Lame young Berner
Posted: Mon Dec 18, 2017 3:24 am
Hi Laurie,
I want to start by apologizing for this email. I am worried that I am missing something obvious and by putting it on the Forum, it would be fodder for giggles and chuckles. So, private G&C’s are at least one degree better.
I saw a 17 month old Berner today for the first time, who has been 4/5 lame for 3 weeks (no better, no worse). There has been no response to NSAID’s or Tramadol. There was a history of suspected trauma (went outside and played with the other Berner and they have been known to get caught up in their chain link fence, etc….. either way, she went out sound and came in lame).
She had rads (paws to ghj) done and they were reviewed by a radiologist and then sent to a surgeon. The radiologist said that there was “evidence of medial coronoid disease and mild elbow arthrosis which is the likely source of the lameness described. Acute traumatic exacerbation of the inflammation may have resulted in the acute presentation. There is evidence of mild L shoulder arthrosis, but there is no evidence of developmental conditions such as OCD. The current clinical significance is uncertain. Mild osteochondrosis is not exluded.”
The surgeon (who did not see the dog) did not think that rads were exciting enough to correlate with the degree of lameness.
During my exam, she was definitely sore with extension of the ghj. She did not react with glides (except mildly with the cranial glide). She did not react with palpation of the tendons of the shoulder (curiously, she didn’t mind the biceps tendon). However, what was interesting was the range of motion when we were testing her for MSI. She was becoming quite reactive with each attempt and so I wasn’t able to get an exact measurement with the goniometer (but I would estimate about 50+ degrees and the opposite shoulder was much tighter). She was also painful.
The elbows had a good ROM and she did not seem reactive with palpation in the medial compartments, etc. She has good ROM with her neck.
From your previous lectures, I would have expected more findings than just the hypermobile ghj. And this is not intermittent, it is consistent and severe. Have you ever diagnosed an MSI that presented in this manner? Or am I likely missing something?
Thanks again for all that you do for the community!
RM
I want to start by apologizing for this email. I am worried that I am missing something obvious and by putting it on the Forum, it would be fodder for giggles and chuckles. So, private G&C’s are at least one degree better.
I saw a 17 month old Berner today for the first time, who has been 4/5 lame for 3 weeks (no better, no worse). There has been no response to NSAID’s or Tramadol. There was a history of suspected trauma (went outside and played with the other Berner and they have been known to get caught up in their chain link fence, etc….. either way, she went out sound and came in lame).
She had rads (paws to ghj) done and they were reviewed by a radiologist and then sent to a surgeon. The radiologist said that there was “evidence of medial coronoid disease and mild elbow arthrosis which is the likely source of the lameness described. Acute traumatic exacerbation of the inflammation may have resulted in the acute presentation. There is evidence of mild L shoulder arthrosis, but there is no evidence of developmental conditions such as OCD. The current clinical significance is uncertain. Mild osteochondrosis is not exluded.”
The surgeon (who did not see the dog) did not think that rads were exciting enough to correlate with the degree of lameness.
During my exam, she was definitely sore with extension of the ghj. She did not react with glides (except mildly with the cranial glide). She did not react with palpation of the tendons of the shoulder (curiously, she didn’t mind the biceps tendon). However, what was interesting was the range of motion when we were testing her for MSI. She was becoming quite reactive with each attempt and so I wasn’t able to get an exact measurement with the goniometer (but I would estimate about 50+ degrees and the opposite shoulder was much tighter). She was also painful.
The elbows had a good ROM and she did not seem reactive with palpation in the medial compartments, etc. She has good ROM with her neck.
From your previous lectures, I would have expected more findings than just the hypermobile ghj. And this is not intermittent, it is consistent and severe. Have you ever diagnosed an MSI that presented in this manner? Or am I likely missing something?
Thanks again for all that you do for the community!
RM