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History of left front recurrent lameness for several years. Physical exam showed pain and resistance on flexion; elbow rads show bone spurs and osteophytes in shoulder.
History of left front recurrent lameness for several years. Physical exam showed pain and resistance on flexion; elbow rads show bone spurs and osteophytes in shoulder.
Rads of right shoulder/elbow:
There was a small isolated bone opacity superimposed onto the major humeral tubercle. The caudal aspect of the humeral head and infraglenoid tubercle presented milt osteophyte formation.
The elbow was within normal limits for a 4 year old dog.
Left shoulder/elbow:
There were multiple large and small well delineated bone opacities within the region of the shoulder joint compatible with the proximomedial and caudal extension of the shoulder joint and the tendon sheath of the biceps. The periarticular margins presented moderate modeling and osteophyte formation. There was an irregular increase in bone opacity noted within the intertubercular groove. The outline of the major humeral tubercle was undulating but well defined.
The elbow was within normal limits for a 4 year old dog.
Ultrasound findings of left shoulder:
The left shoulder joint presented moderate anechoic effusion. The subchondral bone of the humerus was irregular in outline, there was no regular cartilage layer identified within the visible aspects of the joint surface. The tendon sheath of the biceps was severely distended with anechoic effusion. Moderate wall thickening and extensive synovial proliferation was noted. The biceps tendon itself presented was ill defined and presented mild heterogeneity in cross section. The intertubercular groove was mildly irregular in outline. There were several isolated bony bodies within the biceps tendon heath with even surface and distal shadowing. The distal insertions of the supra- and infraspinatus muscles did not present ultrasonographic abnormalities.
Arthroscopic revision of the left shoulder joint and biceps with biceps release, joint lavage and local & systemic anti-inflammatory treatment is recommended. Alternatively corticosteroid injection may be enforced as diagnostic therapy in first place.
