Skip to content
Customize Consent Preferences

We use cookies to help you navigate efficiently and perform certain functions. You will find detailed information about all cookies under each consent category below.

The cookies that are categorized as "Necessary" are stored on your browser as they are essential for enabling the basic functionalities of the site. ... 

Always Active

Necessary cookies are required to enable the basic features of this site, such as providing secure log-in or adjusting your consent preferences. These cookies do not store any personally identifiable data.

No cookies to display.

Functional cookies help perform certain functionalities like sharing the content of the website on social media platforms, collecting feedback, and other third-party features.

No cookies to display.

Analytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics such as the number of visitors, bounce rate, traffic source, etc.

No cookies to display.

Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors.

No cookies to display.

Advertisement cookies are used to provide visitors with customized advertisements based on the pages you visited previously and to analyze the effectiveness of the ad campaigns.

No cookies to display.

ORTHO – Incomplete Biceps Tendon Release with Tenosynovitis and Degenerative Joint Disease (DJD) in an 8 year old MN Doberman Pinscher dog

Case Study

ORTHO – Incomplete Biceps Tendon Release with Tenosynovitis and Degenerative Joint Disease (DJD) in an 8 year old MN Doberman Pinscher dog

History of left front lameness since February 2015. Has received regular rehab therapy since then. MRI done 5/24/15 showed marked left shoulder joint effusion, supraspinatous insertionopathy and evidence of core damage to the bicipital tendon. The marked decrease in size of the biceps at its site of origination is concerning for impending tendon rupture. Unremarkable cervical spine and left axilla.  Left shoulder arthroscopy 6/15/2015 revealed significant inflammation of the joint capsule (synovitis) and subscapularis tendon. A supraspinatus bulge was documented.

History of left front lameness since February 2015. Has received regular rehab therapy since then. MRI done 5/24/15 showed marked left shoulder joint effusion, supraspinatous insertionopathy and evidence of core damage to the bicipital tendon. The marked decrease in size of the biceps at its site of origination is concerning for impending tendon rupture. Unremarkable cervical spine and left axilla.  Left shoulder arthroscopy 6/15/2015 revealed significant inflammation of the joint capsule (synovitis) and subscapularis tendon. A supraspinatus bulge was documented. Inflammation and fraying of the biceps tendon at the origin was also confirmed. A bicipital tendon release was performed. Debriding of the synovitis was performed with a 2.3mm shaver. The subscapularis, once debrided, had multiple linear striations noted. Focal, precise radio frequency was used to the tendon. PRP injections 7/8/2015: 6 mls of fluid was removed from his left shoulder. An intra-articular injection of platelet-rich plasma (PRP) (Angel System 2.5mls) was performed to the left shoulder. An ultrasound-guided intra-lesional PRP injection was performed to the supraspinatus tendon. (Rehab 7/17, 7/31, 8/4).

PE: Lameness persists, especially in the morning

DX

The ultrasonographic findings are suggestive of an incomplete release of the biceps tendon. This may be a function of incomplete resection or a possible reunification. Adhesion formation in chronic proliferative tenosynovitis may prevent retraction and downslip after tenotomy and support coalescence of the tendon stumps. There were signs of moderate to severe chronic proliferative bicipital tenosynovitis and moderate degenerative joint disease (DJD) with osteoarthrosis and cartilage damage.

Image Interpretation

A small volume of tendon fibers with irregular echotexture and echogenicity was
traceable from the biceps origin at the proximal point of the supraglenoid tubercle
through the intertubercular groove. Discontinuous tendon fibers were seen superficial
and deep to the continuous part of the tendon. Level with the intertubercular groove
the tendon was irregular in shape and outline with severe alteration of the echotexture
and echogenicity in cross section.
The biceps tendon sheath and shoulder joint both presented moderate effusion and
moderate synovial proliferation. The inner layer of the biceps tendon sheath was
irregular in outline. The intertubercular groove presented uneven semicircular new
bone formation enfolding the biceps tendon.
The visible aspects of the humeral head surface presented moderate subchondral
bone irregularity. A regular cartilage layer was not seen.
A moderate amount of osteophytes was present at the periarticular margins.
Minor irregularity within the bone surface was noted at the distal insertion of the
infraspinatus muscle. The tendon and muscle belly of the infraspinatus did not present
ultrasonographic abnormalities.
The muscle belly and distal insertion tendon of the supraspinatus muscle did not
present ultrasonographic abnormalities.

Outcome

Arthroscopic revision of the biceps tendon and shoulder joint are advised as well as
local and systemic anti-inflammatory treatment.
The overall prognosis is guarded.

Patient Information

Patient Name : Broker Gskovich, Skylos Sport Medicine
Gender : Male, Neutered
Species : Canine
Type of Imaging : Ultrasound
Status : Complete

Clinical Signs

  • Lameness

Images

bildschirmfoto_2015-08-16_um_22bildschirmfoto_2015-08-16_um_22bildschirmfoto_2015-08-16_um_22bildschirmfoto_2015-08-16_um_23bildschirmfoto_2015-08-16_um_23bildschirmfoto_2015-08-16_um_23bildschirmfoto_2015-08-16_um_23bildschirmfoto_2015-08-16_um_23bildschirmfoto_2015-08-16_um_23

Clinical Signs

  • Lameness