Diagnosis and treatment of infraspinatus tendon-bursa ossification in a Eurasian Dog

 

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Summary

A 4-year-old male Eurasian Dog presented at our veterinary clinic with a history of perpetual forelimb lameness in both thoracic limbs. In the clinical exploration, direct pressure over the infraspinatus tendon of insertion caused pain in both thoracic forelimbs and a firm band-like structure was palpable. No improvement was observed after treatment with rest, non-steroidal anti-inflammatory drugs and an intralesional injection of a long-acting glucocorticoid. Radiographic examination, ultrasonographic exploration and computed tomography were performed, identifying ossified structures lateral to the proximal humerus and an irregular roughened periosteum at the insertion and tendon of the infraspinatus muscle on both sides. There were more distinct alterations on the right thoracic limb. The imaging results led to a diagnosis of an infraspinatus tendon-bursa ossification accompanied by a chronic tendinopathy/tendovaginitis, accentuated on the right side. The dog was subjected to physiotherapy and autologous conditioned plasma (ACP) was injected into the insertion of the infraspinatus muscle of both thoracic limbs. After 5 months of physiotherapy and two injections of ACP with an interval of one week in both forelimbs, the dog showed no signs of lameness. This case report describes the diagnosis and management of infraspinatus tendon-bursa ossification in a Eurasian Dog. To the authors’ knowledge, this condition has previously not been described in this breed of dog.

Zusammenfassung

Ein 4-jähriger, männlicher Eurasier wurde in unserer Kleintierklinik mit dem Vorbericht einer Lahmheit beider Vordergliedmaßen vorgestellt. Bei der klinischen Untersuchung konnte beidseits eine Verhärtung der Ansatzsehne des M. infraspinatus palpiert werden, die bei Ausübung von Druck eine schmerzhafte Reaktion hervorrief. Eine Vorbehandlung mit Ruhighaltung, nichtsteroidalen Antiphlogistika und der lokalen Injektion eines lang wirkenden Glukokortikoids hatte keine Besserung der Symptomatik erbracht. Bei der bildgebenden Diagnostik mittels Röntgen, Ultraschall und Computertomographie stellten sich beidseits Mineralisierungen lateral des proximalen Humerus und irregulär aufgerautes Periost am Ansatz und der Sehne des M. infraspinatus dar. Die rechte Vordergliedmaße zeigte stärkere Veränderungen als die linke. Die Ergebnisse der Bildgebung führten zu der Diagnose einer beidseitigen, rechts ausgeprägteren Ossifikation der Sehne und der Bursa des M. infraspinatus, begleitet von einer chronischen Tendinopathie/Tendovaginitis. Der Hund wurde mit Physiotherapie und beidseitigen Injektionen von autologem konditioniertem Plasma (ACP) in den Ansatz des M. infraspinatus behandelt. Nach 5 Monaten Physiotherapie sowie zwei ACP-Injektionen im Abstand von einer Woche war der Hund lahmheitsfrei. Dieser Fallbericht beschreibt die Diagnose und Therapie der Ossifikation der Sehne und der Bursa des M. infraspinatus bei einem Eurasier. Nach Kenntnisstand der Autoren wurde diese Erkrankung bisher nicht bei Hunden dieser Rasse beschrieben.

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