Case Study

ORTHO – Left stifle degenerative joint disease (DJD) with full cranial cruciate (CCL) rupture and likely meniscal tear in a 2 year old MN Rottweiler dog

History of bilateral CCL injury, Had TTA on right knee Dec17/15, had bilateral U/S knees Dec 11/15. Pathology in left knee also noted. Played with puppy and now limping and favoring left stifle.

Physical Exam: Full Cr drawer sign- very loose left stifle, positive CTT, Now full rupture of CCL

History of bilateral CCL injury, Had TTA on right knee Dec17/15, had bilateral U/S knees Dec 11/15. Pathology in left knee also noted. Played with puppy and now limping and favoring left stifle.

Physical Exam: Full Cr drawer sign- very loose left stifle, positive CTT, Now full rupture of CCL

Image Interpretation

Ultrasound of left stifle (re-examination comparison with scan dated 12/11/2015) –
Left stifle joint:
Both the supra- and infrapatellar recess of the left stifle joint contain a moderate
amount of anechoic effusion respectively. The joint capsule reveals moderate
thickening. Moderate synovial proliferations are noted. A moderate amount of
osteophytes is noted at the periarticular margins of the femoropatellar and femorotibial
joints. There is a slight overall increase in the degenerative changes as compared with
the previous scan.
The cartilage layers as appreciated within the patellar sulcus condyles present mildly
uneven thickness with multifocal increase in echogenicity which was less evident in
the previous examination. The visible aspects oft he cartilage layer on the femoral
condyles are within normal limits.
The cranial cruciate ligament (CCL) presents as an echogenic band emerging from the
intercondylar eminence of the tibia and is discontinuous. Mild periligamentous
effusion as well as irregular echogenic tissue likely associated with the infrapatellar fat
pad is noted. The infrapatellar fat body presents heterogenous increase in echogenicity
as found commonly in chronic degenerative joint disease (DJD).
The view on the medial meniscus is limited. As far as visible it is in situ but with
mildly irregular outline and echogenicity. The lateral meniscus is in situ too with multifocal increase in echogenicity. The lateral meniscal outline is even and smooth.

DX

Left stifle progression of DJD with full CCL rupture and likely meniscal tear

Outcome

The findings of the left stifle joint are compatible with mild overall progression of the
generalized chronic degenerative joint disease (DJD) as compared with the previous
examination. Signs of cartilage breakdown are recognized for the femoral trochlea.
The predegenerated cranial cruciate ligament has progressed to full rupture with
biomechanical failure.
The visibility of the medial meniscus is limited which is likely due to the anatomic
conformation of the stifle joint as it was similar in the previous scan. Yet the findings
are suggestive for meniscal pathology such as tearing here. Signs of lateral meniscal
degeneration are evident.
Surgical therapy is indicated to address the biomechanical instability of the
femorotibial joint and prevent progression of the DJD & further damage.

Patient Information

Patient Name : Mateo Marquis

Gender : Male, Neutered

Species : Canine

Type of Imaging : Ultrasound

Liz Wuz Here : Yes

Clinical Signs

Lameness

History

Cruciate ligament injury

Exam Finding

Cranial drawer posiive

Images

Clinical Signs

Lameness