Page 244 - Canine Lameness

216 14 Elbow Region

the elbow; Chapter 5) may be elicited, while hyperextension of the elbow joint is non-painful with
the primary form. Medial compartment palpation may indicate MCD (i.e. indicating the secondary
form of FE; Section 14.6).

14.13.3 Diagnostics

A diagnosis of FE can be made if radiographs show calcification in the area of the medial epicon-
dyle (Figure 14.11). However, radiographs do not always allow to differentiate primary from
concomitant FE. For this purpose, CT is generally recommended in dogs with radiographic evi-
dence of FE to evaluate for MCD. Arthroscopy can be used to evaluate the origin of the flexor
muscles, nonetheless in one study it was unable to allow differentiation of the two forms (De
Bakker et al. 2013). If no radiographic calcification is present, ultrasound is a useful tool to identify

(A) (C) (E)

ELBOW REGION

(F)

(B) (D)

(G)

Figure 14.11 Flexor enthesopathy (FE): (A, B) primary FE (white arrow); (C, D) concomitant FE with MCD
resulting in severe osteoarthritis; (E, F) primary FE, note the difficulty in identifying the calcification if it is
superimposed over other osseous structures (F, white arrow); (G) primary FE calcification (black arrow) in 3D
reconstruction of a CT.