Long bones – juvenile

image of Long bones – juvenile
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Indications for radiography of the long bones in juvenile animals include: trauma; persistent or shifting lameness; abnormal gait; disparate limb length; dwarfism; angular, flexural or rotational limb deformities and carpal valgus or varus; pain on palpation of one or more long bones; soft tissue swelling or draining sinus tract overlying a long bone; metaphyseal enlargement; evaluation of fractures or fracture healing; and suspected metabolic or systemic illness which may have skeletal manifestations. This chapter looks at radiography, normal anatomy and physiology, alternative imaging techniques and abnormal image findings.

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Image of 8.2
8.2 Vitamin D metabolism and hormonal responses to low serum calcium. Inhibitory mechanisms are not illustrated.
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8.3 (a) Sketch illustrating the radiographic changes associated with premature closure of the distal ulnar physis. (b) Mediolateral (ML) radiograph of a skeletally immature dog with premature closure of the distal ulnar physis. Note the corresponding changes as indicated in (a).
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8.4 (a) Sketch illustrating the radiographic changes associated with premature closure of the distal radial physis. (b) ML radiograph of a nearly skeletally mature dog with premature closure of the distal radial physis. Note the corresponding changes as indicated in (a).
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8.5 (a) ML view of the right stifle of a 9-month-old Dobermann that had been involved in a road traffic accident when 3 months old which resulted in a fracture of the right femur. An undiagnosed physeal fracture resulted in premature closure of the proximal tibial physis, which led to marked caudodistal and lateromedial sloping of the proximal tibia. (b) Craniocaudal (CrCd) view of the same limb demonstrating the marked lateromedial sloping of the tibial plateau. Note the incidental calcinosis circumscripta along the lateral aspect of the stifle joint.
Image of 8.6
8.6 (a) VD extended and (b) VD flexed views of the pelvis of an 8-month-old Weimaraner which presented with pelvic limb lameness without a history of trauma. There is bilateral displacement of the femoral heads relative to the proximal femoral physes and mottled radiolucency of the femoral heads. The diagnosis was slipped capital femoral epiphyses.
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8.8 CrCd view of the antebrachium, carpus and manus of a 5-month-old Domestic Shorthair kitten with chondrodysplasia. There is marked widening of the distal radial, ulnar and metacarpal physes with metacarpal flaring, while other visible physes are spared. There is prominent sclerosis on the metaphyseal aspect of each affected physis.
Image of 8.9
8.9 (a) ML view of the right stifle of a Miniature Dobermann presented at 10.5 months of age with disproportionate dwarfism. Note the lack of ossification of the fibular epiphyses as well as the tibial crest. The femoral condyles have an irregular stippled radiolucent appearance. (b) Lateral view of the lumbar spine of the same patient, demonstrating the markedly irregular vertebral epiphyses. The diagnosis was multiple epiphyseal dysplasia.
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8.10 ML view of the tibia of a cat with osteosclerosis. Note the marked diffuse increased radiopacity in the medullary cavity of the tibia.
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8.11 ML view of the distal antebrachium of a skeletally immature dog with a retained endochondral cartilage core in the ulna showing the typical flame-shaped radiolucency extending from the physis into the metaphysis. Note the sclerotic rim surrounding the radiolucency.
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8.12 Terminology used to describe appendicular dysostoses. In the accompanying sketches, absent bones are highlighted in blue.
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8.13 (a) CrCd view of the left antebrachium in an 18-week-old Chihuahua with ectrodactyly. The radius and ulna are separated and the distal thoracic limb is split. (b) Corresponding CT 3D volume-rendered image viewed from the craniolateral aspect. Note the rotational and flexural deformity at the level of the carpus. (c) The patient also had concurrent spina bifida as indicated by the arrow on the transverse CT image taken at the level of T1. (Courtesy of Murdoch University Veterinary Academic Hospital, Perth, Australia)
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8.14 CrCd view of the right thoracic limb of a 10-week-old kitten with hemimelia (intercalary, longitudinal form). The radius is absent and the ulna is bowed, shorter and thickened, mimicking a weight-bearing radius. Note the concurrent carpal varus.
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8.15 VD view of the pelvis of a 9-month-old Domestic Shorthair cat with suspected proximal femoral focal deficiency. Left coxofemoral subluxation and a shallow acetabulum are evident. The left femoral head and part of the neck are absent (aplasia). The left femur is also markedly shorter than the right and is atrophied.
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8.16 ML view of the antebrachium of a puppy with haematogenous osteomyelitis. Note the moth-eaten lysis in the distal metaphyseal region of the ulna and the subtle immature periosteal reaction along the caudal cortex of the distal ulnar diaphysis.
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8.17 ML view of the antebrachium in a young Labrador Retriever. There is a smooth broad-based bony lesion on the cranial aspect of the proximal radius, with a relatively radiolucent centre. The diagnosis was osteochondroma.
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8.18 A slightly rotated ML view of the right distal antebrachium of a 3-year-old mixed-breed dog. Note the smoothly marginated craniodistal ulnar exostoses (arrowed) with a corresponding focal lucency in the adjacent caudodistal radial cortex due to impingement by an osteochondroma.
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8.19 Slightly rotated ML view of the left pelvic limb of a 3-month-old dog with nutritional secondary hyperparathyroidism. Note the moderate generalized osteopenia. There is an old fracture of the mid-tibial diaphysis with evidence of fracture healing and a recent moderately displaced fracture in the mid-femoral diaphysis. Both fractures are pathological.
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8.21 Radiographs from an 8-month-old Domestic Shorthair cat with nutritional secondary hyperparathyroidism. The patient had been fed an exclusively meat diet since weaning. (a) VD view of the neck and head. Note the marked osteopenia, poorly visible scapulae and ‘floating teeth’. A feeding tube is present. (b) VD view of the lumbar spine. Note the ‘picture frame’ vertebrae due to marked osteopenia. (c) Lateral whole-body view demonstrating generalized osteopenia, cortical thinning and poorly visible dorsal spinous processes.
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8.22 Four-month-old Great Dane diagnosed with renal secondary hyperparathyroidism due to renal dysplasia. (a) DV view of the skull. Note the marked osteopenia of the skull resulting in the appearance of ‘floating teeth’. (b) Sagittal ultrasonographic image of the dysplastic left kidney showing complete loss of normal renal architecture with marked diffuse hyperechogenicity and a mild amount of anechoic fluid in the renal pelvis.
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8.23 CrCd view of the antebrachium and manus of a young dog with rickets. There is widening of the physes of the distal radius and ulna, and the distal metacarpi (arrowed), flaring of the metaphyses and marked thinning of the metacarpal cortices.
Image of 8.24
8.24 (a) Dorsopalmar (DPa) view of the carpus of a 14-week-old kitten diagnosed with congenital hypothyroidism. Note the delayed epiphyseal appearance and retarded ossification of the carpal bones when compared with (b) a normal DPa study from a 12-week-old kitten. (c) Photo of the kitten demonstrating classic disproportionate dwarfism. Note how the head appears large relative to the short thoracic limbs.
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8.25 ML view of the antebrachium of a 10-month-old Old English Sheepdog. A multilocular bone cyst is present in the distal radial shaft.
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8.26 (a) VD view of the pelvis of a 13-month-old dog. Note the focal, well marginated medullary opacity (‘thumbprint’) in the right proximal femoral diaphysis, consistent with early panosteitis (arrowed). (b) ML view of the elbow of the same patient taken at the same time as (a) showing more diffuse ill-defined opacification of the distal humerus and proximal ulnar diaphyses (arrowed).
Image of 8.27
8.27 ML view of the right humerus of an adult dog showing evidence of previously healed panosteitis. Note the relatively empty-appearing medullary cavity with several horizontal radiopaque bands.
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8.28 DPa view of the carpus of a young dog with early MO. The arrow indicates an irregular radiolucent band in the distal radial metaphysis, running parallel to the physis.
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8.29 ML view of the left antebrachium of a 5-month-old Bullmastiff with late-stage MO. Note the marked metaphyseal sclerosis and prominent paracortical cuffs, separated from the underlying cortex by a radiolucent line, in the distal radius and ulna. The proximal radius is also affected but to a much lesser extent. Ill-defined radiolucencies are still noted in the metaphyseal region.
Image of 8.30
8.30 ML view of the right stifle and tibia of a 7-month-old Bullmastiff with advanced MO. Note the prominent metaphyseal enlargement and how the metaphyseal collar has fused with the underlying proximal and distal tibial cortex. The original cortex is still visualized and remodelling will eventually take place. The distal femur is also affected.
Image of 8.31
8.31 ML view of the antebrachium in a dog showing fibrous dysplasia involving the proximal radial and ulnar diaphysis. Note the lytic lesions within the adjacent cortices with extension of lysis into the radial medulla.
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