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Resource Library: Elbow Dysplasia

ELBOW DYSPLASIA
Elbow dysplasia is a group of conditions that affect the elbows of growing dogs due to underlying osteochnodrosis and changes in the growth of the bones that compromise the elbow.

It most frequently affects Labradors and Rottweilers. The canine elbow joint is a complex joint in which three bones (radius, ulna and humerus) are hinged in a very precise fashion. If there is any change in the rate of growth or the quality of the structure of any of these bones it can lead to overload of other areas of the joint or changes in the way the bones function as a group. This condition can then manifest as a fragmented medial coronoid, ununited anconeal process or OCD of the medial humeral condyle. Most affected patients are lame and the severity of the lameness can be quiet variable. Dogs with disease of both elbows have a very stilted (stiff) gait of their front legs. Patients with larger lesions have more severe and consistent signs of lameness. The affected elbows are often fluid filled and are painful to manipulation.

Radiographs are usually sensitive for diagnosis of ununited anconeal process or humeral condyle OCD. Radiographs of the elbow in young dogs with a fragmented medial coronoid process are often normal appearing unless the fragment is very large. Routine radiographs in these patients are very insensitive for identifying the disease. In young patients that have front limb lameness with a painful swollen elbow and "clean" radiographs should have the elbow joint evaluated with either a CT scan , MRI, or exploratory arthroscopy. If the fragment is identified, then it can be removed arthroscopically. If the fragment is removed early in life and no other lesions develop, the prognosis is good to excellent. In patients that are older and heavier, removal is still indicated, but arthritis develops early as the bone fragments rub and erode the surrounding joint surface. They will often improve after surgery, but have a residual low grade or intermittent lameness. Patients that fail to improve significantly with surgical removal of the fragment or entire coronoid and have a moderate residual lameness may benefit from a sliding humeral osteotomy to unload the side of the joint that is abnormal. An ununited anconeal process can either be removed or if large enough anchored back into place with a screw. Humeral condyle OCD is best treated arthroscopically early in life to minimize the development of arthritis. With any form of elbow OCD it is best to identify and treat early and aggressively to minimize the onset of arthritis. The prognosis will decrease quickly with advancing age and weight.


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