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Sesamoid: developmental malformation
Synonym(s): Bipartite / multipartite sesamoid
Introduction
- Cause: developmental malformation of the plantar or palmar sesamoid bones. May arise from multiple centers of ossification. Included under the general heading sesamoid disease in some texts.
- Signs: generally asymptomatic: usually incidental finding on radiography of the pes. More commonly found in the manus.
- Diagnosis: radiography. The sesamoid can be bipartite or multipartite.
- Treatment: if lame: rest and analgesia.
- Prognosis: good.
Presenting signs
- Generally incidental finding on radiographs of the pes or manus.
- Occasionally displace causing pain on direct palpation and on flexion of the digits.
Age predisposition
- Incidental finding when radiographed for another reason, so identified at any age.
- Assumed to be developmental, so probably occurs at stage of ossification of the sesamoid bones.
Breed/Species predisposition
- Rottweiler Rottweiler.
- Greyhound Greyhound.
Cost considerations
- If problems arise they often resolve with rest and analgesia.
Pathogenesis
Etiology
- Two possible mechanisms suggested:
- Multiple centers of ossification that failed to unite; or
- Incomplete ossification of cartilage template.
- Sesamoid bones 2 and 7 most commonly affected, numbering medial to lateral. This is thought to be from pressure from the overlying flexor tendons during hyperextension as the metacarpo/metatarso-phalangeal joints 2 and 5 are slightly outwardly rotated.
Pathophysiology
- Developmental disorder, detailed pathogenesis unknown.
- Sesamoid bones located in tendon of insertion of the interosseous muscles at the metacarpo-phalangeal joints.
- Multiple centers of ossification during development may result in multipartite or bipartite sesamoid bone formation.
- Incomplete ossification of a cartilage template would also be a possible etiology.
- Restriction of vascular foramina in sesamoids 2 and 7 was found in dogs with sesamoid disease and not in clinically normal dogs.
- There is an over-representation in the right manus of the racing Greyhound suggesting a traumatic component.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Harasen G (2009) Sesamoid disease. Can Vet J 50 (10), 1095 PubMed.
- Daniel A, Read R A & Cake M A (2008) Vascular foramina of the metacarpophalangeal sesamoid bones of Greyhounds and their relationship to sesamoid disease. Am J Vet Res 69 (6), 716-721 PubMed.
- Vaughan L C & France C (1986) Abnormalities of the volar and plantar sesamoid bones in Rottweilers. JSAP 27 (9), 551-8 VetMedResource.
- Bennett D & Kelly D F (1985) Sesamoid disease as a cause of lameness in young dogs. JSAP 26 (10), 567-79 VetMedResource.
- Bateman J K (1959) Fractured sesamoids in the greyhound. Vet Rec 71, 101.
Other sources of information
- Robins G M & Read R A (1998)diseases of the sesamoid bones.In:Canine Sports Medicine and Surgery.Bloomberg M S, Dee J F & Taylor R A (eds). Saunders W B Company, Philadelphia, pp 255-264.
- Robins G E & Read R A (1993)diseases of the sesamoid bones.In:Disease mechanisms in small animal surgery.pp 1094.