January 2014 Large animal case

Bovine.

Fresian.

5 Months of age.

Female.

Presented for a lameness of the hind left limb of 2 weeks duration and swelling in the area of the hip joint.

Radiographs of the hip joint were taken.

Faux-profile (mediolateral oblique view) of the right (on the top image) and on the left (on the bottom image) hip joints.

Radiographic findings and diagnosis

  • The right hip joint is normal, the normal appearance of the fovea capitis is a smooth, well defined identation of the femoral head.
  • Compared to the right, the left fovea capitis has a very irregular border, is ill defined ending in a bone defect with flattening of the caudal part of the femoral head (arrows). This region is surrounded by an irregular rim of increased radio opacity (arrowhead).
  • The opposing border of the acetabulum is as well more irregulary defined than the contralateral (open arrow).
  • The radiographic diagnosis is septic arthritis of the left hip joint with aggressive (lytic) bone lesions.

Radiographic examination

Close up of the Faux profile of the left hip joint.

Comments

  • The cell count of the left hip joint was more than 140000cells/μl.
  • The joint was regularly flushed and treated with intraarticular injection of antibiotics over a period of almost three week.
  • With a guarded prognosis the patient was discharged on the owner‘s wish.
  • In calves, primary septic arthritis is quite rare and develops from direct joint penetration by a contaminated foreign body
  • Scondary septic arthritis results from spread of pathogens form an adjacent localised focus.
  • Tertiary septic arthritis results from systemic or haematogenous spreas from a focus elsewhere in the animal.
  • Joint disease in calves are usually tertiary septic arthritis with primary infection most likely affecting the umbilicus (abscess with extension along the umbilical veins).
  • Otherwisradiographic e spread can be from a primary enteric infection.
  • The findings initially can be subtle and of difficult interpretation as limited to focal soft tissue swelling.
  • After 2 to 3 weeks, changes suggestive of joint distruction start to be apparent.