Re: Joint taps helpful or harmful to help diagnose partial cruciate

[Guest guest]

So here are some thoughts:1) joint taps are not harmful if done properly. The stifle is not difficult. I usually sedate with dexdomitor +/- morphine. I prep but usually don't clip anymore. Numerous labs can do joint fluid analysis but for all my cytological samples I really prefer Dr. Menard and Dr. LaTouche at Veterinary Diagnostic Imaging and Cytology. http://www.vdic.com/With cranial cruciate ligament disease you would expect a synovitis but I am not certain you will gain any further information. I would consider lameness in the pelvic limb, positive anterior drawer, localization of pain to the stifle and joint effusion on radiographs a rather definitive diagnosis of CCLD.2) I am impressed with your assessment of MTrPs in the quadriceps, in fact MTrPs can be found in any of the functional unit muscles of the stifle joint brought about by dysfunction of the joint. If your patient is only toe-touching the coxofemoral flexors may not be resting and MTrPs can form in those muscles also, including the iliopsoas, so pain might be appreciated in the ventral lumbar and lumbosacral area. I don't know if this would explain the L7 pain you mentioned or not. 3) I often find that it is very difficult to assess proprioception of the distal limb when there is extreme pain in the upper limb, especially stifle or hip. The patient is slow to flex joints and correct placement of foot due to pain rather than neuro dysfunction. Just a thought. Also since there is a mention of possible bilateral CCLD on radiographs it is worth mentioning that bilateral CCLD is often confused with a neurologic problem due to abnormal ataxic like gait.

Hi, I need some opinions, please

I have a 2 year old sweet agility corgi that is toe touching on her right rear. I diagnosed her with a cruciate based on my exam (positive anterior drawer with snarling) and at that time she had multiple trigger points in her quadriceps. She had muscle atrophy to both rear legs from cage confinement I started therapy with

Leash walking

Icing

Massage

Metacam

1 week later she went to our local orthopod who felt she had a partial cruciate and told her to stop agility forever and try more conservative therapies. He did stifle rads and radiologist read them as basically normal but with a possible effusion. The orthopod did not recommend an MRI due to her small size

Since then I referred her to Tops where they found a mild propioception deficit to her rt rear and pain in lumbar area. Further rads of lumbar area and stifle at a local practice was unremarkable. That veterinarian found her painful at L7 and again felt there was a propioception problem.

She is currently back on Metacam, has fairly normal days and bad days. I am working on core strengthening which is going well but she will not stand on an exercise disk bearing weight on that limb. She has been receiving laser therapy at local veterinary practice as well.Tick panel was negative. I will be rechecking her next week.

Would a joint tap show inflamation if she has a partial cruciate? Would it be risky (we plan on being very sterile). Any other diagnostic ideas?

[Guest guest]

Any success with MRIs in small dogs.? Mona L. Gitter DVM CCRT

So here are some thoughts:1) joint taps are not harmful if done properly. The stifle is not difficult. I usually sedate with dexdomitor +/- morphine. I prep but usually don't clip anymore. Numerous labs can do joint fluid analysis but for all my cytological samples I really prefer Dr. Menard and Dr. LaTouche at Veterinary Diagnostic Imaging and Cytology. http://www.vdic.com/With cranial cruciate ligament disease you would expect a synovitis but I am not certain you will gain any further information. I would consider lameness in the pelvic limb, positive anterior drawer, localization of pain to the stifle and joint effusion on radiographs a rather definitive diagnosis of CCLD.2) I am impressed with your assessment of MTrPs in the quadriceps, in fact MTrPs can be found in any of the functional unit muscles of the stifle join

t brought about by dysfunction of the joint. If your patient is only toe-touching the coxofemoral flexors may not be resting and MTrPs can form in those muscles also, including the iliopsoas, so pain might be appreciated in the ventral lumbar and lumbosacral area. I don't know if this would explain the L7 pain you mentioned or not. 3) I often find that it is very difficult to assess proprioception of the distal limb when there is extreme pain in the upper limb, especially stifle or hip. The patient is slow to flex joints and correct placement of foot due to pain rather than neuro dysfunction. Just a thought. Also since there is a mention of possible bilateral CCLD on radiographs it is worth mentioning that bilateral CCLD is often confused with a neurologic problem due to abnormal ataxic like gait.

Hi, I need some opinions, please

I have a 2 year old sweet agility corgi that is toe touching on her right rear. I diagnosed her with a cruciate based on my exam (positive anterior drawer with snarling) and at that time she had multiple trigger points in her quadriceps. She had muscle atrophy to both rear legs from cage confinement I started therapy with

Leash walking

Icing

Massage

Metacam

1 week later she went to our local orthopod who felt she had a partial cruciate and told her to stop agility forever and try more conservative therapies. He did stifle rads and radiologist read them as basically normal but with a possible effusion. The orthopod did not recommend an MRI due to her small size

Since then I referred her to Tops where they found a mild propioception deficit to her rt rear and pain in lumbar area. Further rads of lumbar area and stifle at a local practice was unremarkable. That veterinarian found her painful at L7 and again felt there was a propioception problem.

She is currently back on Metacam, has fairly normal days and bad days. I am working on core strengthening which is going well but she will not stand on an exercise disk bearing weight on that limb. She has been receiving laser therapy at local veterinary practice as well.Tick panel was negative. I will be rechecking her next week.

Would a joint tap show inflamation if she has a partial cruciate? Would it be risky (we plan on being very sterile). Any other diagnostic ideas?

[Guest guest]

Shipped out July 18 thShall I come up to u tomorrow? About 9:30 10:00?Sent from my iPhone

Any success with MRIs in small dogs.? Mona L. Gitter DVM CCRT

So here are some thoughts:1) joint taps are not harmful if done properly. The stifle is not difficult. I usually sedate with dexdomitor +/- morphine. I prep but usually don't clip anymore. Numerous labs can do joint fluid analysis but for all my cytological samples I really prefer Dr. Menard and Dr. LaTouche at Veterinary Diagnostic Imaging and Cytology. http://www.vdic.com/With cranial cruciate ligament disease you would expect a synovitis but I am not certain you will gain any further information. I would consider lameness in the pelvic limb, positive anterior drawer, localization of pain to the stifle and joint effusion on radiographs a rather definitive diagnosis of CCLD.2) I am impressed with your assessment of MTrPs in the quadriceps, in fact MTrPs can be found in any of the functional unit muscles of the stifle join

t brought about by dysfunction of the joint. If your patient is only toe-touching the coxofemoral flexors may not be resting and MTrPs can form in those muscles also, including the iliopsoas, so pain might be appreciated in the ventral lumbar and lumbosacral area. I don't know if this would explain the L7 pain you mentioned or not. 3) I often find that it is very difficult to assess proprioception of the distal limb when there is extreme pain in the upper limb, especially stifle or hip. The patient is slow to flex joints and correct placement of foot due to pain rather than neuro dysfunction. Just a thought. Also since there is a mention of possible bilateral CCLD on radiographs it is worth mentioning that bilateral CCLD is often confused with a neurologic problem due to abnormal ataxic like gait.

Hi, I need some opinions, please

I have a 2 year old sweet agility corgi that is toe touching on her right rear. I diagnosed her with a cruciate based on my exam (positive anterior drawer with snarling) and at that time she had multiple trigger points in her quadriceps. She had muscle atrophy to both rear legs from cage confinement I started therapy with

Leash walking

Icing

Massage

Metacam

1 week later she went to our local orthopod who felt she had a partial cruciate and told her to stop agility forever and try more conservative therapies. He did stifle rads and radiologist read them as basically normal but with a possible effusion. The orthopod did not recommend an MRI due to her small size

Since then I referred her to Tops where they found a mild propioception deficit to her rt rear and pain in lumbar area. Further rads of lumbar area and stifle at a local practice was unremarkable. That veterinarian found her painful at L7 and again felt there was a propioception problem.

She is currently back on Metacam, has fairly normal days and bad days. I am working on core strengthening which is going well but she will not stand on an exercise disk bearing weight on that limb. She has been receiving laser therapy at local veterinary practice as well.Tick panel was negative. I will be rechecking her next week.

Would a joint tap show inflamation if she has a partial cruciate? Would it be risky (we plan on being very sterile). Any other diagnostic ideas?