SA: Elbow

Question 1

What are the 3 joints of the elbow? What are their functions?

Answer 1

Humeroradial: weight-bearing
Humeroulnar: restricts motion to sagittal plane
Proximal radioulnar: transverse plane pronation/rotation

Question 2

Answer 2

Question 3

What is the best way to diagnose medial coronoid disease?

Answer 3

CT
Scope

Question 4

What is the best way to diagnose Ununited Anconeal Process?

Answer 4

Rads (flexed lateral)

Question 5

What is the best way to diagnose elbow incongruity?

Answer 5

CT
Scope
Rads only when large

Question 6

What is the best way to diagnose elbow OCD?

Answer 6

CT

Question 7

What disease process plays an important role in medial coronoid process disease/ununited anconeal process?

Answer 7

Incongruity

Question 8

What are the components of elbow incongruity?

Answer 8

Humeroulnar: notch incongruity
Proximal radioulnar: step

Question 9

Diagram a normal congruent elbow

Answer 9

Question 10

Diagram what occurs with a short radius

Answer 10

Pressure on coronoid process
MCD
Radioulnar incongruity

Question 11

Diagram what occurs with a short ulna

Answer 11

Pressure on anconeal process
UAP
Radioulnar incongruity

Question 12

What is the treatment for a short ulna (UAP)?

Answer 12

Ulna osteotomy
Proximal: above interosseous ligament (adult)
Distal: below interosseous ligament (growing)

Question 13

What is the treatment for a long ulna (MCD)?

Answer 13

Ulna ostectomy
Allows shortening of ulna

Question 14

Answer 14

Coronoid/Medial Compartment Disease

Question 15

How is coronoid disease diagnosed?

Answer 15

PE, rads (50-70% accurate)
CT
Arthroscopy

Question 16

Signalment: Coronoid Disease

Answer 16

Large breed dogs
6-18m

Question 17

History: Coronoid Disease

Answer 17

Variable lameness, worse after exercise
Stiff gait after rising
Lazy, but will still play
Often bilateral so difficult to notice

Question 18

PE: Coronoid Disease

Answer 18

Abnormal stance
Pain on palpation + effusion
Crepitus, reduced ROM and swelling in older, arthritic patient
Campbell’s test

Question 19

What should we look for on radiographs for coronoid disease?

Answer 19

Discontinuity of the coronoid prcess
Osteophytes on anconeal process and cranial aspect of the proximal portion of the radial head
Ulnar sclerosis
+/- fragment on A/P view

Question 20

Answer 20

Coronoid disease

Question 21

What is the treatment for coronoid disease?

Answer 21

Arthroscopic debridement
Subtotal coronoidectomy
Ulnar ostectomy for incongruity
Arthritis management

Question 22

Presentation: Developmental Coronoid Disease

Answer 22

Puppy with severe ED but little DJD (may need CT for diagnosis)
Adult dog with moderate ED but severe DJD (rads adequate for diagnosis)

Question 23

Presentation: Adult-Onset Coronoid Disease

Answer 23

Any mid-older aged dog with minimal radiographic changes
Need CT for diagnosis

Question 24

Humeral OCD: Diagnosis

Answer 24

CT/arthroscopy

Question 25

How is humeral OCD treated?

Answer 25

Excision of the cartilage flap Currete out subchondral bone OATS

Question 26

Define: UAP

Answer 26

Anonceal process that does unite by week 20

Question 27

Signalment: UAP

Answer 27

Young, large/giant breed dogs 20 - 35% bilateral

Question 28

PE: UAP

Answer 28

Mild-moderate lameness Radiographs (flexed) CT/arthroscopy

Question 29

What are the treatments and outcomes for UAP?

Answer 29