Canis ISSN: 2398-2942

Sesamoid: disease

Synonym(s): Sesamoiditis, Sesamoid degeneration

Contributor(s): Michael Guilliard

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

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