ORTHO – Cranial Cruciate Ligament (CCL) rupture of the right stifle with degenerative joint disease (DJD) in a Labrador Retriever mixed dog

Case Study

ORTHO – Cranial Cruciate Ligament (CCL) rupture of the right stifle with degenerative joint disease (DJD) in a Labrador Retriever mixed dog

The patient is a Labrador Retriever mixed dog who has a history of a bilateral CCL injury. TTA surgery was performed on the left stifle July 2015. 2nd TTA on the right stifle is planned.

Physical exam: Positive cranial drawer, CTT, Medial buttress, no clicking

CBC/Chem wnl

The patient is a Labrador Retriever mixed dog who has a history of a bilateral CCL injury. TTA surgery was performed on the left stifle July 2015. 2nd TTA on the right stifle is planned.

Physical exam: Positive cranial drawer, CTT, Medial buttress, no clicking

CBC/Chem wnl

DX

The findings of the right stifle joint are compatible with moderate to severe generalized chronic degenerative joint disease with joint effusion, osteophytosis, capsular fibrosis, synovial proliferation and multifocal cartilage breakdown as well as subchondral bone sclerosis or rather defects. The right cranial cruciate ligament presents a full rupture.

Image Interpretation

Right stifle joint: 
Both the supra- and infrapatellar recess of the right stifle joint contain a moderate and
mild amount of anechoic effusion respectively. The joint capsule reveals moderate
thickening. Moderate synovial proliferations are noted.
The cartilage layers as appreciated within the patellar sulcus and onto the femoral
condyles present uneven thickness, irregular surface and multifocal increase in
echogenicity. This is most pronounced at the periarticular margins but extends into the
joint surface oft he patellar sulcus as well as the femoral condyles. The subchondral
bone of the femoral condyles as appreciated is uneven in outline with subchodral bone
defects in the periphery oft he joint surface.
A severe amount of osteophytes is noted at the periarticular margins of the
femoropatellar and femorotibial joints.
The cranial cruciate ligament (CCL) presents is a discontinuous broad echogenic band
emerging from the intercondylar eminence of the tibia. Only scant periligamentous
effusion noted. Soft tissue proliferations and marked regional synovial thickening is
evident here.
The infrapatellar fat body is heterogenous and contains a mineralization as found
commonly in chronic degenerative joint disease (DJD).The view on the medial meniscus is restricted by a mineralization. As far as visible it is
in situ with regular outline and multifocal increase in echogenicity. The lateral
meniscus is in situ too but presents multifocal increase in echogenicity and mild
surface irregularity.

Outcome

Both menisci show signs of advanced degeneration. A superficial meniscal tear is not
directly seen.
Surgical therapy is indicated to address the biomechanical failure and prevent
progression of the DJD & further damage.

Patient Information

Patient Name : Buddy MacDonald, Westview VH
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes

Clinical Signs

  • Lameness

History

  • Cruciate ligament injury

Exam Finding

  • Cranial drawer posiive

Images

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Clinical Signs

  • Lameness
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