Now that the school year has started again, our group is meeting for KCC. It’s a chance for residents and faculty to test their interpretation skills on a variety of cases. One of the best things about it are the “pearls” of knowledge that people drop into the discussion. I’ll try to pass some of those on in relation to the cases we saw.
10 year old male neutered dog with lameness in the left hind limb
Radiographs of the left femur showed sclerosis of the distal metaphysis and epiphysis with subtle cortical lysis. This lesion was subtle so the opposite femur was asked for, and was normal. This is a good strategy to increase your confidence in your findings. Differentials from the residents were primary bone tumor and fungal osteomyelitis. A radiologist added metastatic disease to the list. One comment was that fungal disease is less likely in an animal of this age. Recommendations were thoracic radiographs and a biopsy. Diagnosis: metastatic disease.
6 year old female neutered Golden Retriever straining to defecate
There was an oval mid-abdominal mass of soft tissue opacity on the lateral and v/d projections. The margins were well defined and it was centrally located on the v/d. One astute resident asked for the lateral pelvis as the abdominal radiograph did not include it. The colon could be seen tapering to a point in the pelvic canal, with an ill-defined mass ventrally. Differentials included uterus, lymph node and pelvic mass of unknown origin. There were a broad range of differentials for the mid-abdominal mass. Diagnosis – granuloma of the cervix. The mid-abdominal mass was the bladder, extremely enlarged and cranially displaced, possibly from the pelvic mass.
2 month old pug with dyspnea
The cardiac silhouette was markedly enlarged and globoid. Little of the cranial abdomen was included, but the liver was possibly small. Differentials from the residents included congenital cardiac disease and PPDH (peritoneal-pericardial diaphragmatic hernia). Did anyone count the sternebral segments?? There were only 5. Malformation of the sternum is associated with PPDH, and made the diagnosis in this case. One radiologist commented that this is usually an incidental finding, but animals can present with dyspnea with sudden weight gain and increase in omental fat resident within the pericardium. Many sternebral anomalies were discussed in radiology reports this week!
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