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Sesamoid: disease

icanis
Contributor(s):

Michael Guilliard

Synonym(s): Sesamoiditis, Sesamoid degeneration


Introduction

  • Cause: chronic inflammation of the sesamoid bones.
  • Cause of lameness and incidental finding in the racing greyhound.
  • Lameness in large pet breeds, eg Rottweiler.
  • Signs: often an insidious onset, progressive forelimb lameness in young dogs, or can also be acute onset lameness in adults.
  • Diagnosis: clinical signs and radiography.
  • Treatment: conservative, or surgical removal of sesamoids.
  • Prognosis: guarded for resolution.

Pathogenesis

Etiology

  • Lytic lesions possible manifestation of osteochondrosis Osteochondrosis.
  • Inflammatory changes seen with enthesiophyte formation, possible traumatic etiology.
  • Degenerative secondary changes may be present in the metacarpo-phalangeal joint.

Pathophysiology

  • Fragmentation of the sesamoid bone may be result of abnormal endochondral ossification, ie a manifestation of osteochondrosis.
  • Multiple exostoses within the soft tissue attachments of the sesamoid may have a traumatic etiology.
  • There may be calcification around the sesamoid bones or osteophytosis around the metacarpo-phalangeal joint.
  • These changes may be secondary to joint trauma or instability.
  • Repeated stress on palmar surface of sesamoids by digital flexor tendons during hyperextension of metacarpo-phalangeal joints may → fatigue fractures and degeneration of the underlying bone and soft tissues.
  • Digits 2 and 5: flexor tendon pressure solely on inner sesamoids 2 and 7.
  • Digits 2 and 5: metacarpal bones are asymmetrical so axial condyle bears more load.
  • Histologically see bone fracture and necrosis supporting vascular compromise theory.

Timecourse

  • Slow, progressive lameness seen over weeks to months in the young dog.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Harasen G (2009) Sesamoid disease. Can Vet J 50 (10), 1095 PubMed.
  • Daniel A, Read R A & Cake M A (2008) Vascular foramina of the metacarpophalangeal sesamoid bones of Greyhounds and their relationship to sesamoid disease. Am J Vet Res 69 (6), 716-721 PubMed.
  • Matthews K G, Koblick P D, Whitehair J G & Bradley C (2001) Fragmented palmar metacarpo-phalangeal sesamoids in dogs: a long-term evaluation. Vet Comp Ortho Traumatol 14 (1), 7-14 UCDavis.
  • Vaughan L C & France C (1986) Abnormalities of the volar and plantar sesamoid bones in Rottweilers. JSAP 27 (9), 551-8 VetMedResource.
  • Bennett D & Kelly D F (1985) Sesamoid disease as a cause of lameness in young dogs. JSAP 26 (10), 567-79 VetMedResource.
  • Bateman J K (1959) Fractured sesamoids in the greyhound. Vet Rec 71, 101.

Other sources of information

  • Robins G M & Read R A (1998)diseases of the sesamoid bones.In:Canine Sports Medicine and Surgery.Bloomberg M S, Dee J F & Taylor R A (eds) W B Saunders Company, Philadelphia, pp 255-264.
  • Robins G M & Read R A (1993)diseases of the sesamoid bones.In:Disease mechanisms in small animal surgery.2nd edn. pp 1094.

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