Case 1 - Tofu - referred for cranial cruciate ligament rupture.
Hx: LPL lameness
PE: Painful in both stifles on examination, no lameness or pain in forelimbs, lame in left pelvic limb only. No palpable instability of cruciate.
Top ddx - bilateral partial cranial cruciate ligament tears.
Radiographs: Bilateral stifle effusion
Joint taps (4 joints): MULTIFOCAL SEVERE NEUTROPHILIC INFLAMMATION.
Diagnosis: IMPA and doing well on immunosuppression.
Case 2 - Remington - referred for 'not doing well post left TPLO (12 months prior)'
Hx: R pelvic limb lameness progressively getting worse over last 3 months. Now dog not wanting to get up.
PE: Painful in both stifles on examination, no lameness of pain in forelimbs, painful in left (TPLO) stifle and slight discomfort in right stifle. Palpable instability R stifle. Forelimbs nad on exam.
Top ddx - Infection left pelvic limb post TPLO, right cruciate ligament rupture.
Joint taps (4 joints): MODERATE TO MARKED MONONUCLEAR AND NEUTROPHILIC INFLAMMATION
Diagnosis: IMPA and doing well on immunosuppression.
Case 3 - second opinion for 'cruciate ligament rupture' diagnosis.
Hx: Diagnosed with cruciate rupture and owner opted for conservative management due to co-morbidities (diabetic, adrenal tumour)
PE: Significant pain and muscle wastage right stifle.
Top ddx - I want to say cruciate rupture, as it fits with my story. But I was worried given worsening lameness and pain over time and the degree of muscle wastage.
Radiographs: Distal femoral lysis
Diagnosis - Pending, likely neoplastic/possible infection. Not cruciate.
For stifle lameness, the most common diagnosis is cruciate ligament disease. But don't forget your basic diagnostics - radiographs and joint taps. Joint taps are easy and I have made videos in my blog post here;
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