All About Elbow Dysplasia.

What is it?

Elbow dysplasia is a group of four slightly different diseases associated with abnormal development of this joint in puppies:

1. Fragmented medial coronoid process

2. OCD of the medial humeral condyle

3. Ununited anconeal process

4. Incongruity of the elbow joint

The most common form is fragmented medial coronoid process and this involves a small fragment of cartilage and bone loose within the joint that causes inflammation (arthritis).

What sort of dogs are affected?

Typically, the diseases causes lameness and pain in dogs aged 5-18 months. Certain breeds are particularly at risk for these disorders:

Fragmented coronoid process: Many medium to large breed pedigree dogs, but especially Labradors, Golden Retrievers, Rottweilers, Bernese Mountain Dogs, Bullmastiffs.

OCD: Many medium to large breed pedigree dogs, but especially Labradors, Golden Retrievers.

Ununited anconeal process: German Shepherd Dog, Bassett Hound

What causes these diseases?

The cause of elbow dysplasia is not fully understood. Certainly there is a complex genetic basis and it is likely that several different genes are involved. It is also likely that environmental factors (exercise, growth rate, nutrition) play a role. In Liverpool they are investigating the genetic basis of the disease in collaboration with colleagues at CIGMA at the University of Manchester.

What are the signs of these diseases?

All types of elbow dysplasia can cause pain and lameness although in some dogs the disease may remain clinically silent for many months or years. Lameness may appear suddenly or insidiously. Often the condition occurs in both elbows and so signs may relate to joint stiffness in both forelimbs. Later in life, the osteoarthritis initiated by elbow dysplasia may progress to cause pain, stiffness and lameness.

How are these conditions diagnosed?

A clinical examination by a veterinary surgeon is the first step in diagnosis. If elbow dysplasia is suspected, radiographs (x-rays) are the most usual initial step in making a diagnosis. Although some forms of elbow dysplasia may be obvious on radiographs, often there are only subtle changes, particularly early in the disease.However, radiographs only give limited information and a much more accurate assessment can be made with arthroscopy. This involves placing a small endoscope, linked to a video camera and monitor, in to the joint to examine the interior in a key-hole manner.Arthroscopy also provides the opportunity to remove the fragment in a minimally-invasive manner. At Liverpool they have excellent facilities for arthroscopy of canine elbow joints.

What can be done to treat the condition?

If causing persistent problems, fragmentation of the coronoid process is, in most vet´s opinion, best treated with arthroscopy. Removal of the fragment can relieve pain and allow improvement in joint function. OCD can be treated in a similar manner. Treatment of ununited anconeal process is more complicated but currently repair of the fragment with a corrective osteotomy below the elbow appears to offer the best option.