Archive (2005–2015)

Primary and concomitant flexor enthesopathy of the canine elbow

Journal: Veterinary and Comparative Orthopaedics and Traumatology (VCOT)
ISSN: 0932-0814
Issue: 2013: Issue 6 2013
Pages: 425-434

Primary and concomitant flexor enthesopathy of the canine elbow

E. de Bakker (1), I. Gielen (1), J. H. Saunders (1), I. Polis (2), S. Vermeire (1), K. Peremans (1), J. Dewulf (3), H. van Bree (1), B. Van Ryssen (1)

(1) Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Merelbeke, Belgium; (2) Department of Small Animal Medicine and Clinical Biology, Ghent University, Merelbeke, Belgium; (3) Department of Reproduction, Obstetrics and Herd Health, Ghent University, Merelbeke, Belgium


dog, elbow, Flexor enthesopathy, primary, concomitant


Objectives: To report the characteristics of two types of flexor enthesopathy, primary and concomitant, based on different diagnostic techniques. Materials and methods: Over a period of three years a prospective study was performed on dogs admitted for the complaint of elbow lameness. Based on the radiographic findings a selection of dogs underwent a complete series of different imaging modalities. With each technique, pathology of the medial epicondyle and the presence of other elbow disorders were recorded. All joints with signs of flexor pathology apparent with at least three techniques were selected. A distinction was made between primary and concomitant flexor enthesopathy based on the absence or presence of other elbow disorders. Results: Primary flexor enthesopathy was diagnosed in 23 joints and concomitant flexor enthesopathy in 20 joints. In 43% of the joints with primary and in 75% of the joints with concomitant flexor enthesopathy, pathology at the medial epicondyle was demonstrated by all techniques. All joints with concomitant flexor enthesopathy had a diagnosis of medial coronoid disease, osteochondritis dissecans, or both. Clinical significance:Pathology at the medial epicondyle is a sign of flexor enthesopathy. It may be present as the only sign in a joint with primary flexor enthesopathy or concomitant with other elbow pathology. In both groups flexor lesions can be demonstrated with different imaging techniques. The distinction between the primary and concomitant form is based on the presence or absence of other elbow pathology, mainly medial coronoid disease. Recognizing both types is important for a correct treatment decision.

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