Radiology Case
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Radiographic findings: There
is severe periarticular bone remodeling. The proximal portion of the medial
coronoid process is indistinct. There is a 3 mm wide and 3 cm long elliptical
mineral opacity superimposed to the olecranon.
Radiographic impression: Severe degenerative changes (DJD) of the elbow. A fragmented medial coronoid process is likely. The mineral opacity is consistent with an ununited medial epicondyle of the humerus or mineralization of a flexor tendon.
Comments: The chronic lameness in this patient is most likely due to the severe degenerative joint disease. The DJD may be due to elbow dysplasia, previous trauma, or an inflammatory arthritis. Elbow dysplasia is a multifactorial disease that is associated with a fragmented medial coronoid process, ununited anconeal process, and osteochondrosis dissecans of the humeral condyle. It is believed that these abnormalities occur secondary to malformation of the semilunar notch.
The mineralized body caudal to the elbow has been associated with clinical
signs in some patients and has been seen in others that are asymtomatic.
An ununited medial humeral epicondyle may occur secondary to trauma, osteochondrosis,
or idiopathic lack of fusion of the epicondyle. 1,2 Mineralization of
the flexor tendons resembles this radiographically and surgical exploration
with histopathology is required for a definitive diagnosis. 3
References
- Bennett D, May C. Joint Diseases of Dogs and Cats In: Ettinger SJ and Feldman EC, eds. Textbook of Veterinary Internal Medicine. 4th ed. Philadelphia: W.B. Saunders Co., 1995;2048.
- Snaps F, Saunders J, Heimann M, et al. Ununited Humeral Medial Epicondyle in a Dog. Canine Practice 1999;24:7-10.
- Zontine WJ, Weitkamp RA, Lippincott CL. Redefined type of elbow dysplasia involving calcified flexor tendons attached to the medial humeral epicondyle in three dogs. J Am Vet Med Assoc 1989;194:1082-1085.
Dr. John Feleciano, DVM, DACVR
Dr. Renee Leveille, DVM, DACVR