Computed tomography of ununited anconeal process in the dog

E. G. Gasch; J. J. Labruyère; J. F. Bardet

doi:10.3415/VCOT-11-10-0138

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2012; 25(06): 498-505
DOI: 10.3415/VCOT-11-10-0138

Original Research

Schattauer GmbH

Computed tomography of ununited anconeal process in the dog

Authors

E. G. Gasch

¹Clinique Vétérinaire du Dr. Bardet, Neuilly-sur-Seine, France
J. J. Labruyère

²VetCTSpecialists Ltd., St John's Innovation Center, Cambridge, England
J. F. Bardet

¹Clinique Vétérinaire du Dr. Bardet, Neuilly-sur-Seine, France

Abstract

Summary

Objective: The purpose of this study was to describe computed tomography (CT) features of the ununited anconeal process and relate them with the following elbow dysplasia signs: medial coronoid disease, medial humeral condyle changes, osteoarthritis (OA), and radioulnar incongruence.

Methods: Computed tomographic images of dogs older than six months with an ununited anconeal process were evaluated (n = 13). Ununited anconeal process features were described as being complete or incomplete, and the degree of displacement, volume, and presence of cysts and sclerosis were also evaluated. Medial coronoid disease was defined as an irregular medial coronoid process shape, presence of sclerosis and fragmentation. Medial humeral condyle changes were defined as subchondral bone flattening, lucencies, and sclerosis. Osteoarthritis was graded depending on the osteophytes size. Radioulnar incongruence was measured on a sagittal view at the base of the medial coronoid process.

Results: Eleven elbows had a complete and two had an incomplete ununited anconeal process. All ununited anconeal processes had cystic and sclerotic lesions. Seven ununited anconeal processes were displaced and six were non-displaced. Mean ununited anconeal process volume was 1.35 cm3 (0.61 cm³ – 2.08 cm³). Twelve elbows had signs of medial coronoid disease (4 of them with a fragmented medial coronoid process), and one elbow did not show any evidence of medial coronoid disease. Ten elbows had medial humeral condyle changes. One elbow had grade 1 OA, seven elbows had grade 2, and five elbows grade 3. All elbows had radioulnar incongruence: three elbows had a negative and 10 elbows had a positive radioulnar incongruence. Mean radioulnar incongruence was 1.49 mm (0.63 mm – 2.61 mm). Computed tomographic findings were similar in the majority of the elbows studied: complete ununited anconeal processes with signs of medial coronoid disease, positive radioulnar incongruence, high grade of OA, sclerotic medial humeral condyle changes, and large ununited anconeal process volumes.

Clinical significance: Incomplete small ununited anconeal process volumes could be associated with a lower incidence of medial coronoid disease or medial humeral condyle changes. We recommend performing preoperative CT of elbows with an ununited anconeal process to evaluate concurrent lesions.

Keywords

Computed tomography - ununited anconeal process - canine - elbow dysplasia

Full Text

References

References
1 Fox SM, Bloomberg MS, Bright RM. Developmental anomalies of the canine elbow. J Am Animal Hosp Assoc 1983; 19: 605-615.
2 Fossum TW. Small Animal Surgery Textbook. St. Louis, MO: Saunders Elsevier; 2007. pg. 1209-1213.
3 Brinker Flo GL, Piermattei DL. The elbow joint. In: Handbook of Small Animal Orthopedics and Fracture Repair. St. Louis, MO: Saunders Elsevier; 2006. pg. 339-344.
4 Cawley AJ, Archibald J. Ununited anconeal process in the dog. J Am Vet Med Assoc 1959; 134: 454-458.
5 Moores AP, Benigni L, Lamb RC. Computed tomography versus arthroscopy for detection of canine elbow dysplasia lesions. Vet Surg 2008; 37: 390-398.
6 Wagner K, Griffon DJ, Thomas MW. et al. Radiographic, computed tomographic and arthroscopic evaluation of experimental radio-ulnar incongruence in the dog. Vet Surg 2007; 36: 691-698.
7 Mason DR, Schulz KS, Samii VF. et al. Sensitivity of radiographic evaluation of radio-ulnar incongruence in the dog in vitro. Vet Surg 2002; 31: 125-132.
8 House MR, Marino DJ, Lesser LM. Effect of limb position on elbow congruity with CT evaluation. Vet Surg 2009; 38: 154-160.
9 Gemmill TJ, Mellor DJ, Clements DN. et al. Evaluation of elbow incongruency using CT in dogs suffering fragmented coronoid process. J Small Animal Practice 2005; 46: 327-333.
10 Samoy Y, Van Ryssen B, Gielen I. et al. Review of the literature: elbow incongruity in the dog. Vet Comp Orthop Traumatol 2006; 19: 1-8.
11 Reichle Jk, Park RD, Bahr AM. Computed tomography findings of dogs with cubital joint lameness. Vet Radiol Ultrasound 2000; 41: 125-130.
12 Gemmill TJ, Clements DN. Fragmented coronoid process in the dog: is there a role for incongruency?. J Small Anim Pract 2007; 48: 361-368.
13 Cook C, Cook J. Diagnostic imaging of canine elbow dysplasia: a review. Vet Surg 2009; 38: 144-153.
14 Olsson SE. Pathophysiology, morphology and clinical signs of osteochondrosis in the dog. In: Bojrab MJ. editor. Disease Mechanisms in Small Animal Surgery. Philadelphia: Lippincott Williams & Wilkins; 1993: 777-796.
15 Roy RG, Wallace LJ, Johnston GR. A retrospective long term evaluation of ununited anconeal process excision on the canine elbow. J Vet Orthop Trauma 1995; 7: 94-97.
16 Meyer-Lindenberg A, Fehr M, Nolte I. Co-existence of ununited anconeal process and fragmented medial coronoid process of the ulna in the dog. J Small Anim Pract 2006; 47: 61-65.
17 Wind AP. Elbow incongruity and development elbow disease in the dog: Part II. J Am Hosp Assoc 1986; 22: 725-730.
18 Rovesti Gl, Biasibetti M, Schumacher A. et al. The use of the computed tomography in the diagnostic protocol of the elbow in the dog: 24 joints. Vet Comp Orthop Traumatol 2002; 15: 35-43.
19 Corley EA, Sutherland TM, Carlson WD. Genetic aspects of canine elbow dysplasia. J Am Vet Med Association 1968; 153: 449-453.
20 Frazho JK, Graham J, Peck JN. et al. Radiographic evaluation of the anconeal process in skeletally immature dogs. Vet Surg 2010; 39: 829-832.
21 Hayes HM, Selby LA, Wilson GP. et al. Epidemiologic observation of canine elbow disease (emphasis on dysplasia). J Am Anim Hosp Assoc 1979. 15. 449.
22 Wind AP. Elbow incongruity and development elbow disease in the dog: Part I. J Am Hosp Assoc 1986; 22: 711-724.
23 Sjöstrom L, Kasström H, Källberg M. Ununited anconeal process in the dog, Pathogenesis and treatment by osteotomy of the ulna. J Vet Comp Orthop Trauma 1995; 8: 170-176.
24 Wisner ER, Pollard RE. Orthopedic diseases of young and growing dogs and cats. In: Thrall DE. editor. Textbook of Veterinary Diagnostic Radiology. St.Louis, MO: Saunders Elsevier; 2007. pg. 268-283.
25 Schulz KS, Krotscheck U. Canine elbow dysplasia. In: Slatter D. editor. Textbook of Small Animal Surgery. Philadelphia, PA: Saunders Elsevier; 2002. pg. 1927-1935.
26 Carpenter L, Schwarz P. Comparison of radiologic imaging techniques of diagnosis FCP of the cubital joint in dogs. J Am Vet Med Assoc 1993; 203: 78-83.
27 Reichle JK, Snaps F. The elbow. Clin Tech Small Animal Practice 1999; 14: 177-186.
28 Whatmough C, Lamb CR. Computed tomography: principles and applications. The Compendium on Continuing Education for the Practicing Veterinarian. 2006: 789-798.
29 De Rycke LM, Gielen IM, Van Bree H. et al. Computed tomography of the elbow joint in clinically normal dogs. Am J Vet Res 2002; 63: 1400-1407.
30 Kramer A, Holsworth IG, Wisner ER. et al. Computed tomographic evaluation of canine radioulnar incongruence in vivo. Vet Surg 2006; 35: 24-29.
31 Tromblee TC, Jones JC, Bahr AM. et al. Effect of computed tomography display window and image plane on diagnostic certainty for characteristics of dysplastic elbow joints in dogs. Am J Vet Res 2007; 68: 858-871.
32 Preston CA, Schulz KS, Kass PH. In vitro determination of contact areas in the normal elbow joint in dogs. Am Journal Vet Research 2000; 61: 1315-1332.
33 Eckstein F, Löhe F, Müller-Gerbl M. et al. Stress distribution in the trochlear notch. A model of bicentric load transmission through joints. J Bone Joint Surg 1994; 647-653.
34 Murphy ST, Lewis DD, Shiroma JT. et al. Effect of radiographic positioning on interpretation of cubital joint congruity in dogs. Am J Vet Res 1998; 59: 1351-1357.
35 Gemmill TJ, Hammond G, Mellor D. et al. Use of reconstructed computed tomography for the assessment of Joint spaces in the canine elbow. J Small Anim Prac 2006; 47: 66-74.
36 Holsworth IG, Wisner ER, Scherrer WE. et al. Accuracy of computerized tomographic evaluation of canine radio-ulnar incongruence in vitro. Vet Surg 2005; 34: 108-113.
37 Bottcher P, Werner H, Ludewig E. et al. Visual estimation of radioulnar incongruence in dogs using three-dimensional image rendering: an in vitro study based on computed tomography imaging. Vet Surg 2009; 38: 161-168.