Case Study

ORTHO – Chronic degenerative joint disease with cruciate ligament rupture in the right stifle of an 8 year old MN Shetland Sheepdog

The patient is an 8 year old MN Shetland Sheepdog presenting for injury of the right hind leg five months ago during “wrestling” . Intermittent lameness, possible re-injury slipping on snow.

Physical exam: Right stifle medial buttress, Positive CTT, no cranial Drawer, “Click” coming from right stifle. Joint effusion. Left stifle normal.

CBC/chem pending

The patient is an 8 year old MN Shetland Sheepdog presenting for injury of the right hind leg five months ago during “wrestling” . Intermittent lameness, possible re-injury slipping on snow.

Physical exam: Right stifle medial buttress, Positive CTT, no cranial Drawer, “Click” coming from right stifle. Joint effusion. Left stifle normal.

CBC/chem pending

Image Interpretation

Ultrasound of the right stifle- Both the supra- and infrapatellar recess of the right stifle joint contain a moderate
amount of effusion. 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 in thickness and outline with irregular surface echogenicity.
The subchondral bone of the femoral condyles as appreciated is slightly uneven in
outline.
A severe amount of osteophytes is noted at the periarticular margins of the
femoropatellar and femorotibial joints emphasizing the patellar sulcus.
The cranial cruciate ligament (CCL) presents as irregular in width, outline and
echogenicity but can be traced as a continuous band emerging from the intercondylar
eminence of the tibia proximally towards the femoral condyles. There is a moderate
amount of periligamentous effusion noted. The infrapatellar fat body is heterogenous as found commonly in degenerative joint
disease (DJD).
The medial meniscus is small and irregular in outline with a focal surface indentation.
The position of the medial meniscus is in situ. There is perimeniscal effusion with
proliferations of reactive tissue in the meniscal region. The lateral meniscus is in situ
but presents multifocal increase in echogenicity and mild surface irregularity.

DX

The findings of the right stifle joint are compatible with moderate generalized chronic degenerative joint disease with joint effusion, osteophytosis, capsular fibrosis, synovial proliferation and cartilage breakdown. The right cranial cruciate ligament presents signs of advanced degeneration and edema with partial fibre disruption. Incomplete biomechanical failure is likely.

Outcome

Both menisci show signs of advanced degeneration. Fibrocartilage breakdown as a
consequence of the chronic DJD and/or altered mechanical load is a potential. Even
though the medial meniscus reveals surface irregularity a superficial meniscal tear is
not directly seen.
Surgical therapy is indicated to address the ongoing biomechanical failure and prevent
progress of the DJD & further damage.
Rule out other paralleling pathology such as patellar luxation.