Case Study

ORTHO – Full right cranial cruciate ligament (CCL) rupture in a 7 year old FS Border Collie mix with lameness

This 7 year old FS Border Collie mix dog presented non weight-bearing right hind. Lyme positive.

DX

The findings of the right stifle joint are compatible with moderate to severe generalized chronic degenerative joint disease (DJD) with marked synovialitis as well as moderate joint effusion, osteophytosis and emerging cartilage breakdown. There findings are compatible with full partial rupture of the cranial cruciate ligament and suggestive for medial meniscal injury (even though a tear cannot be clearly identified) as well as lateral meniscal degeneration

Image Interpretation

Ultrasound of the right and left stifles –

Left:

The supra- and infrapatellar recesses reveal mild synovial thickening as well as mild anechoic effusion.A mild amount of osteophytes is seen at the periarticular margins of the femoropatellar and femorotibial joint. The cranial cruciate ligament (CCL) presents continuous but with uneven thickness and mild heterogeneity. Mild periligamentous effusion is seen. The infrapatellar fat body presents mild heterogeneity as found commonly in degenerative joint disease (DJD).  The medial and lateral meniscus are in situ with mild overall heterogeneity.

Right:

The supra- and infrapatellar recesses reveal marked synovial thickening as well as moderate anechoic effusion. A large amount of osteophytes is seen at the periarticular margins of the femoropatellar and femorotibial joint. The echogenicity of the cartilage layers has increased towards the periarticular margins. The cranial cruciate ligament (CCL) presents as a broad stump of ecogenic fibres at the intercondylar eminence of the tibia. A possible thin trace of fibres appears to be maintained. Periligamentous effusion and marked regional synovial membrane thickening are seen. The infrapatellar fat body presents heterogeneity as a sign of degenerative joint disease (DJD).  The medial meniscus reveals mild surface irregularity and heterogenous echogenicity with hypoechoic lines. The caudal horn of the medial meniscus is not seen.

The lateral meniscus is in situ with mild overall heterogeneity.

Outcome

A thin trace of fibres of the CCL may be maintained. However, full biomechanical failure is assumed and should be addressed surgically.
The findings of the left stifle joint are suggestive for partial rupture of the CCL as a consequence of chronic DJD. There is no evidence of a meniscal tear at this point.