25/01/17. Primary flexor tendinopathy of the canine elbow: An important differen?al in elbow disease. Primary form.

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1 Primary flexor tendinopathy of the canine elbow: An important differen?al in elbow disease. secondary concomitant BernadeCe Van Ryssen Ghent University Belgium Primary form enthesopathy Concomitant form Primary flexor tendinopathy of the canine elbow: enthesopathy 1

the medial epicondyle & acaching muscles

2 Bernese mountaindog 3 years Bernese mountaindog 3 years Pathology of/near the medial epicondyle & acaching muscles Enthesi?s, degenera?on, mineraliza?on, fragmenta?on, dystrophic calcifica?on Ununited medial epicondyle -Zon?ne WJ,et all. Redefined type of elbow dysplasia involving calcified flexor tendons acached to the medial humeral epicondyle in three dogs. J Am Vet Med Assoc Apr 15;194(8): Meyer-Lindenberg, A., et ai. (24). Vorkommen und Behandlung von knochernen Metaplasien in den am medialen Epikondylus des Humerus entspringenden Beugesehnen beim Hund. Tierarztl Prax, 32, Paster, E. R., et al. (29). Un-united Medial Epicondyle of the Humerus: Radiographic Prevalence and Associa?on with Elbow Osteoarthri?s in a Cohort of Labrador Retrievers. Veterinary Surgery, 38,

Samoyeed 5 years, lei frontleg lameness since several months, painful elbow May C, BenneC D.

also known in the cat Medial humeral epicondyli1s in cats. Streubel R, Geyer H, Montavon PM. Vet Surg.

Streubel R, Bilzer T, Grest P, Damur D, Montavon PM. Vet Surg. 215 Oct;44(7):95-13. à (17 pa?

Radiographic findings of the medial epicondyle in 2 elbows 6% primary flexor enthesopathy 34% concomitant form de Bakker

3 Samoyeed 5 years, lei frontleg lameness since several months, painful elbow May C, BenneC D. Medial epicondylar spur associated with lameness in dogs. Journal of Small Animal Prac?ce. 1988;29: also known in the cat Medial humeral epicondyli1s in cats. Streubel R, Geyer H, Montavon PM. Vet Surg. 212 Oct;41(7): à (6 cadavers) Medial humeral epicondyli1s in clinically affected cats. Streubel R, Bilzer T, Grest P, Damur D, Montavon PM. Vet Surg. 215 Oct;44(7): à (17 pa?ents with lameness) à incidence? Radiographic findings of the medial epicondyle in 2 elbows 6% primary flexor enthesopathy 34% concomitant form de Bakker E et al. Radiographic findings of the medial humeral epicondyle in 2 canine elbow joints. VCOT. 212; 25 (5): An important differen?al diagnosis in elbow disease. INconGRUitY Ununited anconeal process Incomplete ossifica?on humeral condyle Osteochondri?s dissecans Medial coronoid disease Medial compartment erosion 3

Medial coronoid disease osteoarthri?s medial compartment erosion secondary to.

FE 2 joints concomitant FE Both groups Mean age 5 years Large breed dogs Male>female E.

van Bree, B. Van Ryssen. Primary and concomitant enthesopathy of the canine elbow.

Primary&concomitant FE: 43 dogs Primary flexor enthesopathy Concomitant flexor enthesopathy

Newfoundlander Border Collie Bernese Mountain Dog Bouvier Swiss Shepherd Dog Dutch Partridge

enthesopathy Gender Male 1 7 (dogs) Female 4 5 Minimal radiographic signs Primary flexor

discrete radiographic changes. VCOT, 212; 25(3):239-45.

4 Medial coronoid disease osteoarthri?s medial compartment erosion secondary to... aier treatment of MCD Primary&concomitant FE: 43 dogs 43 elbow joints FE 23 joints primary FE 2 joints concomitant FE Both groups Mean age 5 years Large breed dogs Male>female E. de Bakker, I. Gielen, J. Saunders, I. Polis, S. Vermeire, K. Peremans, J. Dewulf, H. van Bree, B. Van Ryssen. Primary and concomitant enthesopathy of the canine elbow. VCOT, 213, 26 (6), Primary&concomitant FE: 43 dogs Primary flexor enthesopathy Concomitant flexor enthesopathy Breed (joints) Great Swiss Mountain Dog Labrador Retriever Golden Retriever Rottweiler Newfoundlander Border Collie Bernese Mountain Dog Bouvier Swiss Shepherd Dog Dutch Partridge Dog Mixed breed 5 (2) 3 4 (2) 3 (1) 5 (1) 1 4 (2) 3 (1) 1 Diagnosis of primary flexor enthesopathy Gender Male 1 7 (dogs) Female 4 5 Minimal radiographic signs Primary flexor enthesopathy of the canine elbow: Imaging and arthroscopic findings in eight dogs with discrete radiographic changes. VCOT, 212; 25(3): and medial coronoid disease in the same joint Bernese mountaindog 2y 1m Normal coronoid Doberman, 1y 9 m Medial coronoid lesion Newfoundlander, 3 years, + medial coronoid disease à concomitant form American bulldog, 5.5 years No coronoid lesion à primary form 4

5 Addi?onal informa?on: ultrasound Addi?onal informa?on: CT Addi?onal informa?on: MRI Scin?graphy Addi?onal informa?on: HiSpect 5

Inspec?on of the flexor enthesis Advised diagnos?

à Methods of choice in human medicine Diagnosis à Treatment

costeroids surgical release Concomitant type: treatment of

short improvement with Rimadyl worsened in the last weeks

6 Inspec?on of the flexor enthesis Advised diagnos?c protocol end start Radiographs CT + IV contrast CT Arthroscopy (E. de Bakker, et al. VCOT Vet Rad Ultrasound) Scin:graphy? Ultrasound, MRI? à Methods of choice in human medicine Diagnosis à Treatment Primary type: physiotherapy PRP local cor?costeroids surgical release Concomitant type: treatment of elbow dysplasia à most oien: Medial Coronoid Disease (MCD or FCP) Landsheer, 4.5 years lei frontleg lameness since > 1 year no trauma short improvement with Rimadyl worsened in the last weeks clear muscle atrophy manipula?on not painful moderate distension of the elbows shoulder, carpus, toes not painful referral case suspected of medial coronoid disease R L 6

7 lei lei right L end Luna: 2 years later lame right front start Treatment with.5 mg/kg Methylprednisolone IA 7

8 Injec?on with cor?costeroids IA: temporary improvement à relaps à tenotomy: lame free 8

Introduction. Keywords Enthesopathy, epicondyle, dog, elbow, radiography

Introduction. Keywords Enthesopathy, epicondyle, dog, elbow, radiography Original Research Schattauer 2012 359 Radiographic findings of the medial humeral epicondyle in 200 canine elbow joints E. de Bakker; J. Saunders; I. Gielen; H. van Bree; E. Coppieters; B. Van Ryssen Department