Tierklinik Hofheim, Hofheim, Germany.
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2023 Apr;51(2):123-130. doi: 10.1055/a-2055-9436. Epub 2023 May 25.
The purpose of this report is to demonstrate that radiographic evaluation of the canine shoulder joint alone is not sensitive enough to detect migrated osteochondral fragments within the biceps tendon sheath, as a sequela to osteochondrosis dissecans of the caudal humeral head. A 6-months-old, male, 35 kg Hovawart was referred due to chronic intermittent lameness on the left forelimb. Survey radiographs revealed a semilunar radiolucency surrounded by a moderately sclerotic rim at the caudal aspect of the left humeral head, referred to as osteochondrosis dissecans. However, only computed tomography combined with ultrasonography could clearly confirm a dislodged osteochondral fragment within the left biceps tendon sheath and a consequent tenosynovitis. Arthroscopic treatment on the clinically affected left forelimb followed by an additional approach over the left biceps tendon sheath to remove the migrated fragment resulted in a complete remission of the lameness until the last follow-up one year after surgery. In our opinion, computed tomography should be applied in the medical work up of canine shoulder osteochondrosis (OC) as standard. Combined with ultrasonography, it can further aid in complete evaluation of the shoulder joint and reliable exclusion of displaced osteochondral fragments, which might also be missed during arthroscopy when located too far distally.
本报告的目的是证明,仅对犬肩关节进行放射学评估,不足以发现肱二头肌腱鞘内的移行性骨软骨碎片,这是肱骨头尾侧骨软骨病的后遗症。一只 6 月龄、35 公斤雄性霍瓦尔特犬因左前肢慢性间歇性跛行而被转诊。初步的放射学检查显示,在左肱骨头的尾侧有一个半月形的透光区,周围有一个中度硬化的边缘,被称为骨软骨病。然而,只有 CT 结合超声才能清楚地确认左肱二头肌腱鞘内有一个脱位移位的骨软骨碎片,导致腱鞘炎。对受影响的左前肢进行关节镜治疗后,再经左肱二头肌腱鞘进入,以取出移行的碎片,跛行完全缓解,直到手术后一年的最后一次随访。我们认为,CT 应作为犬肩关节骨软骨病(OC)的常规影像学检查方法。与超声结合使用,可进一步辅助全面评估肩关节,并可靠排除移位的骨软骨碎片,这些碎片在关节镜检查时如果位于远端太远,也可能会被遗漏。