Case Of the Month

Bilateral Biceps Tendovaginits With Bilateral DJD In A : Our Case Of the Month November 2016

A 10-year-old FS Pit Bull terrier was presented for a long history of left front lameness.

DX

Grade 2 chronic biceps tendovaginitis on the left. Grade 1 chronic biceps tendovaginitis on the right. Moderate chronic degenerative joint disease of both shoulder joints.

Outcome

At this stage conservative management with PRP injection into the left shoulder joint (automatically permeates into the communicating biceps tendon), rest, systemic anti-inflammatory treatment and targeted physical therapy should be considered as a clinical trial for the lame left front limb. However, some patients with exostotic bone formation do not respond well to conservative management and may require arthroscopic revision with tenotomy even at relatively early stages of the disease. Consider proactive local PRP injection and physical therapy for the right front limb as well as it’s a bilateral disease in this patient and favoring of the left front limb may propel progression of the changes on the right side.

Image Interpretation

Left shoulder: Mild tendon sheath effusion and thickening of the synovial membrane is noted. The intertubercular groove presents a moderate exostosis encompassing the biceps tendon. Moderate osteophyte formations are noted at the periarticular margins of the shoulder joint.

Right shoulder: Mild tendon sheath effusion is noted. Synovial thickening is not evident. The intertubercular groove presents a mild exostosis encompassing the biceps tendon. Moderate osteophyte formations are noted at the periarticular margins of the shoulder joint.