What is the name of flexor enthesopathy in cats?

Vet Surgery 2015

Ronny Streubel, Thomas Bilzer, Paula Grest, Daniel Damur, Pierre M. Montavon

Background
Medial humeral epicondylitis (MHE) in cats is an underrecognized condition characterized by inflammation and degeneration at the origin of the flexor carpi ulnaris muscle (FCUM) on the medial epicondyle of the humerus. It is associated with pain, lameness, and possible ulnar nerve involvement. This study aimed to describe clinical and histological findings in affected cats and to evaluate long-term outcomes of conservative versus surgical treatment.

Methods
A prospective cohort study enrolled 17 client-owned cats diagnosed with MHE based on clinical signs, radiographic imaging, and computed tomography (CT). Cats received initial conservative treatment (indoor confinement, glucosamine/chondroitin, meloxicam) for four weeks. Depending on owner preference, further management included surgery or continued conservative care. Outcomes were assessed at 6, 12 weeks, and a final follow-up (6–49 months). Surgical intervention included excision of affected tissues and treatment of ulnar nerve adhesions.

Results
Subjects: Cats had a mean age of 10.3 years. Most had chronic, unilateral lameness, although bilateral MHE was detected on CT in 65% of cases.

Imaging: Common findings included new bone formation, bony spicules, and intra-articular free joint bodies (53%). Early stages of MHE without mineralization were better detected with CT than radiographs.

Histology: Mineralized tissue showed osseous metaplasia, and neurogenic myopathy of the FCUM was present in 4/9 surgically treated cats. Ulnar nerve compression with fibrosis was also noted.

Outcomes:
-Surgical treatment resolved lameness in 7/9 cats, with improvements observed as early as 6 weeks postoperatively.
-Conservative management led to persistent lameness in 7/8 cats, with only one achieving full resolution by 48 months.

Complications: Two surgically treated cats had residual lameness attributed to additional joint or nerve issues.

Limitations
Selection bias may exist as more severe cases were referred for surgery. Long-term outcomes for conservative treatment in less affected cats remain unclear. The lack of blinded assessment may have influenced outcome evaluation.

Conclusions
MHE in cats is associated with chronic lameness, pain, and ulnar nerve dysfunction. Surgical treatment is more effective than conservative management, providing long-term resolution of lameness in most cases. Early diagnosis via CT and timely surgical intervention are recommended for optimal outcomes. Further studies are needed to refine diagnostic tools and surgical techniques.

Radiographs of the right elbow of cat 14. (A) An irregular and rounded edge of the medial epicondyle (white arrow heads) in extended mediolateral projection. (B) Flexed mediolateral projection. (C) Compact, irregular new bone formation (white arrow heads) on the medial epicondyle appears close to the humeral condyle in the straight craniocaudal projection. (D) Oblique, supinated projection.

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