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What does a subungual keratoacanthoma look like on radiographs (same same but different)

VRU 63(5): 513-517

Study: This is a multicenter, retrospective, observational, descriptive study on the radiographic characteristics of canine subungual keratoacanthoma (SKA).

Method: The medical records of one veterinary university referral hospital in the United States and eight primary and referral veterinary hospitals in Japan were retrospectively searched over a five-year period from 2015 to 2020 for dogs with a histologic diagnosis of subungual keratoacanthoma. The radiographs of the manus or pes were reviewed by two veterinary radiologists and one veterinarian.

Results: A total of 12 dogs and 12 digits met the inclusion criteria. The radiographic features of canine SKA identified in the present study included severe pressure resorption of the P3 ungual process, expansile pressure resorption of the P3 ungual crest, and enlargement and deformation of the nail with or without cracking.

Conclusions: Canine SKA should be suspected with these radiographic features, and digital amputation and confirmatory diagnosis with histopathology are recommended.

Dorsoplantar (A) and mediolateral (B) radiographs of a dog with keratoacanthoma of the fourth digit (Technique: kVp, 48; mAs, 5.0). Osteolysis is present in both P2 and P3 with well-defined and smooth margins (asterisk). Osteolysis involves 50% of P2, > 90% of the P3 ungual process, and > 90% of the P3 ungual crest (white arrowheads). The nail is enlarged and straightened with cracking (white arrows)

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