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Elbow dysplasia

Elbow disease (elbow dysplasia)

Elbow disease, elbow dysplasia or developmental elbow disease is a debilitating condition affecting young growing dogs especially Labrador retrievers. As the name implies developmental elbow disease usually presents in dogs between the ages of four and twelve months. Clinical signs usually relate to lameness affecting the forelimbs, which appears worst following extended periods of exercise with stiffness and lameness present after rest. Improvement is often noted with restricted levels of activity and non steroidal anti-inflammatory medication.

The underlying cause of developmental elbow disease is poorly understood but may have an inherited component and consequently the British Veterinary Association and Kennel Club (BVA/KC) have introduced an elbow dysplasia scoring scheme. Developmental elbow disease is an umbrella term that covers several different abnormalities within the elbow joint and include:

  • Fragmentation of the medial portion of the coronoid process (FMCP)
  • Osteochondrosis of the medial humeral condyle (OCD)
  • Elbow incongruity
  • Incomplete ossification of the humeral condyles (IOHC)

The most commonly found abnormality is fragmentation of the medial portion of the coronoid process and is likely the result of uneven loading within the elbow joint. This results in fragmentation or fissuring of a small portion of bone within the elbow which causes inflammation, discomfort and progressive osteoarthritis.

Diagnosis is usually based on the signalment, history and radiographic signs. Often dogs show signs of early subtle osteoarthritis within the elbow joints. However a definitive diagnosis usually requires advanced imaging (CT) or arthroscopy.

Arthroscopic image of fragmented medial coronoid process

CT image of fragmentation of the medial coronoid process

CT image of incomplete ossification of the humeral condyles

 

Treatment of developmental elbow disease primarily focuses on debridement of the abnormal region of the elbow joint. This can provide improvement in clinical signs in approximately 60-70% of cases. Unfortunately surgery does not alter the progression of osteoarthritis, which can be a limiting factor in long-term outcome. A variety of other surgical techniques have been proposed for the elbow joint although clinical outcomes from these surgeries have yet to be established.

Further information regarding developmental elbow disease can be found in the PDF downloads.

CT 3D reconstruction of elbow osteoarthritis