3 year old MN Shih Tzu with hind limb lameness

Discussion

Ultrasound-guided fine-needle aspirates of the bone and sublumbar lymph node were taken, and showed inflammatory change. A coccidiomycosis titer was high at 1:32, indicating a severe infection.
The mixed but aggressive bone lesion has two main differentials; neoplasia and osteomyelitis. The signalment of the animal, and the infectious agents common to the area can help to priortitize the causes.