Radiology Case
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Radiographic findings: There are radiolucent lines adjacent and parallel to the physes within the metaphyses of the distal radius and ulna bilaterally (arrows). There is flaring of the metaphyses and mild overlying soft tissue swelling.
Radiographic impression: Hypertrophic Osteodystrophy (HOD, metaphyseal osteopathy)Comments: The cause of hypertrophic osteodystrophy
is unknown. Canine distemper virus or other infectious processes have
been considered. This disease usually affects large breed, rapidly growing
dogs in the age range of 2-8 months. It is generally characterized by
a history of inappetance, depression, fluctuating pyrexia, palpable pain
in the limbs, and soft tissue swelling in the metaphyseal regions. The
radiographic changes are usually appreciated bilaterally in the limbs,
although the ribs and scapulae can also be involved. The bilateral metaphyseal
radiolucent lines parallel to the physis described in this case are the
typical early changes identified. The histological changes in the radiolucent
line involve the primary spongiosa of the metaphysis and include: acute
suppurative osteomyelitis, necrosis, microfractures, and defective bone
formation. In some cases a metaphyseal expansion with new periosteal bone
proliferation may develop. Remodeling of these changes usually occurs;
however, the irregularities may persist.
Pain control with anti-inflammatory analgesics and supportive care are
typically recommended since no specific treatment exists. Recovery can
occur in several days or longer, but relapses may occur.
Dr. John Feleciano, DVM, DACVR
Dr. Renee Leveille, DVM, DACVR