Case Study

ORTHO- normal shoulder musculature and tendons in a 7 year old MN Cavalier King Charles Spaniel with lameness

This 7 year old MN Cavalier King Charles Spaniel presented for evaluation of a chronic intermittent forelimb lameness of about one year’s duration. The onset of lameness was not associated with any known trauma. The lameness has become more consistent and the dog will externally rotate his right forelimb while standing and seated.

Physical Exam: Gait/Lameness: Grade I/V right thoracic limb lameness ; Posture: Slightly off weights the right thoracic limb while seated with mild external rotation of the paw ; Joint palpation: All joints of the thoracic limbs had normal range of motion ; Muscle mass: Mild to moderate muscle atrophy over the right scapula ; Muscle palpation: Right shoulder- Mild spasm on the biceps tendon stretch and with abduction of the right shoulder. Mild discomfort on palpation of the medial aspect of his elbow

DX

The findings of the right and left shoulder musculature and tendons are within normal limits.

Image Interpretation

Ultrasound of the right and left shoulder –

The biceps tendon is well delineated, even in diameter and presents uniform echogenicity and echotexture. There is no tendon sheath effusion or thickenin and no joint effusion. The intertubercular groove surface is even and smooth. There is no evidence of biceps impingement.

The distal insertion tendon of the supraspinatus presents with subjectively normal volume and echoarchitecture (equal between left and right). The greater humeral tubercle is even and smooth.

The infraspinatus muscle presents the expected echogenicity and fibre pattern. The thin distal insertion tendon is even in diameter, well-delineated and uniformly hyperechoic with regular echotexture. No bursa enlargement is seen.