ELBOW DYSPLASIA
Elbow dysplasia is another developmental problem some dogs can be prone to. German Shepherds, Labrador Retreivers,Rottweilers and Bassett Hounds are some of the breeds we see most commonly with this condition.
Normal Elbow Anatomy
The elbow joint is formed where the 3 long bones of the foreleg meet; namely the humerus (runs from shoulder to elbow) and radius and ulna (run from elbow to carpus or wrist). All bone ends are covered in smooth articular cartilage and the joint is surrounded by a tough joint capsule. The synovial membrane lines the joint and produces the lubricating synovial fluid.
The ulna has a number of bony prominences on it.These include the anconeal process and the coronoid process.
WHAT IS ELBOW DYSPLASIA
Elbow dysplasia is an abnormal development of the elbow joint. Elbow dysplasia is a group of diseases that include osteochondrosis, fragmented coronoid process (FCP) and united anconeal process(UAP). Basically, some of the normal bony prominences that develop in the elbow are diseased. There is strong evidence of a hereditary component in the German Shepherd dog and FCP and UAP are particularly common. As with hip dysplasia Xrays of potential breeding stock is recommended to screen for the disease. This appears to be done very infrequently despite the fact that like hip dysplasia mildly affected dogs can appear normal most of the time.
CLINICAL SIGNS
Dogs with elbow dysplasia show signs of front leg lameness. This may be in one or both legs as the disease often affects both elbows. Often there are signs of stiffness after rest. The lameness often gets worse with exercise. Often a relatively minor trauma to the elbow can flare up clinical signs.
DIAGNOSIS
On examination the vet may feel thickening of the elbow joints and pain on movement. Assessment of foreleg lameness can be very difficult if both legs are affected.
Xrays are the next step. They usually need to be done under general anaesthetic as perfectly positioned xrays are needed to recognise characteristic changes that are often very subtle.
Even then, a definite diagnosis may not be possible from xrays. Often the only changes visible are those caused by arthritis that usually occurs in dysplastic elbows very early on in the disease. Immature dogs with evidence of elbow arthritis often have elbow dysplasia.
Sometimes arthroscopy (looking directly into the joint with a special piece of equipment) is needed to diagnose elbow dysplasia. With this equipment the cartilage surfaces and bony prominences can be directly viewed.
TREATMENT
The major part of the decision making process in treating elbow dysplasia is whether to operate or not. Due to the abnormal development of the joint and so abnormal forces going through the bones osteoarthritis is an envitable sequel to elbow dysplasia. The decision is whether osteoarthritic change will happen faster with or without surgery.
Medical treatment is aimed at managing the secondary osteoarthritis.Often surgery is needed. Surgical removal of diseased bone and cartilage usually results in improvement in the lameness. This may be done via the arthroscope or by opening the joint up surgically. Arthroscopy (sometimes called keyhole surgery) is less traumatic than opening the joint up completely but it is more difficult to view all the areas of concern. Ultimately it is the surgeon’s choice.
Despite surgery, arthritis will tend to continue and ongoing medical treatment is likely.
Summary
Elbow dysplasia is a common and serious disease affecting many dogs. Radiographic screening programmes are becoming more widely available to detect affected dogs. Dogs affected with elbow dysplasia should not be bred from.
