A 10 month old female spayed Labrador retriever presented to Cornell’s Orthopedic Surgery Service for evaluation of thoracic limb lameness of 2-3 month duration. Since December 2017, the patient had been medically managed for lameness on firocoxib, as prescribed by her primary care veterinarian. Medical management had yielded mild improvement of clinical signs, but the patient was still lame.

On initial physical examination, the patient was bright, alert, and responsive. She exhibited pain on elbow extension (worse on the right limb) and was sensitive to palpation of the elbow joint bilaterally. She had mild elbow effusion that was easily palpable in the medial compartments in both limbs. When lying down, she internally rotated her forelimbs, making her elbows externally rotated. The patient’s problem list consisted of bilateral thoracic limb lameness, characterized by joint effusion, decreased range of motion, and sensitivity to elbow palpation/manipulation.

Computed tomography was used to image both thoracic limbs, revealing bilateral fragmented medial coronoid processes. Fragment removal using bilateral arthroscopy was elected as the treatment of choice. Apart from the fragments, the remainder of the joint appeared normal on arthroscopy. There was no evidence of osteoarthritis and the radioulnar, humeroulnar, and humeroradial joints articulated well. The cartilage adjacent to the fragments was found to be smooth and undamaged. This report will describe elbow dysplasia and disease pathogenesis of fragmented medial coronoid processes, as well as different imaging and treatment options.