Page 335 - Canine Lameness

307

19

Stifle Region

1
Jennifer Warnock and Felix Michael Duerr 2
1 Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
2 Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA

19.1 Introduction and Common Differential Diagnoses

Pathology of the stifle joint is a common source of clinical pelvic limb lameness in dogs. While
many conditions affect the stifle region, cranial cruciate ligament disease (CCLD) and patellar
luxation are the two diseases responsible for the majority of clinical lameness seen in dogs. STIFLE REGION
Fortunately, both of these conditions can be tentatively diagnosed based on physical exam and
radiographs. Additional imaging modalities such as computed tomography (CT), ultrasound, mag-
netic resonance imaging (MRI), arthrocentesis, and arthroscopy can be used to confirm diagnoses,
detect additional and less common injuries affecting the region, and allow for surgical planning.
Osteoarthritis of the stifle joint most frequently is the consequence of cranial cruciate ligament
(CCL) deficiency. Other conditions such as patellar luxation and osteochondrosis dissecans (OCD)
are less common primary causes of osteoarthritis. The stifle is one of the joints reported to be
affected by immune-mediated as well as infectious arthritis and, therefore, arthrocentesis and syn-
ovial fluid evaluation should be considered in cases where establishing a diagnosis is difficult.
Figure 19.1 and Table 19.1 outline common differential diagnoses and diagnostic steps for the
stifle region.

19.2 Normal Anatomy

19.2.1 The Stifle Joint

The stifle joint is a large complex condylar joint. Articulating joint surfaces are found between the
femoral and tibial condyles (femorotibial joint), the patella and femur (femoropatellar joint), and
the fabellae (sesamoid bones of the gastrocnemius muscle) and the femur. The joint surfaces of the
tibial and femoral condyles are convex, and the plateau of the tibia is sloped, making the stifle a
relatively incongruent and unstable joint without its soft tissue supporting structures. This is one
of the main reasons, why injury to the stabilizing articular structures typically results in instability,
dysfunction, and pain.

Canine Lameness, First Edition. Edited by Felix Michael Duerr.
© 2020 John Wiley & Sons, Inc. Published 2020 by John Wiley & Sons, Inc.
Companion website: www.wiley.com/go/duerr/lameness