405-706-0404 [email protected]
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405-706-0404 [email protected] www.ovdionline.com Patient Name: “XXXXX” Client Name: XXXXX Patient ID: XXXXX Referring Hospital: XXXXX Requesting Doctor: XXXXX Report Date: XXXXX RADIOLOGY REPORT CLINICAL HISTORY: 8 year old, female, Belgian Tervuren- Limping and licking on right carpus area for the last month BILATERAL DISTAL ANTEBRACHIA/CARPI/FRONT FEET: Lateral and dorsopalmar views are provided for interpretation (2 total views). FINDINGS: There is moth-eaten to permeative osteolysis involving the distal right radial diaphysis to epiphysis. There is circumferential irregular periosteal new bone production at the same location more pronounced medially. There is thinning and discontinuity of the distocaudal metaphyseal cortex. There is evidence of pathologic fracture with a 1cm in length thin cortical fracture fragment involving the distocaudal metaphyseal cortex, which is slightly caudally displaced. There is mild soft tissue swelling also seen involving the distal right antebrachium. There are no abnormalities involving the right carpus or metacarpus. There are a few very small smoothly marginated osseous bodies seen medial to the metacarpophalangeal joint of the right second digit, which is likely due to incidental mineralization of the medial collateral ligament. There is also a small smoothly marginated round osseous body seen medial to the middle phalanx of the right 5 th digit. The left distal antebrachium, carpus, metacarpus, and digits are normal with no evidence of soft tissue swelling or osseous abnormality found. CONCLUSIONS: 1. Aggressive mixed osteolytic and osteoproliferative lesion involving the right distal radius with evidence of pathologic fracture formation. This lesion has a primary differential of primary osseous neoplasia (such as osteosarcoma). Metastasis or mycotic osteomyelitis would be considered less likely. 2. Trivial incidental medial collateral ligamentous enthesopathy involving the metacarpophalangeal joint of the right 2 nd digit. 3. Small osseous body seen medial to the middle phalanx of the right 5 th digit could be superimposed debris artifact, dystrophic mineralization of soft tissues, or a small chronic chip or avulsion fracture of unknown origin. It is of unlikely clinical significance. 4. Unremarkable left distal antebrachium, carpus, and front foot. RECOMMENDATIONS: Fine needle aspirates or bone biopsies of the distal right radius would be recommended to obtain samples for cytology/histopathology. There is always the chance of worsening pathologic fracture with bone biopsies. Often a diagnosis can be obtained with less invasive fine needle aspirates with bone biopsies to follow if fine needle aspirates are unrewarding diagnostically. Three view thoracic radiographs should also be obtained to evaluate for pulmonary metastases. Consultation with an oncologist would also be beneficial especially to discuss right thoracic limb amputation and follow up chemotherapy versus palliative treatment options. Jennifer L. Johnson-Neitman, DVM, DACVR If you have any questions, please do not hesitate to contact me directly at [email protected] or 1- 405-706-0404. This contact information is for veterinarian use only please. Thank you.
Transcript of 405-706-0404 [email protected]
405-706-0404 [email protected]
www.ovdionline.com
Patient Name: “XXXXX” Client Name: XXXXX Patient ID: XXXXX Referring Hospital: XXXXX Requesting Doctor: XXXXX Report Date: XXXXX
RADIOLOGY REPORT CLINICAL HISTORY: 8 year old, female, Belgian Tervuren- Limping and licking on right carpus area for the last month BILATERAL DISTAL ANTEBRACHIA/CARPI/FRONT FEET: Lateral and dorsopalmar views are provided for interpretation (2 total views). FINDINGS: There is moth-eaten to permeative osteolysis involving the distal right radial diaphysis to epiphysis. There is circumferential irregular periosteal new bone production at the same location more pronounced medially. There is thinning and discontinuity of the distocaudal metaphyseal cortex. There is evidence of pathologic fracture with a 1cm in length thin cortical fracture fragment involving the distocaudal metaphyseal cortex, which is slightly caudally displaced. There is mild soft tissue swelling also seen involving the distal right antebrachium. There are no abnormalities involving the right carpus or metacarpus. There are a few very small smoothly marginated osseous bodies seen medial to the metacarpophalangeal joint of the right second digit, which is likely due to incidental mineralization of the medial collateral ligament. There is also a small smoothly marginated round osseous body seen medial to the middle phalanx of the right 5th digit. The left distal antebrachium, carpus, metacarpus, and digits are normal with no evidence of soft tissue swelling or osseous abnormality found. CONCLUSIONS:
1. Aggressive mixed osteolytic and osteoproliferative lesion involving the right distal radius with evidence of pathologic fracture formation. This lesion has a primary differential of primary osseous neoplasia (such as osteosarcoma). Metastasis or mycotic osteomyelitis would be considered less likely.
2. Trivial incidental medial collateral ligamentous enthesopathy involving the metacarpophalangeal joint of the right 2nd digit.
3. Small osseous body seen medial to the middle phalanx of the right 5th digit could be superimposed debris artifact, dystrophic mineralization of soft tissues, or a small chronic chip or avulsion fracture of unknown origin. It is of unlikely clinical significance.
4. Unremarkable left distal antebrachium, carpus, and front foot. RECOMMENDATIONS: Fine needle aspirates or bone biopsies of the distal right radius would be recommended to obtain samples for cytology/histopathology. There is always the chance of worsening pathologic fracture with bone biopsies. Often a diagnosis can be obtained with less invasive fine needle aspirates with bone biopsies to follow if fine needle aspirates are unrewarding diagnostically. Three view thoracic radiographs should also be obtained to evaluate for pulmonary metastases. Consultation with an oncologist would also be beneficial especially to discuss right thoracic limb amputation and follow up chemotherapy versus palliative treatment options. Jennifer L. Johnson-Neitman, DVM, DACVR If you have any questions, please do not hesitate to contact me directly at [email protected] or 1-405-706-0404. This contact information is for veterinarian use only please. Thank you.
