– 7 year old FS American Bull dog presented with painful swelling on left elbow
– referring DVM sent me this x-ray which is dark but soft tissue swelling is seen as well as some cortical disruption of of the boney surface on the medial aspect of the distal humerus
– she has requested an ultrasound guided FNA of the region which I think is doable provided I can guide my needle through the region of bone disruption but am curious about other’s success rate in getting a diagnostic sample doing this?
– 7 year old FS American Bull dog presented with painful swelling on left elbow
– referring DVM sent me this x-ray which is dark but soft tissue swelling is seen as well as some cortical disruption of of the boney surface on the medial aspect of the distal humerus
– she has requested an ultrasound guided FNA of the region which I think is doable provided I can guide my needle through the region of bone disruption but am curious about other’s success rate in getting a diagnostic sample doing this?
Comments
You can use US to identify a
You can use US to identify a break in the cortical bone and then insert the needle and aspirate. Can also “walk” the needle down from normal hard bone until it goes through the affected bone. Don’t push the needle too deep as it may then miss the lesion and end up with bone marrow cytology.
Thanks Remo – are you finding
Thanks Remo – are you finding that you often get a diagnostic sample?
Yes and it cuts out the need
Yes and it cuts out the need fo full anesthesia and the risk of inducing a pathological fracture post biopsy.
Just find the lytic
Just find the lytic hypoechoic area in the periosteum and go there 22 or 20g fna corkscrew technique. works very well.
Final diagnosis was
Final diagnosis was histiosarcoma.
Thanks for the follow up JP
Thanks for the follow up JP