Interactive Case Tutorial

 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

 Signalment: 2 year old, Bernese mountain dog  History: presenting for OFA evaluation of hips and elbows  Study: Extended limb VD view of the pelvis and flexed lateral views of both elbows  These are the standard views for OFA submission  Technique note: the stifles are externally rotated (not straight)

Right Stifle Both stifles are rotated leading to positional artifact of lateral patellar luxation (these stifles are normal) Right Coxofemoral Joint Good coverage of the femoral head. No degenerative change. Left Coxofemoral Joint Normal acetabular shape and depth

Medial Humeral Epicondyle Irregularity of medial humeral epicondyle is due to osteophytes of the DJD Radial Head Pointy radial head is an osteophyte of DJD Trochlear Notch Mild sclerosis of the trochlear notch of the ulna Medial Coronoid Process Medial coronoid process is blunted

Trochlear Notch Moderate sclerosis of the trochlear notch of the ulna Medial Coronoid Process Medial coronoid process is blunted Radial Head Large osteophyte on radial head is DJD Anconeal Process New bone formation Medial Humeral Epicondyle Irregularity of medial humeral epicondyle is due to osteophytes of the DJD

 Provide a diagnosis for the elbows based on your findings. Submit Bilateral elbow dysplasia with DJD (right worse). The most likely underlying cause is medial coronoid process disease (fragmentation). Feedback Continue

 Provide a diagnosis for the pelvis based on your findings. Submit Normal pelvis with no dysplasia. OFA rating is expected to be good to excellent. Feedback Continue

 Provide your recommendation for this client. Submit The orthogonal view of both elbows should be obtained to further evaluate for the underlying cause of the elbow dysplasia and plan for any necessary intervention. Feedback Continue

 Pelvis:  The coxofemoral joint conformation is good with deep acetabula and good conformation of the femoral heads  Bilateral elbows:  The radial head and medial humeral epicondyle have osteophytes (bilateral). The medial coronoid process is blunted (bilateral). The trochlear notch of the ulna is sclerotic (bilateral). The right anconeal process has new bone formation.