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RAD – Traumatic avulsion of the cranial cruciate ligament (CCL) with failure in a 6 month old FS shepherd mix

Case Study

RAD – Traumatic avulsion of the cranial cruciate ligament (CCL) with failure in a 6 month old FS shepherd mix

This 6 month old FS Shepherd mix has a history of intermittent lameness left hind with bunny-hop type gait. Left stifle swollen and painful on extension. R/O CCL tear vs trauma va OCD

This 6 month old FS Shepherd mix has a history of intermittent lameness left hind with bunny-hop type gait. Left stifle swollen and painful on extension. R/O CCL tear vs trauma va OCD

Image Interpretation

Rads of left pelvic limb: 

The volume of the thigh musculature is mildly reduced compared to the contralateral limb. The stifle joint presents marked enlargement of the articular soft tissue opacity effacing with the infrapatellar fat-pad and marked caudal displacement of the caudal fascial planes. Three well delineated bone fragments are seen next to the point of distal insertion of the cranial cruciate ligament (CCL). The cranial aspect of the tibial plateau presents irregular with a complementary radiolucent fragment bed. Marked cranial thrust of the tibia is noted which is an indirect radiographic sign of CCL failure. The popliteal sesamoid bone is dislocated distally which is an indirect radiographic sign of CCL failure as well.

DX

The findings are consistent with traumatic avulsion of the cranial cruciate ligament (CCL) of the left stifle joint with three avulsion fragments and secondary marked joint effusion.

Outcome

Full biomechanical failure of the CCL has to be assumed.
The missing obvious drawer sign is most likely due to distension of the joint capsule and possible chronicity of the lesion with emerging fibrosis.

Surgical repair is recommended. Even though correction osteotomy is considered ideal these need to weighed against conventional surgical techniques here as to the skeletal immaturity. In any case timely surgical debridement of the femorotibial joint maybe beneficial as well as systemic anti-inflammatory & pain management and manual therapy until correction osteotomy can be performed.

Patient Information

Patient Name : Sadie Salcido/Blairstown
Gender : Female, Spayed
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 17_00071

Clinical Signs

  • Lameness

Images

bildschirmfoto_2016-09-10_um_11

Clinical Signs

  • Lameness