Case Study

RAD – Eosinophilic Panosteitis in a 12 week old German Shepherd dog

The patient is a 12 week old F German Shepherd dog puppy presenting yesterday with sudden onset yelping and holding up the right front leg. Palpable “click” right shoulder. Possibly warm at right carpus.

Physical Exam – non-weight bearing lameness right front and vocalizing with palpation; otherwise wnl

Image Interpretation

Rads – mediolateral and craniocaudal views of front limbs – Radiographic findings:
The patient is skeletally immature. The stage of bone development is as anticipated.
Moderate patchy medullary sclerosis noted for the diaphyses of all long bones which is
mainly centered around the vascular foramina and channels as a main finding. This is
accompanied by mildly irregular endosteal thickening.
The distal radius and ulna metaphyses of both front limbs present multifocal clusters of
mildly decreased bone opacity paralleling the physis. This is not accompanied by soft
tissue swelling nor by periosteal new bone formation.
Mild bilateral modeling of the medial coronoid process is noted on the craniocaudal
view along with mild focal sclerosis of the humeral trochlea.
The toe pads of the 2nd, 3rd & 4th phalanx of the right front paw appear to be swollen.
This may be a result of distal limb rotation and superimposition. Correlate with the
clinical findings to rule out possible pathology here

DX

Eosinophilic Panosteitis

Outcome

Bloodwork is recomended for further work up. Dietetic management (reduce caloric
intake and change to low protein diet), rest and antiinflammatory therapy with
NSAIDs is recommended.
Typical signs for hypertrophic osteodystrophy are not noted. The described changes in
the metaphyses of the radius and ulna are compatible with irregularities noted during
regular longitudinal growth.
The assessment of the medial coronoid process is limited to the age of the dog at this
point. Orthogonal recheck radiographs centered on the elbows are recommended in 3-4
months.