Case Study

ORTHO – Bilateral stifle chronic degenerative joint disease (DJD) with cranial cruciate ligament failure in a 9 year old FS Cocker Spaniel dog

Ths 9 year old FS Cocker Spaniel presented with a hisotry of dermatitis, chronic otitis, obesity. Has had bilateral CCL suture technique for CCL ruptures June/2010 L Knee, Oct 2011 R Knee.

Physical Exam: Limping and favoring Left stifle. Palpates stable, bit of crepitus.

Reason for Ultrasound Exam: Stifle evaluation for DJD

Ths 9 year old FS Cocker Spaniel presented with a hisotry of dermatitis, chronic otitis, obesity. Has had bilateral CCL suture technique for CCL ruptures June/2010 L Knee, Oct 2011 R Knee.

Physical Exam: Limping and favoring Left stifle. Palpates stable, bit of crepitus.

Reason for Ultrasound Exam: Stifle evaluation for DJD

DX

The ultrasonographic examination of the right stifle joint is compatible with moderate chronic degenerative joint disease with cranial cruciate ligament failure and a history of extracapsular surgical stabilization. There is evidence of lateral meniscal degeneration but no indication of meniscal injury at this point. The ultrasonographic examination of the left stifle joint is compatible with moderate chronic degenerative joint disease with cranial cruciate ligament failure and a history of extracapsular surgical stabilization. There is no evidence of meniscal injury at this point.

Image Interpretation

Ultrasound of the right and left stifle-

Right stifle: Mild anechoic effusion and moderate capsular as well as synovial thickening is noted within the suprapatellar recess and infrapatellar recess of the right stifle joint.
There is a moderate amount of osteophytes noted at the periarticular margins of the femoropatellar and femorotibial joint. A mild overall increase in echogenicity of the cartilage layer is noted within the femoral trochlea and at the femoral condyles as well as mild subchondral bone irregularity.
The cranial cruciate ligament presents as a discontinuous echogenic stump surrounded by mild periligamentous effusion at the intercondylar eminence of the tibia.
Marked heterogeneity of the infrapatellar fat pad is noted.
The visible portions of the medial lateral meniscus are in situ, uniform in echogenicity and smooth in outline.

Left stifle: Mild anechoic effusion and moderate capsular as well as synovial thickening is noted within the suprapatellar recess and infrapatellar recess of the right stifle joint.
There is a moderate amount of osteophytes noted at the periarticular margins of the femoropatellar and femorotibial joint. A moderate overall increase in echogenicity of the cartilage layer is noted within the femoral trochlea and at the femoral condyles as well as moderate subchondral bone irregularity.
The cranial cruciate ligament presents as a short echogenic stump at the intercondylar eminence of the tibia. Marked heterogeneity of the infrapatellar fat pad is noted.
The visible portion of the medial meniscus is in situ, uniform in echogenicity and smooth in outline.
The lateral meniscus is in situ and smooth in outline. A non-shadowing echogenic focus is noted within the lateral meniscus.

Outcome

The findings are relatively symmetric between the left and right stifle joint. However, the degree of osteophyte formation & cartilage breakdown appears to be more advanced for the left stifle joint.