Equis ISSN 2398-2977

Elbow joint: disease - overview

Synonym(s): Antebrachiohumeral joint disease, cubital joint disease

Contributor(s): Stephen Adams, Graham Munroe

Introduction

  • The elbow is an uncommon site for forelimb lameness.
  • Cause: direct trauma is the most common cause. 
  • Signs: usually sudden onset, moderate to severe, forelimb lameness. 
  • Diagnosis: clinical examination and range of ancillary aids including joint anesthesia   Forelimb: joint anesthesia  and radiography   Forelimb: radiography  . 
  • Treatment: depends on cause. 
  • Prognosis: depends on cause.

Pathogenesis

Etiology

Trauma

  • Most common cause of acquired elbow conditions. 
  • Fractures: of the olecranon of the ulna are one of the most commonly seen long bone fractures   Ulna: fracture  ; also seen proximal radius   Radius: fracture  . Articular fractures may be comminuted, open, closed, distracted, non-distracted.
  • Luxation/subluxation of the elbow joint is uncommon: usually seen with fractures of the olecranon or proximal radius, or separation of the radius and ulna.
  • Tearing of collateral ligaments: uncommon; lateral more commonly involved.
  • Tearing of the attachments of the biceps brachii muscle from the cranioproximal aspect of the radius. 
  • Traumatic synovitis and capsulitis occur following single or repeated episodes of trauma to the elbow joint. It may progress to degenerative joint disease   Musculoskeletal: osteoarthritis (joint disease)  . 
  • Subchondral bone stress of the distal humerus in young jumping animals.
  • Olecranon bursitis (capped elbow, shoe boil)   Elbow: hygroma  .
  • Hematoma   Hematoma  .
  • Pressure sores   Elbow: wound - pressure sore  .

Infectious

Multifactorial

Immune-mediated

Miscellaneous

  • Tumors are extremely rare.
  • Osseous cyst-like lesions of the elbow joint are uncommon   Elbow: osseous cyst-like lesion - CaCr radiograph  , typically communicate with the joint, and occur most commonly in the medial proximal radial epiphysis or the distal medial condyle of the humerus   Bone: osseous cyst-like lesions  .

Predisposing factors

General

Pathophysiology

  • The elbow joint is the articulation between the humerus, radius and ulna, stabilized by medial and lateral collateral ligaments.
  • The joint capsule forms a pouch in the olecranon fossa where it is extremely thin.
  • Oblique fibers strengthen the joint capsule cranially.
  • The joint capsule blends with the collateral ligaments medially and laterally.
  • There is minimal soft tissue cover over the lateral aspect of the elbow joint making it vulnerable to trauma and penetration.
  • See Joint: synovial pathobiology   Joint: synovial pathobiology  .

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.
  • Livesey L, Schumacher J, Sartin E, Caldwell M, Ziska S & Brock K (2009) Ruptured capsule of the elbow joint of a draught horse. Equine Vet J 41 (6), 371-374 VetMedResource.

Other sources of information

  • Dyson S J (2003) The Elbow, Brachium, and Shoulder. In: Diagnosis & Management of Lameness in the Horse. Eds: Ross M W & Dyson S J. Saunders, USA. pp 399-405.
  • Stashak T S (2002) The Elbow. In: Adams Lameness in Horses. 5th edn. Lippincott, Williams & Wilkins, Baltimore. pp 879-894.


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