Case Study

ORTHO – Right stifle DJD with effusion, osteophytosis and likely CCL repair failure in a 4 year old MN Labrador Retriever dog

The patient is a 4 year old MN Labrador Retirever dog preseneted with lameness on the right hind leg; originally would not put any weight on limb at all but is now toe touching lame. Currently on Previcox once daily and 4 – 5 tablet of tramadol daily with minimal improvement. Right luxating patella repair in 2013

Physical Exam: NSF other than lame right hind leg. Lyme negative

Image Interpretation

Ultrasound of the right stifle-
The supra- and infrapatellar recesses and the synovial sheath of the long digital
extensor muscle of the right stifle joint contain a marked amount of anechoic effusion.
The joint capsule reveals severe thickening with marked synovial proliferation.
The cartilage layers within the patellar sulcus of the femoral trochlea and onto the
femoral condyles is irregular in thickness, outline and increased in echogenicity. The
subchondral bone of the femoral condyles as appreciated is even and smooth.
Severe osteophyte formations are noted at the patellar sulcus and moderate osteophytes
are developed at the periarticular margins of the femorotbial joint.
The patella is in situ during the examination.
The cranial cruciate ligament (CCL) can only be inspected in one loop and the
thickened joint capsule pushes onto the ligament. The CCL appears to be
discontinuous and uneven in outline and width. The infrapatellar fat pad is increased in echogenicity.
Both menisci are increased in echogenicity and heterogeneity.

DX

The right stifle joint is affected by a generalized, severe chronic degenerative joint disease with effusion, osteophytosis, synovial proliferation and capsular fibrosis. The ultrasonographic findings support biomechanical failure of the CCL and degenerative meniscopathy.

Outcome

The degree of effusion and capsular fibrosis is unusual. Consider other underlying
pathology such as recurrent activated arthritis, immune mediated arthropathy or
infectious arthropathy. Aspiration of synovia is recommended prior to surgery to rule
out other arthropathies.
Ensure in situ position of the patella