CT Synovitis, Synovial Herniation and Focal Osteomyelitis in the Stifle of a 4 year old F Pit Bull dog

Case Study

CT Synovitis, Synovial Herniation and Focal Osteomyelitis in the Stifle of a 4 year old F Pit Bull dog

This 4 year old female Pit Bull had ACL repair 4.5 weeks ago using swivel lock anchor and fiber tape. The anchor was placed distal to femoral fabella joint. Presented with non-weight bearing right rear leg. 

This 4 year old female Pit Bull had ACL repair 4.5 weeks ago using swivel lock anchor and fiber tape. The anchor was placed distal to femoral fabella joint. Presented with non-weight bearing right rear leg. 

Image Interpretation

CT of the right stifle, plain and iodinated post contrast series: The scan showed a status after surgical correction for cranial cruciate ligament pathology using swivel lock anchor and fiber tape. There was significant widening and halo formation with reduction of bone mass and moderate sclerosis surrounding the femoral screw. The screw was off axis in respect to the formerly drilled canal. Mild widening surrounding the tibial bone anchor with mild sclerosis was noted. There was a moderate to severe amount of joint effusion within the femorotibial joint. Moderate joint capsule thickening and synovial proliferations were present. There was significant soft tissue swelling lateral to the stifle joint with irregularly increased contrast enhancement, emphasizing the region of the femoral condyle. Focal lateral capsular extension was noted lateral to the screw. Focal soft tissue thickening with rim enhancement pattern was seen in the intercondylar region of the stifle joint. A moderate amount of new bone formation which presented mildly unsharp in outline was seen at the periarticular margins. The lateral compartment of the femorotibial joint was decreased in height. The subchondral bone of the lateral femoral condyle showed significant sclerosis and a subchondral bone defect. The cranial cruciate ligament was not seen. Two popliteal lymph nodes were mildly enlarged in size but normal for shape, short-to-long-axis ratio and contrast uptake.

DX

The CT findings are compatible with inflammatory implant loosening with synovitis, synovial herniation and emerging focal femoral osteomyelitis. Emerging drainage tract formation is suspected and has to be expected with disease progression lateral to the femorotibial joint.

Outcome

Removal of the implants and surgical revision is recommended. Bacterial culture of the synovia and removed implants is advised. A lateral compartment syndrome with femoral condylar cartilage and subchondral bone defect damage as a late sequel to cranial cruciate ligament failure is suspected. A primary osteochondral bone defect is a possible differential but low in potential here. The regional lymph nodes show reactive lymphadenitis

Patient Information

Patient Name : Diva Hart -- Neel VH
Gender : Female, Intact
Species : Canine
Type of Imaging : Ultrasound

Clinical Signs

  • Lameness

Images

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Clinical Signs

  • Lameness
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