Australian Veterinary Practitioner | Volume 50 (2) June 2020 - Flipbook - Page 47
Figure 1: Orthogonal radiographs. Mediolateral and craniocaudal views of the left stifle.
A and B: At initial examination. Note evidence of osteolytic bone lesions with a moth-eaten pattern in the proximal tibial metaphysis (arrows)
associated with the presence of a poorly defined transition zone. There is a wide sclerotic reaction in the proximal area of the tibial metaphysis
(asterisk). Mild signs of a periosteal reaction in the medial tibial cortex (B) and possibly compatible with the previous presence of the TPLO plate.
C and D: Three weeks later. A periosteal neoformation was found at the level of the cranial tibial crest (dotted arrows) along with areas with cortical
lysis (star) and increased epiperiosteal soft tissue swelling (dotted line). Signs of degenerative joint disease are diffusely observable (circle).
therapy. An ultrasonographically-guided fine
needle aspiration of the epiperiosteal and
bone tissue, and of the inguinal, internal iliac
and popliteal lymph nodes were performed.
Subsequently, a whole body computed
tomography (CT) examination with pre- and
post-contrast scans was done as part of
complete staging tests. An open incisional
biopsy of the lesion on the proximal left tibia
and removal of the popliteal lymph node were
The CT scans confirmed the presence of
the proximal left tibial osteolytic lesions
associated with medullar sclerosis and
swelling and irregularity of peripheral
Figure 2: Computed tomography; post-contrast 3D-rendered view of the pelvis and hind limbs.
A muscular filter was used to identify the muscular planes affected by the soft tissue swelling of the left hind limb. A medial and lateral soft
tissue enlargement is evident (A). Lateral and medial view of the left hind limb (B). The left femoral artery with distal ramifications are visible
(B). On the caudal view (C), a vessel filter was selected to evaluate the neovascularization of the suspected mass. Substantial differences
relative to distal ramifications of the popliteal artery and collateral vessels neoformation were found between the pathological (left) and
normal hind limb (right).