radiographic grading of arthrosis vs. arthroscopic findings in 150 elbows in 100 dogs with elbow lameness.

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by Henri van Bree, Ingrid Gielen, Bernadette Van Rijssen, Hilde De Rooster

Rottweiler:

24 male

11 female dogs

Bernese Mountain Dogs: 12 male

8 female dogs

Retrievers:

21 male

6 female dogs

In a study of 100 dogs with elbow lameness, the Rottweiler, Retriever and Bernese Mountain Dog breeds represented 82% of patients.

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Volume 22(4), December 2012 SPECIAL ISSUE

FCP: arthroscopy vs. radiology

Commissioned paper

Early diagnosis of fragmented coronoid process in the dog: elbow arthroscopy compared to radiographic signs of degenerative joint disease

Read more...

To establish the diagnosis of a fragmented coronoid process (FCP), radiographic and arthroscopic examinations were performed on 150 elbow joints (from 100 dogs with lameness referable to the elbow joint). In 122 joints, radiographic signs of degenerative joint disease (DJD) were present. ...