Even radiologists agree “Interpreting young dog elbow radiographs can be frustrating!” We often receive referral elbow radiographs from frustrated veterinarians looking for hidden lesions in the elbows of young dogs. Most of the time these radiographs are normal but the veterinarian has (correctly) localized the lameness to the elbow and correctly suspects elbow dysplasia. This is an all too common scenario.

While, some cases of elbow dysplasia may have radiographic changes it is often the case that elbow radiography in young dogs is unrewarding. It cannot be overstated that normal radiographs certainly do not rule out the presence of elbow dysplasia in young dogs.

As stated in one text, “in most cases the radiographic diagnosis of fragmented medial coronoid process is made indirectly through the recognition of secondary degenerative changes that accompany the primary lesion.” Waiting until degenerative change is present can result in a less than rewarding outcome.

In many referral hospitals, elbow radiography in young dogs has gone out of favor. Some recommend arthroscopic evaluation of the elbows if radiographs are normal. However, scoping is an invasive diagnostic procedure and exploring both elbows is a tough (and expensive) diagnostic for many owners to swallow. Therefore, many specialists now opt for non-invasive CT of the elbow. In the past, CT of the elbow was a diagnostic test that was unavailable to the general practitioner and cost prohibitive. Fortunately, the situation has changed. Outpatient imaging centers are becoming more common in veterinary medicine and many referral hospitals offer CT screening of the elbow.

So, the next time you have a young dog with lameness localized to the elbow you should consider skipping the elbow radiographs and going straight to CT.