Page 270 - Canine Lameness

242 15 Shoulder Region

Figure 15.13 When obtaining a skyline view of shoulder, position the patient in sternal recumbency with the
patient’s head and neck placed on midline, or toward the contralateral shoulder, to prevent superimposition.
With the shoulder and elbow joints of the limb of interest kept in alignment, flex the elbow, and position the
radius and ulna laterally. The humerus should be parallel to the table top. Center the radiographic beam on
the shoulder joint, collimated to either side and several centimeters cranial and caudal to the shoulder joint.
SHOULDER REGION 15.7 Supraspinatus Tendinopathy

Similar to biceps tendinopathy, supraspinatus tendinopathy has also been described as a calcifying
and non-calcifying tendinopathy (Lafuente et al. 2009; Canapp et al. 2016). While there is some
confusion whether these conditions are separate or a continuum of the disease, the term supraspi-
natus tendinopathy encompasses all conditions affecting the tendon. This may include partial,
complete, or micro-tears of the tendon (tendinosis) as well as the chronic phases which may result
in calcification of the tendon. The condition may go unidentified, or be misdiagnosed as a different
shoulder injury, and therefore may be under-recognized. On the other hand, calcification may be
an incidental finding (Maddox et al. 2013) and therefore radiographic abnormalities must be cor-
related with clinical signs. Although the pathogenesis of supraspinatus tendinopathy is not clearly
understood, repetitive microtrauma has been suggested. Medical management of supraspinatus
tendinopathy is most frequently performed but surgical resection for calcifying supraspinatus
tendinopathy has also been reported (Lafuente et al. 2009).

15.7.1 Signalment and History
Supraspinatus tendinopathy most commonly occurs in medium- to large-breed, active dogs, func-
tioning as pet, working, and agility dogs (Lafuente et al. 2009; Canapp et al. 2016). A unilateral
lameness is more common than bilateral, and the disease can present acutely or after a chronic