COMPUTED TOMOGRAPHY OF CRANIOMANDIBULAR OSTEOPATHY IN A DOG

Bilateral angular carpal deformity in a dog with craniomandibular osteopathy

A four-month-old West Highland White Terrier was presented to the Small Animal Teaching Hospital at the University of Liverpool with the complaint of a bilateral angular carpal deformity. A 20° valgus deformity was present in both thoracic limbs, centred on the distal radial physes. Both distal ulnas were grossly thickened and there was concomitant thickening of the rostral mandible and calvarium. The dog exhibited signs of resentment on palpation of the mandible and signs of pain were elicited on flexion and extension of both elbow joints. No signs of pain were evident on palpation of the ulnas or calvarium. Radiographic images of both ulnas showed marked amorphous periosteal new bone formation. The distal ulnar physes were closed centrally and both elbow joints had humeroulnar subluxation. Radiographic changes to the calvarium and mandibular rami were consistent with a diagnosis of craniomandibular osteopathy. A bilateral ulna ostectomy was performed to correct the angular limb deformity and elbow subluxations. Histology of the ostectomised pieces showed changes consistent with craniomandibular osteopathy.

Idiopathic canine juvenile cranial hyperostosis in a Pit Bull Terrier

CASE HISTORY

An 8-month-old male Pit Bull Terrier was presented with bilateral firm swellings of the cranium in the region of the frontal sinuses. The dog was aggressive when approached and had also been anorexic during the 3.5 days prior to presentation.

CLINICAL FINDINGS

Using computed tomography (CT) and radiology, periosteal new bone formation and hyperostosis were detected on the frontal, parietal and mandibular bones bilaterally. Histopathology of the calvarial and mandibular bones was similar, comprised of thick trabeculae of immature woven and mature lamellar bone separated by cementing lines. Sites of prominent osteoblastic and osteoclastic activity were also present.

DIAGNOSIS

Craniomandibular osteopathy with clinical similarities to calvarial hyperostosis.

CLINICAL RELEVANCE

Pit Bull Terriers are not predisposed to either craniomandibular osteopathy or calvarial hyperostosis. This observation, in addition to the clinical and pathological similarities between the two diseases, suggests that craniomandibular osteopathy and calvarial hyperostosis may represent a single disorder, with predilection sites that vary between breeds of dog. We propose a new term, idiopathic canine juvenile cranial hyperostosis, for this disorder, to include both craniomandibular osteopathy and calvarial hyperostosis.

Craniomandibular osteopathy with a unique neurological manifestation in a young Akita

This report describes a 4 mo old intact male Akita that presented for evaluation of a life-long history of facial swelling and failure to thrive. Physical examination revealed an enlarged cranium with prominent bony swellings on the maxillary bone, excessive laxity and crepitus involving multiple joints, and proprioceptive deficits. Radiographs demonstrated multiple osseous abnormalities including endosteal thickening of the femurs and ilium. Necropsy revealed gross compression of the cerebellum and brainstem. Physical exam findings, radiographic abnormalities, and histopathology of multiple bony lesions were all consistent with craniomandibular osteopathy. In this unique case of craniomandibular osteopathy, the dog was affected with severe bony proliferations leading to generalized hyperostotic lesions and brainstem compression resulting in neurologic deficits.

Computed tomography in small animals – Basic principles and state of the art applications

Since its clinical introduction, computed tomography (CT) has revolutionized veterinary medicine and is considered to be one of the most valuable tools for the imaging work-up of neurological, oncological and orthopaedic canine and feline patients. In small animals with acute trauma, particularly those involving complex anatomic areas such as the head, spine or pelvis, CT has been established as a standard imaging method. With the increasing availability of radiation therapy in veterinary medicine, CT has also become the principal tool to stage a tumour, assess response, and guide radiation therapy. The increasing availability of helical CT in veterinary medicine has allowed novel techniques such as spiral CT angiography and high-resolution CT. This review provides a brief overview of the historical and technical development of CT and literature reviews of the major clinical CT applications in small animals such as intracranial and extracranial lesions, the spine, the appendicular skeleton, and abdominal and thoracic diseases.

Calvarial hyperostosis syndrome in two bullmastiffs

Two bullmastiffs with calvarial hyperostosis syndrome are described and are the first documented examples in females. The clinical and radiologic features were similar to those previously reported in males. Magnetic resonance (MR) imaging findings have not previously been reported. One dog underwent MR imaging and abnormalities included thickening of the frontal bones with loss of normal fat signal and changes in the overlying soft tissues. In one of the dogs, long bone changes were seen in the femora and resembled those seen with craniomandibular osteopathy.

The head: excluding the brain and orbit

Applications for computed tomography (CT) and magnetic resonance imaging (MRI) scans of the head (excluding the brain and orbit) include the evaluation of neoplastic, inflammatory, and traumatic disorders of the skull (including the cranium, maxilla, mandible, and temporomandibular joints); of the nasal and oral cavities; of the nasopharynx and paranasal sinuses; and of the tympanic bullae. CT and MRI provide information not obtained with routine radiography and should be considered whenever advanced surgical or radiation therapy is anticipated. In this article, the role of CT and MRI in the diagnosis of head disorders will be reviewed and illustrated with case examples.

Craniomandibular osteopathy in two Pyrenean mountain dogs

Craniomandibular osteopathy was diagnosed in two Pyrenean mountain dogs with a history of mandibular swelling, pain, fever and, in dog 1, lameness. Radiographs demonstrated extensive, active new bone formation on the ventral aspect of the mandibular bodies of both dogs. Dog 2 responded well to treatment but dog 1 was euthanased owing to severe pain, dysphagia and unsuccessful treatment. The mandibles were examined by means of back-scattered scanning electron microscopy and a well arranged mineralised trabecular network of chondroid tissue and woven bone was observed. The mandibular cortical bone under the areas of periosteal proliferation was also affected, showing a looseness of the characteristic compact appearance of lamellar bone. This is the first report of craniomandibular osteopathy in this breed.