Avulsion of the medial epicondyle of the humerus in the dog

Culvenor, J. A.; Howlett, C. R.

doi:10.1111/j.1748-5827.1982.tb01639.x

Cited by 8 publications

(24 citation statements)

References 6 publications

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“…In 3 cats (cats 1–3), radiographically visible new bone formation at the medial aspect of the elbow joint was not associated with histologic intraarticular abnormalities like cartilage defects (Figs , ). Periarticular new bone formation is a potential cause of chronic pain and calcifying tendinosis is cited as a cause of lameness in dogs . Although previous medical history was not examined, cats with new bone formation at the medial epicondyle on radiographs may show lameness in our experience.…”

Section: Discussionmentioning

confidence: 73%

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Medial Humeral Epicondylitis in Cats

Streubel

Geyer²,

Montavon

2012

Veterinary Surgery

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Objective: To describe medial humeral epicondylitis in cats based on radiographic, anatomic, and histologic observations. Study Design: Prospective cohort study. Animals: Feline cadavers (n = 60). Methods: Extended craniocaudal, and extended and flexed mediolateral radiographic projections were taken of both elbows of 60 consecutive European shorthair cats that died or were euthanatized. Elbows with new bone formation at the medial epicondyle were dissected and embedded in methyl-methacrylate (MMA). For comparison, both elbows of a cat with no radiographic changes were prepared in a similar manner. Sections of the MMA blocks were Giemsa stained and examined with light microscopy. Results: Bilateral new bone formation was identified radiographically at the medial aspect of the humeral epicondyle in 6 cats (10%). All of these cats had mineral deposition in the humeral head of the flexor carpi ulnaris muscle. Other findings were cartilage damage (n = 3 cats), an additional loose medial joint body (1), and tendinosis (3). The ulnar nerve was flattened and displaced caudally, and signs of chronic epineural fibrosis were present in 2 severely affected cats. Conclusions: Ten percent of this feline population had radiographic evidence of medial humeral epicondylitis with chronic degeneration, mineralization, and metaplastic bone formation in damaged fibrillar matrix involving the origin of the humeral head of the flexor carpi ulnaris muscle. New bone formation caused displacement and compression of the ulnar nerve in severely affected elbows. Based on our findings, medial humeral epicondylitis appears to be a common disorder in cats with potential clinical sequelae.People participating in athletic activities may develop lateral (tennis elbow) or medial humeral epicondylitis depending on the mechanical demands on the elbow and its muscular attachments, inherent to the type of sport activity. Both types of epicondylitis are caused by repetitive overuse injuries. Medial humeral epicondylitis in people is usually associated with sports like baseball and golf. In children, overuse injuries can lead to medial epicondylar apophysitis and epicondylar avulsion fractures referred to as little leaguer's elbow.

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Section: Discussionmentioning

confidence: 73%

“…New bone formation at the medial aspect of the feline elbow joint has generally been ascribed to osteoarthrosis . Although enthesiopathies or insertion tendinopathies of the elbow are described in dogs with and without lameness, medial epicondylitis is rarely described in cats …”

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confidence: 99%

Medial Humeral Epicondylitis in Cats

Streubel

Geyer²,

Montavon

2012

Veterinary Surgery

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“…Calcifications in this area are mostly considered to be a coincidental finding, although several mostly older papers reported those lesions as a cause of elbow lameness (2,(12)(13)(14)(15)(16)(17)(18)(19)(20). Osteophytosis or a 'spur' is usually interpreted as a sign of osteoarthritis (14,25).…”

Section: Discussionmentioning

confidence: 99%

“…Careful palpation of the medial side of the elbow joint, caudodistal to the medial epicondyle, often reveals a firm well-defined swelling, which is absent in joints with medial coronoid disease (10). Radiographic changes of the medial humeral epicondyle are often considered to be concomitant findings with limited clinical importance, although they have been mentioned as a cause of forelimb lameness in several, mostly older, case reports (2,(12)(13)(14)(15)(16)(17). Radiographic changes at the medial humeral epicondyle were first described as an ununited medial epicondyle and were temporarily classified under the elbow dysplasia complex (2).…”

Section: Introductionmentioning

confidence: 99%

Radiographic findings of the medial humeral epicondyle in 200 canine elbow joints

Bakker¹,

Saunders²,

Gielen³

et al. 2012

Vet Comp Orthop Traumatol

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SummaryObjectives: To determine the frequency and radiographic aspect of medial humeral epicondylar lesions as a primary or concomitant finding and to evaluate the association with osteoarthritis. Methods: Medical records of dogs diagnosed with elbow lameness were reviewed. Inclusion criteria for this study were a complete clinical examination, a complete set of digital radiographs and a final diagnosis made by computed tomography or magnetic resonance imaging and arthroscopy. Changes of the medial humeral epicondyle were recorded and correlated with the radiographic osteoarthritis and final diagnosis. Results: Eighty of the 200 elbows showed changes of the medial humeral epicondyle.In 12 of these 80 elbows, changes of the medial epicondyle were the only findings within the joint, and these elbows were diagnosed with primary flexor enthesopathy. In the remaining 68 elbows, other concomitant elbow pathologies were found. In those cases of concomitant epicondylar changes, high grades of osteoarthritis were recorded, while most elbows with primary flexor enthesopathy showed a low grade of osteoarthritis. Clinical significance: Changes of the medial humeral epicondyle are often considered clinically unimportant and are regarded as an expression of osteoarthritis. This study showed the relatively frequent presence of epicondylar changes of which the majority were considered concomitant to a primary elbow problem. If changes of the medial humeral epicondyle are the only pathologic finding (primary flexor enthesopathy) they should be considered as the cause of lameness and not as a sign of osteoarthritis.

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“…Nur selten und meist in Form von Fallberichten wird über das Auftreten von umschriebenen Verkalkungen im Bereich des Weichteilgewebes des medialen Epicondylus humeri als Lahmheitsursache berichtet (4,6,9,15,21,22). In der Literatur findet sich für diese Veränderung auch die Bezeichnung isolierter medialer Epikondylus (5,8) oder Avulsion des medialen Epikondylus (3,20). Die Verkalkungsherde können einseitig oder beidseitig auftreten (5,21,22) und befinden sich entweder in der Gelenkkapsel (15) oder in den Sehnen der Flexorenmuskulatur: M. flexor digitalis profundus (9), M. flexor digitalis superficialis (4,6,21), M. flexor carpi ulnaris (22), M. flexor carpi radialis (21,22) oder M. pronator teres (21).…”

Section: Introductionunclassified

Vorkommen und Behandlung von knöchernen Metaplasien in den am medialen Epikondylus des Humerus entspringenden Beugesehnen beim Hund

Meyer‐Lindenberg¹,

Heinen²,

Hewicker‐Trautwein³

et al. 2004

Tierarztl Prax Ausg K

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Zusammenfassung: Gegenstand und Ziel: In der Literatur existieren nur wenige Berichte über Metaplasien in den am medialen Epikondylus des Humerus entspringenden Beugesehnen (MEHB) als Ursache einer Lahmheit beim Hund. Daher sollte das Vorkommen dieser Erkrankung im eigenen Patientengut untersucht und zudem die Behandlungsergebnisse überprüft werden. Material und Methoden: Binnen fünf Jahren wurden alle Hunde mit einer Lahmheit der Vordergliedmaße in die Untersuchung einbezogen, die eine entsprechende Metaplasie aufwiesen. Die Diagnose wurde röntgenologisch gestellt. Vor der chirurgischen Entfernung der Veränderung erfolgte eine arthroskopische Untersuchung des Ellbogengelenks, um möglicherweise gleichzeitig bestehende Erkrankungen zu diagnostizieren und zu behandeln. Die Nachuntersuchung fand frühestens sechs Monate post operationem durch eine klinische und radiologische Kontrolle sowie eine Besitzerbefragung statt. Ergebnisse: Im Untersuchungszeitraum wurde bei 23 Hunden (26 Gelenke) eine MEHB diagnostiziert. Die Rasse Labrador Retriever war mit acht Tieren (34,7%) am häufigsten betroffen. Sowohl junge als auch ältere Hunde ohne (n = 5) bzw. mit gering-(n = 8), mittel(n = 5) oder hochgradiger (n = 8) Arthrose waren erkrankt. Bei neun Gelenken lagen außer der Metaplasie keine anderen Erkrankungen des Ellbogengelenks vor. Sechsmal wurde zusätzlich ein fragmentierter Processus coronoideus medialis der Ulna (FPC), davon einmal mit gleichzeitiger Osteochondrosis dissecans der Trochlea humeri (OCD), und zweimal eine alleinige OCD nachgewiesen. Ein operativer Eingriff mit Entfernung der Metaplasie erfolgte bei 22 Gelenken. Alle betroffenen Hunde konnten nach durchschnittlich 18 Monaten nachuntersucht werden. In 15 Fällen war das Behandlungsergebnis »gut«. Fünfmal lautete das Resultat »befriedigend« und zweimal »unbefriedigend«. Röntgenologisch ließ sich in der Mehrzahl der Fälle (8/15) ein Fortschreiten der Arthrose feststellen. Zu einem Rezidiv kam es nur in einem Fall. Schlussfolgerung: Die Studie zeigt, dass eine Metaplasie als Ursache einer Lahmheit der Vordergliedmaße häufiger vorkommt, als es in der Literatur beschrieben wird. Klinische Relevanz: Durch eine chirurgische Entfernung lässt sich bei den meisten Hunden eine Verbesserung oder ein Verschwinden der Lahmheit erzielen.

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Avulsion of the medial epicondyle of the humerus in the dog

Abstract: Avulsion of the medial epicondyle of the humerus is described in five dogs. In four cases the injury followed recent trauma while in the other, it appeared as a chronic problem.

Cited by 8 publications

References 6 publications

Medial Humeral Epicondylitis in Cats

Medial Humeral Epicondylitis in Cats

Radiographic findings of the medial humeral epicondyle in 200 canine elbow joints

Vorkommen und Behandlung von knöchernen Metaplasien in den am medialen Epikondylus des Humerus entspringenden Beugesehnen beim Hund

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