Medial humeral epicondylar lesions in the canine elbow

E. de Bakker; Y. Samoy; I. Gielen; Van B. Ryssen

doi:10.3415/VCOT-10-04-0052

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2011; 24(01): 9-17
DOI: 10.3415/VCOT-10-04-0052

Review Article

Schattauer GmbH

Medial humeral epicondylar lesions in the canine elbow

A review of the literature

E. de Bakker

¹Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Merelbeke, Belgium

,

Y. Samoy

¹Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Merelbeke, Belgium

,

I. Gielen

¹Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Merelbeke, Belgium

,

Van B. Ryssen

¹Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Merelbeke, Belgium

› Author Affiliations

Abstract

Summary

A calcified fragment near the medial epicondyle of the humerus was originally described as an ununited medial epicondyle in 1966. Since then several papers reported similar lesions as a cause of elbow lameness. The aetiology and clinical significance of those lesions is poorly known. This paper gives an overview of the veterinary and human literature in an attempt to explain the aetiology and to suggest a diagnostic protocol and treatment plan.

Keywords

Review - enthesopathy - tendinopathy - medial humeral epicondyle - dog

Full Text

References

References
1 Morgan JP, Wind A, Davidson AP. Elbow Dysplasia. In: Hereditary Bone and Joint Diseases. Hannover: Schlüttersche GmbH & Co. KG; 2000: 41-94.
2 Ljunggren G, Cawley AJ, Archibald J. The elbow dysplasias in the dog. J Am Vet Med Assoc 1966; 148: 887-891.
3 Fox SM, Bloomberg MS, Bright RM. Developmental anomalies of the canine elbow. J Am Anim Hosp Assoc 1983; 19: 605-615.
4 Piermattei DL, Flo GL, DeCamp CE. Brinker, Piermattei and Flo's Handbook of Small Animal Orthopedics and Fracture Repair. 4th edition. Philadelphia: WB Saunders Elsevier; 2006
5 Grondalen J, Braut T. Lameness in two young dogs caused by a calcified body in the joint capsule of the elbow. J Small Anim Pract 1976; 17: 681-684.
6 Vaughan LC. Muscle and tendon injuries in dogs. J Small Anim Pract 1979; 20: 711-736.
7 Culvenor JA, Howlett CR. Avulsion of the medial epicondyle of the humerus in the dog. J Small Anim Pract 1982; 23: 83-89.
8 May C, Bennett D. Medial epicondylar spur associated with lameness in dogs. J Small Anim Pract 1988; 29: 797-803.
9 Zontine WJ, Weitkamp RA, Lippincott CL. Redefined type of elbow dysplasia involving calcified flexor tendons attached to the medial humeral epicondyle in three dogs. J Am Vet Med Assoc 1989; 194: 1082-1085.
10 Walker TM. A redefined type of elbow dysplasia in the dog – 2 cases. Can Vet J 1998; 39: 573-575.
11 Harasen G. The mysterious dysplastic elbow. Can Vet J 2003; 44: 673-674.
12 Meyer-Lindberg A, Heinen V, Hewicker-Trautwein M. et al. Vorkommen und Behandlung von knochern Metaplasien in den am medialen Epikondylus des Humerus entspringenden Beugesehnen beim Hund. Tierarztl Prax 2004; 32: 276-285.
13 Cain Jr EL, Dugas JR, Wolf RS. et al. Elbow injuries in throwing athletes: a current concepts review. Am J Sports Med 2003; 31: 621-635.
14 Benjamin M, Toumi H, Ralphs JR. et al. Where tendons and ligaments meet bone: attachment sites ('entheses') in relation to exercise and/or mechanical load. J Anat 2006; 208: 471-490.
15 Miller ME, Christensen GC, Evans HE. Anatomy of the dog. Philadelphia: WB Saunders CO.; 1964
16 Hare WCD. The ages at which the centers of ossification appear roentgenographically in the limb bones of the dog. Am J Vet Res 1961; 22: 825.
17 Adams D. Canine Anatomy. A systemic study. 1st edition ed. Ames, Iowa: The Iowa State University Press; 1986
18 Paster ER, Biery DN, Lawler DF. et al. Un-united medial epicondyle of the humerus: radiographic prevalence and association with elbow osteoarthritis in a cohort of labrador retrievers. Vet Surg 2009; 38: 169-172.
19 International Elbow Working Group Protocol Vet Radiol Ultrasound. 1995; 36: 172-173.
20 Bennett GE. Elbow and shoulder lesions of baseball players. Am J Surg 1959; 98: 484-492.
21 Klingele KE, Kocher MS. Little league elbow: valgus overload injury in the paediatric athlete. Sports Med 2002; 32: 1005-1015.
22 Shaw HM, Benjamin M. Structure-function relationships of entheses in relation to mechanical load and exercise. Scand J Med Sci Sports 2007; 17: 303-315.
23 Miller TT, Shapiro MA, Schultz E. et al. Comparison of sonography and MRI for diagnosing epicondylitis. J Clin Ultrasound 2002; 30: 193-202.
24 Leach RE, Miller JK. Lateral and medial epicondylitis of the elbow. Clin Sports Med 1987; 6: 259-272.
25 Benjamin M, Rufai A, Ralphs JR. The mechanism of formation of bony spurs (enthesophytes) in the achilles tendon. Arthritis Rheum 2000; 43: 576-583.
26 Hazewinkel HAW. Elbow Dysplasia; definitions and clinical diagnoses. Proceedings of the 23rd Annual Meeting International Elbow Working Group 2008. August 20 Dublin; Ireland:
27 Houlton J, Collinson R. Manual of Small Animal Arthrology. Shurdington, Cheltenham, Gloucester-shire: British Small Animal Veterinary Association; 1994
28 Robins GM. Some aspects of the radiographical examination of the canine elbow joint. J Small Anim Pract 1980; 21: 417-428.
29 Martinoli C, Bianchi S, Zamorani MP. et al. Ultrasound of the elbow. Eur J Ultrasound 2001; 14: 21-27.
30 Finlay K, Ferri M, Friedman L. Ultrasound of the elbow. Skeletal Radiol 2004; 33: 63-79.
31 Lamb C, Wong K. Ultrasonographic anatomy of the canine elbow. Vet Rad Ultrasound 2005; 46: 319-325.
32 De Rycke LM. Correlative Computed Tomography, Magnetic Resonance Imaging and Cross-sectional Anatomy of Selected Regions of the Canine Body. PhD [dissertation]. Ghent: Faculty of Veterinary Medicine, Ghent University; 2007
33 Kijowski R, De Smet AA. Magnetic resonance imaging findings in patients with medial epicondylitis. Skeletal Radiol 2005; 34: 196-202.
34 Brunton LM, Anderson MW, Pannunzio ME. et al. Magnetic resonance imaging of the elbow: update on current techniques and indications. J Hand Surg Am 2006; 31: 1001-1011.
35 Martin CE, Schweitzer ME. MR imaging of epicondylitis. Skeletal Radiol 1998; 27: 133-138.
36 De Rycke LM, Gielen IM, Van BH. et al. Computed tomography of the elbow joint in clinically normal dogs. Am J Vet Res 2002; 63: 1400-1407.
37 Ciccotti MC, Schwartz MA, Ciccotti MG. Diagnosis and treatment of medial epicondylitis of the elbow. Clin Sports Med 2004; 23: 693-705. xi.
38 Laitinen OM, Flo GL. Mineralization of the supraspinatus tendon in dogs: a long-term follow-up. J Am Anim Hosp Assoc 2000; 36: 262-267.
39 Vangsness C, Jobe F. Surgical technique of medial epicondylitis: results in 35 elbows. J Bone Joint Surg Br 1991; 73: 409-411.
40 Gabel G, Morrey B. Operative treatment of medial epicondylitis: the influence of concomitant ulnar neuropathy at the elbow. J Bone Joint Surg Br 1995; 77: 1065-1069.