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Veterinary Radiology

Teaching and learning about veterinary diagnostic imaging.

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3 year old MN Shih Tzu with hind limb lameness

April 22, 2021 By Allison Zwingenberger

This week’s case is a 3-year-old Shih Tzu with a 5-week history of increasing left hind limb lameness and lethargy.

R LAT
VD
Show findings...

Findings

There 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.
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Differential Diagnosis

  • osteomyelitis – bacterial, fungal
  • neoplasia
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Diagnosis

Coccidioidomycosis
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Discussion

Ultrasound-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.

Filed Under: Case of the Day, Equine, Musculoskeletal, Radiographs, Residents

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