Radioulnar Ischaemic Necrosis in a Dog with Concurrent Osteomyelitis and Bone Sequestration

Katherine D Watson,Amy S Kapatkin,Kathryn L Phillips,Theresa L Aller

doi:10.1055/s-0040-1702152

Abstract

AbstractAn 11-month-old intact female Golden Retriever presented for a 3- to 4-week history of right thoracic limb lameness. Computed tomography of the limb showed a sequestrum with a periosteal and endosteal reaction at the level of the nutrient foramen of the radius. Septic osteomyelitis was suspected based on cytology. Repeat examination and imaging revealed improvement in the lesion and resolution of the lameness. This lesion is similar to reports of radioulnar ischaemic necrosis, but is the first report with concurrent osteomyelitis and sequestration.

Highlights

Osteonecrosis in dogs has been reported to occur with Legg-Calves-Perthes, idiopathic osteonecrosis of the carpal bone and maxillofacial osteonecrosis.2–4. This is the first case report of concurrent haematogenous osteomyelitis and ischaemic necrosis occurring at the site of a lesion that is radiographically consistent with Radioulnar ischaemic necrosis (RUIN)
Formation of sequestra is most often associated with osteomyelitis following traumatic fractures and/or an orthopaedic surgical complication
Osteomyelitis was diagnosed based on the imaging features of an aggressive bone lesion and the presence of septic suppurative inflammation in the involucrum

Summary

Introduction

Radioulnar ischaemic necrosis (RUIN) is a term that has been used to describe osteonecrosis secondary to ischaemia of the radius and ulna in the dog.1 There is a small amount of data in the literature describing the radiographic appearance of a RUIN lesion.1 Osteonecrosis in dogs has been reported to occur with Legg-Calves-Perthes, idiopathic osteonecrosis of the carpal bone and maxillofacial osteonecrosis.2–4 This is the first case report of concurrent haematogenous osteomyelitis and ischaemic necrosis occurring at the site of a lesion that is radiographically consistent with RUIN.referring veterinarian suspected panosteitis due to the lack of overt radiographic findings in the right thoracic limb. Computed tomography of the limb showed a sequestrum with a periosteal and endosteal reaction at the level of the nutrient foramen of the radius.

Results

Conclusion