"Chula" Hafner
"Chula", a 1-1/2 year old spayed female black Labrador Retriever, came to us in January of 2000 with a history of intermittent right foreleg lameness since June 1999. The lameness worsened with exercise. The initial examination revealed some resistance and objection to manipulation of the right shoulder but no objection to manipulation of the right elbow.
Figure 1.


Figure 2.

Radiographs of the right elbow joint indicated some reactivity of the front part of the joint, however (Figure 1), and there was a "stairstep" between the level of the radial head and ulnar coronoid surface (Figure 2).

The stairstepping is a result of growth incongruity between the radius and ulna and is a condition strongly conducive to fragmentation of the coronoid process (a bone/cartilage free-floating chip in the elbow joint) and development of arthritis. This is what is commonly known as elbow dysplasia. The left elbow did not have the stairstepping (Figure 3).



Figure 3

Elbow dysplasia is a developmental condition that should be looked for in young dogs, before arthritis develops and becomes a problem. If caught early, surgery can be VERY helpful!

Because the physical exam suggested resistance in the shoulder while the radiographs suggested a problem in the right elbow, we suggested that a bone scan be done to help localize the primary source of pain and lameness (Figures 4 - 6).


Figure 4

Figure 5

The bone scan, called scintigraphy, is a process whereby a radioisotope, Technesium99, is injected into the patient. Dynamic flow images are taken with a special camera. Both soft tissue and bone are elucidated.

Chula's bone scan (scintigrams) indicated increased radionuclide distribution in the right elbow, especially the medial aspect of the elbow joint in the region of the coronoid process. Surgery was recommended.


Figure 6

Figure 7
Figure 8

Surgical exploration of the right elbow joint revealed some early bone spurs and a loose bone/cartilage fragment (fragmented coronoid process). The loose fragments were removed. A proximal ulnar osteotomy was performed (Figure 7).

This eliminated the "stairstep" between the radial head and the coronoid process, thus eliminating the abnormal wear of the joint surfaces of the coronoid process and humeral condyle that was occurring because of excessive contact (Figure 8).


We fully expect Chula to significantly improve. Chula should not become as lame as quickly after exercise and we do not expect her arthritis to progress very much over time. She should have a good long term prognosis.