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- Stenosing tenosyno-what-is?
Katharina M. Hittmair, Veronika Groessl, Elisabeth Mayrhofer
Background
Stenosing tenosynovitis of the abductor pollicis longus (APL) muscle in dogs, akin to de Quervain’s tenosynovitis in humans, causes chronic forelimb lameness. This condition is characterized by tendon sheath thickening, fluid accumulation, and mineralization due to repetitive carpal motion or overuse. The study aimed to evaluate the utility of radiography and ultrasonography in diagnosing APL tenosynovitis.
Methods
Thirty dogs with chronic forelimb lameness, painful carpal flexion, and swelling medial to the carpus were evaluated. Radiographic assessments included identifying a deep distal radial sulcus, osteophytes, and soft tissue swelling. Ultrasonographic examinations characterized tendon and sheath lesions, including thickness, echogenicity, fluid accumulation, and mineralization. Measurements of tendon and sheath thickness were graded on established scales.
Results
Radiographic Findings:
-All 37 affected carpi showed medial soft tissue swelling.
-A deep distal radial groove (95%) and osteophytes (84%) were common.
-Enthesopathies at the tendon insertion were observed in 16% of cases.
Ultrasonographic Findings:
-Tendon thickening was present in 59% of cases, with irregular hypoechoic patterns in severe cases.
-All tendon sheaths were thickened; 68% exhibited mineralization.
-Fluid-filled tendon sheaths were observed in 51%.
-Tendon and sheath thickening were graded, showing variable severity.
-Bilateral involvement was noted in 23% of dogs.
Limitations
Breed and functional biases may influence the results, as the study included working, agility, and companion dogs.
Long-term outcomes for surgically and medically treated dogs were not uniformly available, with many lost to follow-up.
The correlation between ultrasonographic findings and clinical severity of lameness was not established.
Conclusions
Radiography is effective for identifying bony changes and tendon sheath mineralization, while ultrasonography excels in differentiating tendon and sheath lesions and assessing fluid accumulation. The findings provide a basis for diagnosing and grading APL tenosynovitis, which is essential for guiding treatment, including corticosteroid injections, immobilization, and surgical intervention when necessary.
Fig. 2. Comparative radiographs of the carpus, 8-year-old male GoldenRetriever, agility training. (A) Right carpus, dorsopalmar view. The distalradial groove is radiolucent with radiopaque contours (arrows). Soft tissueswelling is present medial to the carpus. The sesamoid bone at the abductorpollicis longus insertion is visible (arrowhead). (B) Left carpus, dorsopalmarview. Normal distal radius and carpus.
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