Suspect palmolateral desmopathy with avulsion of the palmar accessory metacarpal ligament.
Posted: Sat Nov 13, 2021 3:11 am
Hi Laurie,
Millie is a 6 year old, female spayed, golden retriever who is
6 weeks post acute LTL lameness with left carpus lateral swelling. Patient has been on activity restriction, laser therapy, Assisi loop, Therapaw carpal sport wrap and tumeric.
RADIOGRAPHIC FINDINGS
Stationary soft tissue swelling is seen palmar and lateral of the left carpal joint.
No evidence of subluxation or luxation of the carpus is noted. However, next to the stationary
soft tissue swelling, progressive enthesophytosis of the distal bone surface of the accessory
carpal bone as well as osseous remodeling with new bone formation and multifocal reduced
opacity of the proximal, lateral, and palmar contour of the 5th metacarpal bone is seen.
The antebrachiocarpal and intercarpal joints present no significant evidence of osteoarthritis
changes.
RADIOGRAPHIC DIAGNOSIS
• Suspect palmolateral desmopathy with avulsion of the palmar accessory metacarpal ligament.
INTERPRETATION OF THE FINDINGS & FURTHER RECOMMENDATIONS
The radiographic findings are highly suggestive for injury of the palmar accessory metacarpal
ligament with avulsion from the proximal 5th metacarpus and/or accessory metacarpal bone. The
soft tissue swelling is stationary which suggests enduring injury or disturbed healing of the
ligament. Further verification by means of ultrasound could be considered. Temporary
immobilization of the carpus may be required in order to achieve healing progress
We are currently trying to get a musculoskeletal Ultrasound scheduled. My question is should we be immobilizing the carpus and digits in a spoon splint or similar to prevent weight bearing on the paw and create some tendon laxity for healing or would a surgical consultation be more appropriate at this point ? Can the client expect a full recovery or is it possible that she may have a persistent or long term lameness?
Thank you as always
Dr. Wendy Robins
Millie is a 6 year old, female spayed, golden retriever who is
6 weeks post acute LTL lameness with left carpus lateral swelling. Patient has been on activity restriction, laser therapy, Assisi loop, Therapaw carpal sport wrap and tumeric.
RADIOGRAPHIC FINDINGS
Stationary soft tissue swelling is seen palmar and lateral of the left carpal joint.
No evidence of subluxation or luxation of the carpus is noted. However, next to the stationary
soft tissue swelling, progressive enthesophytosis of the distal bone surface of the accessory
carpal bone as well as osseous remodeling with new bone formation and multifocal reduced
opacity of the proximal, lateral, and palmar contour of the 5th metacarpal bone is seen.
The antebrachiocarpal and intercarpal joints present no significant evidence of osteoarthritis
changes.
RADIOGRAPHIC DIAGNOSIS
• Suspect palmolateral desmopathy with avulsion of the palmar accessory metacarpal ligament.
INTERPRETATION OF THE FINDINGS & FURTHER RECOMMENDATIONS
The radiographic findings are highly suggestive for injury of the palmar accessory metacarpal
ligament with avulsion from the proximal 5th metacarpus and/or accessory metacarpal bone. The
soft tissue swelling is stationary which suggests enduring injury or disturbed healing of the
ligament. Further verification by means of ultrasound could be considered. Temporary
immobilization of the carpus may be required in order to achieve healing progress
We are currently trying to get a musculoskeletal Ultrasound scheduled. My question is should we be immobilizing the carpus and digits in a spoon splint or similar to prevent weight bearing on the paw and create some tendon laxity for healing or would a surgical consultation be more appropriate at this point ? Can the client expect a full recovery or is it possible that she may have a persistent or long term lameness?
Thank you as always
Dr. Wendy Robins