Case Study

ORTHO – Stifle degenerative joint disease (DJD) and partial cranial cruciate ligament CCL) rupture in a 9 year old FS King Charles Cavalier Spaniel dog

History of right hind lameness at the beginning of January 2016. Left and right knee rads and pelvis unremarkable at the time. No cranial drawer sign noted on either knee. Pet was placed on a trial of Metacam but owner still seeing lameness. Pet re-examined today and lameness noted on the L hind leg. Crepitus noted in left knee and subtle cranial drawer present. Ultrasound of left and right knees performed.

DX

DJD with partial cranial cruciate ligament rupture

Image Interpretation

Left stifle joint:
Both the supra- and infrapatellar recess of the left stifle joint contain a mild amount of
anechoic effusion respectively. The joint capsule reveals moderate thickening.
Moderate synovial proliferations are noted.
The cartilage layer as appreciated within the patellar sulcus presents mildly uneven
surface and echogenicity. The cartilage seen onto the femoral condyles is within
normal limits.
A mild amount of emerging osteophytes is noted at the periarticular margins of the
femoropatellar and femorotibial joints.
The cranial cruciate ligament (CCL) presents irregular in width, echogenicity and
outline. An echogenic band emerging from the intercondylar eminence of the tibia is
seen as well as a continuous portion which is tapering proximally. Mild
periligamentous effusion as well as synovial thickening is noted. Mild soft tissue
proliferation is evident here as well.
The infrapatellar fat body presents heterogenous increase in echogenicity as found
commonly in chronic degenerative joint disease (DJD).
Only still images of the medial menisci were provided and were within normal limits.

RIght stifle joint:
There is no joint effusion. The joint capsule is even and thin.
The cartilage layers as appreciated within and onto the femoral condyles are within
normal limits.
Minor emerging osteophytes are noted at the periarticular margins.
The cranial cruciate ligament (CCL) presents mildly regular in width and with mildly
undulating course but regular for echogenicity and outline. Minor periligamentous
effusion is noted.
Both menisci were in situ and within normal limits.

Outcome

The findings of the left stifle joint are compatible with mild to moderate generalized
chronic degenerative joint disease with joint effusion, osteophytosis, capsular fibrosis,
synovial proliferation and emerging cartilage breakdown.
The findings are suggestive for partial rupture of the cranial cruciate ligament with
biomechanical failure.
There is no evidence of meniscal injury.
Surgical therapy is indicated to address the biomechanical failure and prevent
progression of the DJD & further damage.
The findings of the right stifle joint are compatible with emerging degenerative joint
disease with edema and degeneration of the cranial cruciate ligament. Currently there
is no evidence of biomechanical failure or meniscal pathology.