1. Interactive Case Tutorial

2.  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. When you’ve clicked on the image, click the same spot again to make the label disappear.  Answer the questions regarding a diagnosis and recommendations  Review the radiologist’s findings

3.  Signalment: 10 year old, FS, Boxer  History: right thoracic limb amputated 1 year prior for osteosarcoma; follow-up chemotherapy completed 8 months ago; for the past 2 weeks has been reluctant to rise and painful along lumbar spine  Study: lateral and VD views of the lumbar spine

4. Lysis and proliferation of L1 spinous process Osteophyte production on articular processes Spondylosis deformans (ankylosing)

5. Lysis and proliferation of L1 spinous process Lateral spondylosis Spondylosis deformans (ankylosing)

6.  Provide a diagnosis based on your findings. Submit Semi-aggressive lesion of the spinous process of L1 is most likely a metastatic lesion from the osteosarcoma Lumbar spinal degenerative joint disease Feedback Continue

7.  Provide your recommendation for this client. Submit Medical management with prednisone, tramadol and codeine for pain and inflammation Palliative radiation therapy of the lumbar spine could be performed for management of uncontrolled pain Feedback Continue

8.  Within the spinous process of L1 is geographic lysis and indistinct proliferation  The majority of the lumbar articular processes have osteophyte formation  Spondylosis deformans is incidentally present in the cranial lumbar spine

9.  The patient had also developed pulmonary metastasis  The clients opted for medical management of pain  The patient was euthanized three months later