1. Interactive Case Tutorial
Case 05 SA Developmental

2. Instructions 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
Answer the questions regarding a diagnosis and recommendations
Review the radiologist’s findings

3. Case Presentation Signalment: 9 month old, FI, Papillon
History: started with lameness several weeks ago; non-weight bearing lameness in the left pelvic limb
Study: Extended limb VD view of the pelvis
Technique note: the pelvis is rotated and the left pelvic limb is not fully extended leading to some distortion and foreshortening (artifact leading to the left femur seeming shorter than the right femur)

4. Pelvis R Normal right hip Collapsed, sclerotic femoral head
Remodeled acetabulum with subluxation
Mottled lucency and sclerosis of femoral neck
Thigh atrophy

5. Conclusions Provide a diagnosis based on your findings. Feedback
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Aseptic necrosis of the left femoral head with mild secondary degenerative joint disease
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6. Recommendations Provide your recommendation for this client. Feedback
Femoral head and neck excision (FHO – femoral head ostectomy) is recommend on the left
The prognosis is very good with no further care needed on the left hip after surgery.
The right hip appears normal. Although we can’t be absolutely sure that the right hip won’t be affected, the disease is generally unilateral and most dogs already show changes by 8 months of age if they will be affected.
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7. Findings
The muscles of the left hemipelvis and left pelvic limb are markedly decreased in size
The left femoral neck has mottled lucency and sclerosis as well as thickening
The left femoral head is collapsed, irregularly shaped and sclerotic
The left acetabulum is flared and remodeled with joint subluxation (note: some of the decreased coverage is artifact of positioning)
The right coxofemoral joint is normal

8. Follow-up
The patient returned for a femoral head and neck excision on the left and recovered well after surgery.
Note that the left femoral head and neck have been surgically excised

9. The End