Joint Incongruity

Question 1

Joint incongruity is defined as growth discrepancy within components of the _____

Answer 1

elbow

Question 2

Sequelae of joint incongruity***:

Answer 2

OA, un-united anconeal process, fragmented coronoid process, osteochondrosis- medial aspect of humeral condyle

Question 3

What breeds are predisposed to joint incongruity? What is the cause??

Answer 3

GSD**, Basset hounds, St. Bernard’s; cause is unknown, possibly OCD-related, trauma or genetics

Question 4

What are the CS of un-united anconeal process (UAP)?

Answer 4

lameness, stiff, pain, crepitus, secondary OA, usually bilateral issue but may look unilateral on CS

Question 5

Pain on flexion and extension of the elbow, pain with pressure on anconeal process, possible joint effusion or periarticular swelling =

Answer 5

un-united anconeal process (UAP)

Question 6

un-united anconeal process (UAP) will have pain on _____ and ____ of the elbow and pressure on the anconeal process

Answer 6

Flexion and Extension

Question 7

What do we see on rads with un-united anconeal process (UAP)

Answer 7

Lateral AP and hyperflexed Lateral elbow views are both required, will see radiolucent cleavage line seen which is the separation of the anconeal process from the ulna

Question 8

Tx of un-united anconeal process (UAP)–>

Answer 8

conservative or surgery (excise the ununited fragment in dogs more than 6 moths old or fixation with lag screw if under 6 months of age. Another option is ulnar osteotomy

Question 9

What is the prognosis for un-united anconeal process (UAP)???

Answer 9

Fair but know secondary OA is inevitable and will need to be managed for the rest of dog’s life. Removal is often beneficial even if remodeling changes are severe to help limit further OA