Infraspinatus contracture is a uni- or bilateral fibrotic myopathy of the infraspinatus muscle that is usually secondary to trauma in hunting or working dogs. Initial clinical signs include an acute lameness, pain, and swelling in the shoulder region. The lameness subsides, but a gait abnormality develops 2–4 weeks after injury as muscle fibrosis and contracture progress. Clinical signs include a characteristic adduction of the elbow, abduction of the foreleg, and external rotation of the carpus and paw. The limb is circumducted with each stride of the leg. Palpation of the shoulders reveals outward rotation of the humerus as the elbow is flexed. Treatment consists of resection of the fibrous musculotendinous portion of the muscle, including tenotomy of the tendon of insertion. Limb and joint functions are immediately improved, and prognosis for full recovery is excellent.
Tenosynovitis of the Biceps Brachii Tendon
This inflammation of the biceps brachii tendon of origin and associated synovial sheath can be uni- or bilateral. It usually affects mature, large dogs. The mechanism of injury can be direct, indirect, overuse, or migration of osteochondral fragments (“joint mice”) from humeral osteochondrosis lesions.
Clinical signs include a progressive or chronic, intermittent lameness that worsens after exercise and improves with rest. The range of motion of the shoulder joint is reduced, and atrophy of the shoulder muscles may be apparent. Acute pain can be elicited by applying digital pressure to the biceps tendon during flexion and extension of the shoulder joint.
Diagnosis can be confirmed by ultrasonography Ultrasonography in Animals Ultrasonography is the second most commonly used imaging format in veterinary practice. It uses ultrasonic sound waves in the frequency range of 1.5–15 megahertz (MHz) to create images of body... read more or arthroscopy of the damaged tendon. Radiography Radiography of Animals Radiography (generation of transmission planar images) is one of the most commonly used diagnostic tools in veterinary practice even though other imaging modalities such as ultrasonography,... read more can reveal dystrophic calcification of the tendon, osteophytes in the intertubercular groove, or mineralized fragments within the tendon sheath. Contrast arthrography may demonstrate filling defects and irregularities of the synovial sheath. Arthrocentesis may be inconclusive. Diagnosis can also be made by exploration of the tendon and associated sheath.
Acute, mild cases can be treated with rest and oral NSAIDs Nonsteroidal Anti-inflammatory Drugs in Animals The importance of pain management and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in animals has increased dramatically in recent decades, and use of NSAIDs in companion animals... read more and opioids. Acute, severe cases can be treated with intralesional injections of methylprednisolone acetate (20–40 mg) and rest. Chronic cases refractory to multiple corticosteroid Corticosteroids in Animals Two classes of steroid hormones, mineralocorticoids and glucocorticoids, are naturally synthesized in the adrenal cortex from cholesterol. (Also see The Adrenal Glands.) Mineralocorticoids ... read more injections or cases involving identifiable tendon defects or tears, or “joint mice,” are treated by tenodesis (resection and attachment of the tendon to the proximal humerus) and osteochondral fragment removal. Arthroscopic-guided tendon resection has also been described. Prognosis for recovery is good.
Quadriceps Contracture (Quadriceps Tie-down, Stiff Stifle Disease)
This serious fibrosis and contracture of the quadriceps muscles develops secondary to distal femoral fractures, inadequate surgical repair, and excessive dissection in young dogs. Adhesions develop between the bone, periosteal tissue, and quadriceps muscles, which lead to limb extension, disuse, osteoporosis, degenerative joint disease Degenerative Arthritis in Dogs and Cats Degenerative joint disease, ventrodorsal projection, characterized by irregular bone margins in the joint. Degenerative joint disease, lateral projection, characterized by irregular bone margins... read more , and bone and joint deformations. Clinical signs include hyperextension and cranial displacement of the affected limb. Surgery is usually required to resect fibrous tissues and increase motion of the stifle joint. Bone and soft-tissue reconstructions along with postoperative flexion bandages and physical therapy are required to recover limb function. Prognosis is guarded. Prevention of the condition by accurate, biologic stable repairs of bone fractures is preferred.
Achilles Tendon Disruption (Dropped Hock)
This acute, traumatic injury to the common calcaneal tendon (gastrocnemius, superficial digital flexor, biceps femoris, semitendinosus, and gracilis muscle tendons) is seen primarily in mature working and athletic dogs. The common tendon can be ruptured or avulsed from the tuber calcanei of the talus. Ruptures may be partial or complete, and the gastrocnemius tendon component is most frequently affected.
Clinical signs include a severe nonweight-bearing lameness, tarsal hyperflexion, and a plantigrade stance. Palpation reveals swelling, pain, and torn or fibrotic tendon ends. Radiography Radiography of Animals Radiography (generation of transmission planar images) is one of the most commonly used diagnostic tools in veterinary practice even though other imaging modalities such as ultrasonography,... read more may reveal avulsed bone fragments.
Treatment is by surgical repair of torn ends and reattachment of tendinous tissue to the tuber calcanei. External splints or fixators should be used to protect the repair for 4 weeks. Prognosis is variable and based on chronicity of the injury, success of the surgery, and expected performance of the dog.
Iliopsoas Muscle Trauma
Trauma to the iliopsoas muscle or tendon of insertion can cause an acute or chronic lameness in active dogs. Physical examination reveals focal pain at the proximal medial aspect of the thigh (attachment of tendon to the lesser trochanter), especially during simultaneous hip joint extension and internal rotation. Ultrasonography Ultrasonography in Animals Ultrasonography is the second most commonly used imaging format in veterinary practice. It uses ultrasonic sound waves in the frequency range of 1.5–15 megahertz (MHz) to create images of body... read more reveals disruption of muscle fibers, and radiography may reveal dystrophic calcifications at the region of tendon insertion. Treatment with rest and NSAIDs Nonsteroidal Anti-inflammatory Drugs in Animals The importance of pain management and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in animals has increased dramatically in recent decades, and use of NSAIDs in companion animals... read more is helpful.
For More Information
Also see pet health content regarding exertional myopathy in dogs Exertional Myopathy (Rhabdomyolysis) Myopathies are diseases that primarily cause damage to muscles or muscle tissues. They may be present at birth or occur due to nutritional imbalances, injury, metabolic disturbances, cancer... read more .