Sophie, a 14-month-old, 32-kg, intact female greyhound presented with acute right forelimb lameness.
History. There was no history of former trauma or injury. Two days before initial presentation, Sophie began exhibiting intermittent lameness of the right forelimb. The lameness was acute after exercise, but gradually improved until it was no longer noticeable after a few hours.
A complete physical examination was performed by the primary veterinarian. Temperature and respiratory rate were unremarkable; spinal reflexes, withdrawal, and conscious proprioception were normal. The orthopedic examination revealed a very mild pain response during flexion of the right carpal joint, but no instability was detected. Standard dorsopalmar and lateral radiographs appeared to be unremarkable.
A mild sprain of a non–well-defined carpal ligament was diagnosed and Sophie was prescribed carprofen (50 mg Q 12 H for 5 days); rest and controlled activity were recommended for a week. Since Sophie did not show any sign of lameness after a week, her owner allowed her to resume normal activities but she became lame again on the same limb. Sophie was referred to a specialist for further examination.
Physical Examination. Nine days after initial onset of clinical signs, Sophie was walking normally. General physical and neurological examinations were unremarkable. The orthopedic examination confirmed a mild pain response during flexion of the right carpus. A very mild decreased range of motion was noted during flexion—the cranial translation movement at 90º of flexion of the affected carpal joint was decreased when compared with the contralateral carpal joint.
A very mild swelling was detected on the dorsomedial aspect of the proximal carpal joint between the dorsal articular margin of the radius and the ulnar carpal bone. Direct finger pressure exerted on the articular margin of the radius at the swollen area elicited a pain response. Joint effusion and crepitus were absent. The carpal joint was stable in both flexion and forced extension; collateral stability was normal in extension and flexion.
Radiographic Examination. Radiographic examination included standard orthogonal and oblique views of the carpus. Flex oblique views were also taken (Figure 1).
- What are the possible causes of forelimb lameness affecting the carpal region in a large breed, skeletally mature dog?
- What views would you include during the radiographic examination of the carpal region?
- Are there any dedicated radiographic views that can be considered highly sensitive for the possible cause of this forelimb lameness?
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