Abstract
Objective This study provides information on clinical features, diagnosis, treatment and associated
risk factors of spontaneous septic elbow arthritis in the dog.
Methods Medical records between March 2007 and June 2015 were searched for cases of spontaneous
septic elbow arthritis with a diagnosis based on clinical signs, arthrocentesis, cytological
and microbiological analysis of elbow joint synovial fluid, radiography and outcome
following treatment.
Results Twenty-one cases of septic arthritis were identified. Pre-existing osteoarthritis
was present in 14/15 elbows for which diagnostic imaging was available. Although all
cases had increased neutrophil count on synovial fluid cytology, culture was only
positive in 12/21. Despite initial improvement in lameness scores (pre-treatment 9/10
[range: 1–10] versus post-treatment 3/10 [range: 1–5]), 11/12 had residual long-term
lameness. Recurrence of infection was noted in 3/12 elbows for which long-term (>8
weeks) follow-up was available. There was an acute mortality rate of 2/21 associated
with severe systemic sepsis.
Clinical Significance Septic arthritis, even in the absence of pyrexia, should be considered as a major
differential diagnosis in middle aged, large breed dogs, with pre-existing elbow arthritis,
that suffer an acute onset lameness, with elbow joint effusion and discomfort. Antibiotic
therapy alone was effective for treatment with high initial response rates. Chronic
lameness post-treatment was common, and a high rate of recurrence was seen with 3/12
dogs suffering more than one episode.
Keywords
septic arthritis - elbow - osteoarthritis - elbow dysplasia - infections
