Hi Laurie and David,
I have a question about sesamoidititis. One of my BCs (6yo, agility), has been lame on her RF. Holds it up after exercise/when stopping exercising totally NWB. Not limping when moving. She has crepitus on flexion of sesamoid 7/8 repeatedly but no pain on this or flexion of the toe/foot. NSAIDS seem to help. Not xrayed yet.
Has been low grade intermittently lame on the leg for 4 weeks or so. Nothing else found on leg.
Suspicious of the sesamoids (her father had premature retirement from agility due to issues with his) but unsure why she is not painful on palp despite definite crepitus.
I will do PEMF, pad her foot when exercising ,anything else?
Thanks as per always!
Kriszty
Sesamoidititis?
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David Lane
- Posts: 164
- Joined: Mon Oct 24, 2016 10:51 pm
Re: Sesamoidititis?
Crepitus doesn't automatically mean pain; it likely indicates degenerative changes, but I see a fair few dogs with enlarged sesamoids that never manifest with clinical foot pain. Same same for dogs with enlarged MCP1 or MTP1 joints - its something to watch, but they may never amount to significant pain.
Don't be afraid to dig in hard with your palpation of the sesamoids; they take a lot of abuse whenever that foot strikes the ground anyway, so I am more concerned about under palpating than I am over palpating. If you can firmly roll the pads of your fingers over the sesamoids, prodding, pushing, and poking with no pain response, and there is no pain response when extending the digits and carpus concurrently, then I would look somewhere else to be the source of lameness, crepitus or not.
Don't be afraid to dig in hard with your palpation of the sesamoids; they take a lot of abuse whenever that foot strikes the ground anyway, so I am more concerned about under palpating than I am over palpating. If you can firmly roll the pads of your fingers over the sesamoids, prodding, pushing, and poking with no pain response, and there is no pain response when extending the digits and carpus concurrently, then I would look somewhere else to be the source of lameness, crepitus or not.
David Lane DVM
ACVSMR, CVA, CVSMT, CCRP
ACVSMR, CVA, CVSMT, CCRP
Re: Sesamoidititis?
I agree with David... and,
I've never has a 'sesamoiditis case' present with crepitus. They tend to be lame WITH weight bearing versus after. Never have I heard of or had a dog that would hold up its leg.
So, yes, go in and dig for it... but I don't think that's the root of your problem.
Go back to checking all other things. All joints. All ligaments. All tendons. All bones. Neck. Ribs 1 - 3. T1 - 3.
And get back to us with your next round of findings!
Cheers,
Laurie
I've never has a 'sesamoiditis case' present with crepitus. They tend to be lame WITH weight bearing versus after. Never have I heard of or had a dog that would hold up its leg.
So, yes, go in and dig for it... but I don't think that's the root of your problem.
Go back to checking all other things. All joints. All ligaments. All tendons. All bones. Neck. Ribs 1 - 3. T1 - 3.
And get back to us with your next round of findings!
Cheers,
Laurie
LAURIE EDGE-HUGHES
Re: Sesamoidititis?
Thanks David and Laurie for your replies, much appreciated as always.
She definitely isn’t giving me a pain response even on hard palpation.
The only thing she is (inconsistently) reacting to is full carpus flexion. Shoulder 1st rib neck etc all NAD.
I took her to my orthopod and he also said carpus.
I’ve put a BOT carpal wrap on for exercise and doing gentle mobes/traction and pemf (unsure on settings though). Any other suggestions? Thanks!
She definitely isn’t giving me a pain response even on hard palpation.
The only thing she is (inconsistently) reacting to is full carpus flexion. Shoulder 1st rib neck etc all NAD.
I took her to my orthopod and he also said carpus.
I’ve put a BOT carpal wrap on for exercise and doing gentle mobes/traction and pemf (unsure on settings though). Any other suggestions? Thanks!
Re: Sesamoidititis?
Well, the carpus is a joint that you primarily have to support. So, the Back On Track braces might be a great place to start. PEMF settings depend on which unit you have... but somewhere between 5 and 26Hz seems to have the most research to back them.
Continue on with what you're doing. Look into joint supplements if she's not yet on joint supplements.
Laurie
Continue on with what you're doing. Look into joint supplements if she's not yet on joint supplements.
Laurie
LAURIE EDGE-HUGHES
Re: Sesamoidititis?
Yup on antinol magnesium and collagen 
Would fit with response to nsaids too.
Thanks!
Would fit with response to nsaids too.
Thanks!
Re: Sesamoidititis?
Hi Laurie,
Would you shock wave a carpus? Her teres and triceps seem sore, so I will u/s and shock wave her shoulder but I was wondering about the carpus as well.
Previously I have tried it on a hock but it wasn't very well tolerated and not very useful.Thanks!
Would you shock wave a carpus? Her teres and triceps seem sore, so I will u/s and shock wave her shoulder but I was wondering about the carpus as well.
Previously I have tried it on a hock but it wasn't very well tolerated and not very useful.Thanks!
Re: Sesamoidititis?
Edited to add:Kriszty wrote: ↑Fri Apr 22, 2022 10:37 amHi Laurie,
Would you shock wave a carpus? Her teres and triceps seem sore, so I will u/s and shock wave her shoulder but I was wondering about the carpus as well.
Previously I have tried it on a hock but it wasn't very well tolerated and not very useful.Thanks!
I just watched your v good teres major vid and she's definitely got a teres strain- I suspect a grade 2 :/
At this stage it would be subacute- chronic. Have you shock waved one of these before and if so did you go in medially or just causally? TIA!
Re: Sesamoidititis?
Hi Kriszty,
I have shockwaved the carpus... but a a much lower dose than I would over a fleshy area.
I have not ever shockwaved a Teres Major! I don't see an issue with Radial. With Focused, you would want to be very confident of your localization and placement so that you aren't shockwaving the lungs or heart... If I were to do it I would come at it from the caudo-medial aspect - in the axilla.
Just adding some stretches might do a great job for the Teres Major issue.
Laurie
I have shockwaved the carpus... but a a much lower dose than I would over a fleshy area.
I have not ever shockwaved a Teres Major! I don't see an issue with Radial. With Focused, you would want to be very confident of your localization and placement so that you aren't shockwaving the lungs or heart... If I were to do it I would come at it from the caudo-medial aspect - in the axilla.
Just adding some stretches might do a great job for the Teres Major issue.
Laurie
LAURIE EDGE-HUGHES