Page 236 - Canine Lameness

208 14 Elbow Region

(A) (C) (E) (G)

(B) (D) (F) (H)

ELBOW REGION

Figure 14.7 Examples of MCD: (A, B) juvenile patient with no degenerative changes, the only subtle
abnormality is the lack of a clear distinction of the coronoid process on the lateral view (white arrow); (C, D)
11-month-old dog with mild sclerosis (C; lateral view, white arrow) and irregularity in the area of the
medial coronoid process (D; craniocaudal view and white arrow); (E, F) adult dog with degenerative changes
secondary to MCD; (G, H) 7-year-old dog with normal-appearing radiographs that was diagnosed with
traumatic fracture of the medial coronoid process based on CT.

14.7 Traumatic Fracture of the Medial Coronoid Process

Fragmentation of the coronoid process has also been described in adult patients without degenera-
tive changes (Meyer-Lindenberg et al. 2002; Tan et al. 2016). Termed “traumatic fracture of the
medial coronoid process,” this presentation is also referred to as “adult-onset FCP” or “jump-down
syndrome” (Tan et al. 2016). This disease has been proposed to be associated with traumatic
descents or concussive activities such as agility or fly ball. It is unknown to date whether these
patients suffer from nonclinical, developmental ED prior to the traumatic event or whether the
disease is exclusively traumatic in origin. Regardless of the etiology, it is important to note that
adult dogs can suffer from coronoid disease even if radiographs are normal (Figure 14.7).
Establishing a diagnosis follows the same diagnostic pathway as for juvenile dogs with MCD (i.e.
CT and/or arthroscopy). Treatment with arthroscopic fragment removal carries a good prognosis
based on the limited information available (Tan et al. 2016).