QUARTERLY BEAT / JULY 2021 ///
WEBINAR HIGHLIGHTS
Making Sense of Common Muscle and Tendon Injuries in Dogs
MICHAEL H. JAFFE , DVM, MS, CCRP, DACVS Mississippi State University College of Veterinary Medicine
In this VETgirl webinar entitled “Diagnosis and treatment of canine muscle and tendon injuries,” Dr. Michael Jaffe, DVM, MS, CCRP, DACVS reviews some of the most common muscle and tendon injuries in dogs such as calcanean tendon rupture, biceps tenosynovitis, supraspinatus tendon injuries, infraspinatus contracture, and iliopsoas muscle injuries. As a VETgirl ELITE member, watch it again HERE to learn how to diagnose and treat these musculoskeletal conditions and general aftercare.
Radiographs may be useful when a muscle injury is suspected. Although there may be concurrent injuries to bones and joints, muscle and tendon injuries frequently show subtle or no radiographic changes. It is important to obtain radiographs, however, to aid in ruling out other causes of lameness. Ultrasound is an underutilized but very valuable tool when tendon injury is suspected. For those not familiar with the radiographic appearance of the tendon in question, use of the contralateral limb (if it is clinically normal) may be of value in comparing tendons and assessing for changes. Mineralization noted on radiographs can also be better delineated as to which tendon has these changes. Frequently supraspinatus tendinopathies are misinterpreted on radiographs as biceps tenosynovitis. Ultrasound will help determine which tendon is affected. I have frequently noted mineralization in one of these tendons with secondary inflammation of the other indicating 2 tendons showing injury. Computed Tomography (CT) and MRI are sometimes utilized when muscle and tendon injuries are suspected. Whereas CT is not the best diagnostic tool for soft tissue injuries, contrast CT studies and non-contrast studies will show changes in the muscles of suspect. Use of MRI is often not easily obtained due to cost and accessibility; however, MRI is extremely valuable in noting muscle and tendon changes. Bicipital tenosynovitis is an inflammatory condition of the tendon of origin of the biceps brachii muscle. Inflammation of the tendon is typically due to repeated stress or trauma to the tendon. Clinical signs may be either a gradual onset or a progressive lameness that worsens with activity. Diagnosis is aided by palpation of pain over the tendon of origin with
There are generally 4 broad categories of injuries that cause lameness in dogs. My approach to a limping patient is to try to rule out each category when developing a list of rule-outs for the cause of lameness. These categories include: • Orthopedic injuries (bone and joints) • Neurologic injuries (think root signatures and peripheral nerve injuries) • Immune-mediated and infectious causes (immune-mediated polyarthritis, etc.) • Muscle and Tendon injuries Orthopedic injuries are generally ruled in or out via radiography. Neurologic causes for lameness are frequently identified via a good neurologic exam. Immune and infectious causes are challenging and may require arthrocentesis and blood titers. Muscle and tendon injuries are frequently frustrating and difficult to diagnose. There are 5 broad mechanisms of injuries that may occur to muscle and tendons:
• Contusions • Lacerations • Ruptures • Strains • Contracture/Fibrosis
Physical exam findings will often guide the clinician to consider muscle or tendon injuries as the cause of lameness. Patients are often partial to non-weight bearing lame, there may be swelling of the muscle present, muscles and tendons will be painful on manipulation and palpation, there may be decreased or increased range of motion in the joint, and disuse atrophy may be noted.
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