This week’s case is a 3-year-old Shih Tzu with a 5-week history of increasing left hind limb lameness and lethargy.
FindingsThere is a mixed lytic and productive bone lesion on the wing of the left ilium, extending to the cranial acetabulum. The femoral head is not involved. The lesion is seen best on the v/d projection.
- osteomyelitis – bacterial, fungal
DiscussionUltrasound-guided fine-needle aspirates of the bone and sublumbar lymph node were taken, and showed inflammatory change. A coccidiomycosis titer was high at 1:32, indicating a severe infection.
The mixed but aggressive bone lesion has two main differentials; neoplasia and osteomyelitis. The signalment of the animal, and the infectious agents common to the area can help to priortitize the causes.