Interactive Case Tutorial Case 05 SA Developmental

Instructions Review the history and signalment for the client Evaluate the radiographs provided Explore the interactive images and compare the answers given with your own interpretations Answer the questions regarding a diagnosis and recommendations Review the radiologist’s findings

Case Presentation Signalment: 9 month old, FI, Papillon History: started with lameness several weeks ago; non-weight bearing lameness in the left pelvic limb Study: Extended limb VD view of the pelvis Technique note: the pelvis is rotated and the left pelvic limb is not fully extended leading to some distortion and foreshortening (artifact leading to the left femur seeming shorter than the right femur)

Pelvis R Normal right hip Collapsed, sclerotic femoral head Remodeled acetabulum with subluxation Mottled lucency and sclerosis of femoral neck Thigh atrophy

Conclusions Provide a diagnosis based on your findings. Feedback Submit Aseptic necrosis of the left femoral head with mild secondary degenerative joint disease Feedback Continue

Recommendations Provide your recommendation for this client. Feedback Femoral head and neck excision (FHO – femoral head ostectomy) is recommend on the left The prognosis is very good with no further care needed on the left hip after surgery. The right hip appears normal. Although we can’t be absolutely sure that the right hip won’t be affected, the disease is generally unilateral and most dogs already show changes by 8 months of age if they will be affected. Feedback Continue Submit

Findings The muscles of the left hemipelvis and left pelvic limb are markedly decreased in size The left femoral neck has mottled lucency and sclerosis as well as thickening The left femoral head is collapsed, irregularly shaped and sclerotic The left acetabulum is flared and remodeled with joint subluxation (note: some of the decreased coverage is artifact of positioning) The right coxofemoral joint is normal

Follow-up The patient returned for a femoral head and neck excision on the left and recovered well after surgery. Note that the left femoral head and neck have been surgically excised

The End