Details
Elbow
dysplasia is characterized by varying degrees of elbow incongruity, boney
fragments (bone chips) , and ultimately, severe arthritic change. The term was
introduced to describe generalized osteoarthritis (arthritis) of the elbow joint
in which the anconeal process may be ununited, the medial coronoid of the ulna
may be fragmented, and osteochondrosis of the humeral condyle may be present.
Clinically, the symptoms range from an occasional, intermittent lameness in some
affected dogs to severe, crippling disease in others.
Affected dogs are frequently lame or have an abnormal gait. The gait is often
characterized by excessive paddling or flipping of the front feet. The animal
may either hold the elbows out or tucked in and often stands with the feet
rotated outward. Many sit or lie down much of the time, or play for shorter
periods of time than other dogs of comparable age. They are often described as
quiet or even lazy. Frequently, they are stiff when rising and tire easily.
Exercise typically makes the lameness worse. In dogs with bilateral elbow
dysplasia, the lameness may seem intermittent or shift from one front leg to the
other.When both front legs hurt, dogs do not limp constantly, rather, they shift weight off their elbows by altering
their gait and stance. These dogs will only "limp" when one elbow is
more painful than the other.
The diagnosis of elbow dysplasia is made from a combination of clinical signs,
palpation (manipulation) of the joints, and radiographs (x-rays). Correct
radiograph technique is critical for making the diagnosis. Radiographs will reveal the
incongruity of the joint. Sclerosis (increased bone density) of the ulnar notch
is evident. OCD lesions and united anconeal processes are often evident. While
the fragments of the coronoid process cannot readily be seen on x-ray, the
coronoid process will be missing. Arthritis is often present, and can be mild to
severe.
Treatment of elbow dysplasia is often a combination of medical and surgical
management. The objectives of therapy are to relieve pain and maintain limb
function, as well as to continue the dog at as normal an activity level as possible. Surgical removal of the fragments is recommended before the
development of severe arthritis occurs. While the choice of surgical technique
(arthroscopy or traditional surgery) may vary, the results with both are similar.
Unfortunately, this disease is progressive, improvement is expected, but not
normality. Medical therapy
consists of weight control, moderate exercise and antiinflammatory medications.
Each case is evaluated for the degree of discomfort and arthritic change before
a final treatment choice is elected.
