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
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.
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.
