Degenerative disease of the distal interphalangeal joint and sesamoid bone in calves: 9 cases (1995–2004)

Pierre-Yves Mulon Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St Hyacinthe, QC J2S 6K9, Canada.

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Marie Babkine Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St Hyacinthe, QC J2S 6K9, Canada.

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Marc-André d'Anjou Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St Hyacinthe, QC J2S 6K9, Canada.

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Christiane Girard Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, St Hyacinthe, QC J2S 6K9, Canada.

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André Desrochers Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St Hyacinthe, QC J2S 6K9, Canada.

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Abstract

Objective—To evaluate the clinical signs, diagnosis, treatment, and outcome associated with distal interphalangeal joint (DIJ) degenerative disease in calves.

Design—Retrospective case series.

Animals—9 calves with degenerative disease of the DIJ.

Procedures—Medical records of calves with lameness for which the cause had been localized to the distal aspect of a limb but without evidence of trauma or sepsis were included. Signalment and results of physical, lameness, radiographic, and postmortem examinations were recorded. Outcomes of medical and surgical treatments were evaluated.

Results—All 9 calves had forelimb lameness (4 bilaterally). The medial digit was affected in 12 limbs and the lateral digit was affected in 9 limbs. Radiographic examination revealed bridging osteoproliferation along the abaxial and palmar aspects of affected DIJs (18/21), subchondral cyst-like lucencies (19/21), and sclerosis (16/21). The DIJ was resected in 3 calves (7 joints), resulting in resolution of lameness within 3 months. Medical management was attempted in 4 calves (6 joints), and 2 calves (6 joints) did not receive treatment; 5 calves had a normal stance within 5 months. Results of postmortem com-puted tomographic and histologic examination were in accordance with degenerative joint disease processes.

Conclusions and Clinical Relevance—Degenerative disease of the DIJ should be considered in calves with insidious, progressive forelimb lameness. Although the etiology of this process remains undetermined, results of radiographic, computed tomographic, and histologic examinations suggested an underlying developmental anomaly, such as osteochondrosis. Surgical treatment appeared promising on the basis of postop-erative resolution of lameness in all surgically treated calves.

Abstract

Objective—To evaluate the clinical signs, diagnosis, treatment, and outcome associated with distal interphalangeal joint (DIJ) degenerative disease in calves.

Design—Retrospective case series.

Animals—9 calves with degenerative disease of the DIJ.

Procedures—Medical records of calves with lameness for which the cause had been localized to the distal aspect of a limb but without evidence of trauma or sepsis were included. Signalment and results of physical, lameness, radiographic, and postmortem examinations were recorded. Outcomes of medical and surgical treatments were evaluated.

Results—All 9 calves had forelimb lameness (4 bilaterally). The medial digit was affected in 12 limbs and the lateral digit was affected in 9 limbs. Radiographic examination revealed bridging osteoproliferation along the abaxial and palmar aspects of affected DIJs (18/21), subchondral cyst-like lucencies (19/21), and sclerosis (16/21). The DIJ was resected in 3 calves (7 joints), resulting in resolution of lameness within 3 months. Medical management was attempted in 4 calves (6 joints), and 2 calves (6 joints) did not receive treatment; 5 calves had a normal stance within 5 months. Results of postmortem com-puted tomographic and histologic examination were in accordance with degenerative joint disease processes.

Conclusions and Clinical Relevance—Degenerative disease of the DIJ should be considered in calves with insidious, progressive forelimb lameness. Although the etiology of this process remains undetermined, results of radiographic, computed tomographic, and histologic examinations suggested an underlying developmental anomaly, such as osteochondrosis. Surgical treatment appeared promising on the basis of postop-erative resolution of lameness in all surgically treated calves.

Lameness in growing cattle is frequently caused by septic and traumatic diseases.1,2 However, in the same age group, developmental abnormalities, such as flexural or angular limb deformities and osteochondrosis, may also represent a source of lameness.3–5 Flexural limb deformities are typically detected in calves shortly after birth and can resolve without treatment when not severe or after surgical treatment when calves are unable to walk on the palmar or plantar surfaces of the hooves. Angular limb deformity is a rare condition that can result as a complication following a fracture or as a consequence of bending stresses and bone remodeling in a fetus during early gestation.6 Osteochondrosis and epiphysitis are infrequent causes of lameness that predominantly involve the tarsal and stifle joints.3,7

Diseases of the digits are the most frequent cause of lameness in adult cattle but not necessarily in calves.8–10 Affected DIJs are typically septic, which is attributable to ulceration or perforating trauma of the sole.10,11 There are few reports12–15 of nonseptic diseases of the DIJ in calves and adult cattle. In calves, deforming ankylosis of the DIJ in Simmental calves13,14 and of a bipartite distal sesamoid bone in a Holstein calf15 has been reported. The calves in these reports13–15 were not treated; except for 1 calf, all of the calves had worsening of their lameness.

The objective of the study reported here was to evaluate the clinical, radiographic, CT, and histologic features of a degenerative process of the distal sesamoid bone and DIJ in calves. Additionally, the respective outcomes of conservative and surgical treatments were compared.

Materials and Methods

Case selection—Medical records of all cattle < 2 years old with lameness originating distal to the metacarpophalangeal or metatarsophalangeal joint that were examined at the veterinary medical teaching hospital of the Université de Montréal between January 1995 and December 2004 were reviewed. For inclusion, cattle had to have radiographic abnormalities of the DIJ. Cattle with a phalangeal fracture, luxation of the DIJ, or septic DIJ were excluded from the study.

Medical records review—Information collected from the medical records included signalment and results of physical and lameness examinations. Lameness score was based on a scale of 0 (no lameness) to 4 (nonambulatory), as reported elsewhere.16 Complete examination of the affected limbs was performed with emphasis on the digits. A hoof tester was applied to various locations of all digits of the affected forelimbs. After the lameness was localized to the digits, 4-point digital perineural anesthesia was used to confirm the origin of the lameness.17

Dorsopalmar and lateromedial radiographic projections were obtained in all calves. Additional projections obtained in some of the calves included dorsolateralpalmaromedial oblique, dorsomedial-palmarolateral oblique, and interdigital views. All radiographs were assessed by a board-certified veterinary radiologist (MAD) for evidence of periarticular osteoproliferation, subchondral sclerosis, and cyst-like lesions.

Treatment was conservative or surgical. Conservative treatment was chosen for economic reasons and when at least 1 digit of the same foot was assessed as being able to bear weight as determined on the basis of radiographic findings. Conservative treatment included the application of a wooden block on the radiographically normal digit and administration of phenylbutazone (4.5 mg/kg [2.05 mg/lb], PO, q 48 h).a Surgical treatment was elected when there was no improvement or there was worsening of the lameness with conservative treatment. Surgical treatment consisted of a DIJ resection via various approaches.11,18

The medical records review identified 1 calf that was culled 6 months after the initial examination and on which an extensive postmortem examination of the forelimbs was performed. The calf was culled because of persistent lameness. The forelimbs of that calf were obtained from the slaughterhouse, and CT,b gross, and histologic examinations were performed on the affected forelimbs. Transverse and sagittal images (2-mm thickness and index) of the affected limb were acquired helically, reconstructed with a bone algorithm, and viewed on a diagnostic workstation.c Three-dimensional surface rendering was also performed to enhance the assessment of all joint components. Anatomic pieces were sectioned axially, fixed in neutral-buffered 10% formalin, and decalcified with EDTA and hydrochloric acid until they could be easily cut with a scalpel. The specimens were then embedded in paraffin, sectioned at a thickness of 4 Pm, and stained with hematoxylin, eosin, and saffron.

Outcome—Follow-up information was obtained during lameness reassessment 2 to 4 months after the initial examination. Additional information was obtained by telephone conversation with the owners 6 to 48 months after discharge from the hospital. The answers to specific questions regarding change in signs of lameness, whether the calf remained within the herd, and rate of growth (compared with that of herdmates) were evaluated.

Statistical analysis—Analysis was performed by use of an exact binomial test. Significance was set at values of P ≤ 0.05.

Results

Clinical evaluation—Nine female Holstein calves between 2 and 6 months of age were included in the study. Physical examination results were within anticipated limits, except for the lameness. Only forelimbs were affected clinically (13 forelimbs in the 9 calves). Lameness was insidious in onset; the duration before the initial examination ranged from 0.5 to 4.5 months (mean, 2.4 months). The lameness was characterized by signs of severe reluctance to walk. The calves bore weight only on the toes with the metacarpophalangeal joint held moderately flexed.

Six calves had definitive lameness scores entered in their medical records; 2 calves had grade 2 lameness, and 4 calves had grade 3 lameness. Four calves were affected bilaterally. The proportion of bilaterally affected calves (4/9 [0.44]) did not differ significantly (P = 1.00; exact binomial test) from the null hypothesis proportion of 0.50. Three calves were unilaterally lame in the left forelimb, and 2 calves were unilaterally lame in the right forelimb.

Both digits were affected in 8 of the limbs that were lame, the medial digit was affected in 4 limbs, and the lateral digit was affected in 1 limb. The coronary band was not swollen in any of the affected limbs. Abnormal hoof wear was evident. An elevated heel was the only sign noticed and was attributed to an irregular shift in bearing weight toward the toes. Signs of pain were particularly evident when the hoof tester was applied across the heel and during extension of the affected digit.

Regional anesthesia was performed in 7 calves. This resulted in full weight–bearing locomotion in 6 calves (improvement in lameness score of at least 2 grades) and in a mild improvement in 1 calf for which a lameness score was not available.

Radiographic examination—Radiographic images were obtained in 3 calves by use of standard radiographs and in 6 calves by use of computed radiographs. Radiographic lesions were detected in 21 DIJs (12 medial digits and 9 lateral digits). Lesions were localized to the abaxial and palmar aspects of all affected DIJs and were most evident on oblique projections. Subchondral radiolucencies were detected in 19 of 21 affected joints. These lucencies appeared as multiple cyst-like lesions in 18 joints, and 16 of the multiple cyst-like lucencies were surrounded by sclerosis. These subchondral lesions typically involved the middle phalanx. Bridging osteoproliferation was evident at the palmar aspect of 18 joints, and the corresponding distal sesamoid bone was deformed and reduced in size in 17 of these joints (Figure 1). The portion of the sesamoid bone adjacent to the bridging osteoproliferation was small and had a triangular shape, and the axial portion of the sesamoid bone was often displaced axially. The joint space was widened in 1 affected DIJ and narrowed in 4 affected DIJs.

Figure 1—
Figure 1—

Dorsomedial-palmarolateral oblique computed radiographic view of the DIJ of the medial digit from a calf with forelimb lameness. Smooth bridging osteoproliferation (arrowhead) is evident between the middle and distal phalanges along their palmar and abaxial surfaces. The palmar aspect of the distal phalanx and the distal aspect of the middle phalanx are irregular. The adjacent portions of the subchondral plates are irregular and sclerotic (white arrow). This irregularity extends into the bridging osteoproliferation (ie, formation of new bone). The corresponding sesamoid bone (black arrow) is deformed, with a small abaxial portion.

Citation: Journal of the American Veterinary Medical Association 234, 6; 10.2460/javma.234.6.794

Arthrocentesis—Arthrocentesis of the DIJ was attempted in 3 calves. Blood contaminated 2 of the samples, and they were judged not suitable for cytologic evaluation. Cytologic findings for the remaining calf were compatible with those of normal articular fluid.19

Treatment—Conservative treatment was attempted in 7 calves, whereas 2 were discharged immediately without treatment. The conservative treatment consisted of stall rest and administration of phenylbutazonea (4.5 mg/kg, PO, q 48 h for 2 to 4 weeks). A wooden block was applied to the radiographically normal digit of the affected foot in 3 calves; this was associated with immediate and complete resolution of the lameness. In the other 4 conservatively treated calves, no substantial clinical improvement was detected during the 3 months after diagnosis.

Facilitated ankylosis of the DIJ was performed in 3 calves (7 digits). For 2 calves, a bulbar approach was used. These calves also had a wooden block glued to the radiographically normal digit of the affected foot. For the third calf, an abaxial approach was used for all 4 digits of the affected forelimbs.18 For all approaches, a 6.5-mm drill bit and a size 3 Brun curette were used to remove the cartilage and a portion of the subchondral bone. In addition, half-limb casts were applied to each forelimb of the third calf; the casts were left in place for 3 weeks. All calves that underwent surgical treatment received postoperative antimicrobial treatment consisting of procaine penicillin Gd (22,000 U/kg [10,000 U/ lb], IM, q 12 h for 5 days), and pain was controlled by administration of phenylbutazonea (4.5 mg/kg, PO, q 48 h for 1 to 3 weeks [mean duration, 2 weeks]).

Calves treated conservatively were discharged from the hospital between days 0 and 5 (day 0 = day of admission). Calves treated surgically were discharged from the hospital between days 3 and 19 (day 0 = day of surgery).

Follow-up evaluation—Follow-up information was obtained for all calves (range, 6 to 48 months; mean, 27 months). One untreated calf continued to deteriorate and was eventually culled 6 months after discharge. The other untreated calf gradually improved over several months; this calf was sold as a pregnant heifer to another dairy herd.

The 3 surgically treated calves had no postoperative complications, except for 1 calf with a mild deformation in the region of the proximal interphalangeal joint. According to the owners, duration of the lameness during the postoperative period was between 2 and 3 months, and the lameness subsequently resolved. Two of these calves completed lactations in their original herds, and the third was sold to another dairy herd after her second parturition.

Two of the 4 conservatively treated calves improved during the 4- to 6-month period after discharge and completed at least 2 lactations in their herds of origin. The other 2 calves were culled before 24 months of age because of delayed growth. Residual lameness was evident in all 4 of these conservatively treated calves.

Six of the affected calves subsequently reproduced. None of their offspring have been observed with similar lameness conditions.

Postmortem examination—Forelimbs of the culled calf that did not receive any treatments were obtained from the slaughterhouse and examined by use of CT. All changes involving the DIJ and corresponding sesamoid bone that were evident in CT images were in accordance with the changes detected in the radiographs obtained previously. Subchondral cyst-like lesions associated with sclerosis on the palmaroabaxial side of the middle phalanx were more visible in the CT images (Figure 2) than in the radiographic images. Three-dimensional reconstruction provided better definition of the deformation of the distal sesamoid bone (Figure 3). Prominent bridging osteoproliferation was evident in each affected digit.

Figure 2—
Figure 2—

Sagittal CT image of the DIJ of the medial digit from a calf with forelimb lameness. Marked osteoproliferation (arrowhead) is apparent along the palmar border of the DIJ. Notice the prominent subchondral cyst-like hypodensities (black arrow) with adjacent sclerosis that involve the middle and distal phalanges. The abaxial tip of the sesamoid bone (white arrow) is small.

Citation: Journal of the American Veterinary Medical Association 234, 6; 10.2460/javma.234.6.794

Figure 3—
Figure 3—

Three-dimensional CT surface rendering of the distal portion of a forelimb from a calf with lameness. Bridging osteoproliferation (arrowheads) between the middle and distal phalanges is clearly visible. The sesamoid bones (S) are misshapen. Some of the subchondral cyst-like lesions are also visible (arrows).

Citation: Journal of the American Veterinary Medical Association 234, 6; 10.2460/javma.234.6.794

Macroscopically, the digits had axial fibrocartilaginous bridging of the articular surfaces of the middle and distal phalanges (Figure 4); osteocartilaginous osteophytes united the middle and distal phalanges. The articular cartilage was focally absent in the areas of the articular surface adjacent to the subchondral cyst-like lesions. Microscopic examination revealed that the cyst-like lesions corresponded to areas of bony lysis and were filled by fibrous or cartilaginous tissue, with ossification sometimes evident (Figure 5). Other changes compatible with osteoarthrosis included irregularity of the cartilage surface, loss of staining of the matrix, chondronecrosis, and numerous clefts and chondrones.

Figure 4—
Figure 4—

Photograph of an axial section of the DIJ from a calf with forelimb lameness. An osteocartilaginous bridge is evident on the palmar aspect of the articulation (arrowheads), and there is a subchondral cyst (arrow) at the distal end of the second phalanx.

Citation: Journal of the American Veterinary Medical Association 234, 6; 10.2460/javma.234.6.794

Figure 5—
Figure 5—

Photomicrograph of a tissue section obtained from the DIJ of a calf with forelimb lameness. There is normal appearing cartilage at the dorsal aspects of the middle (a) and distal (b) phalanges. A large osteocartilaginous osteophyte (c) is evident at the palmar aspect of the articulation. There is no articular cartilage visible in this area. Hematoxylin, eosin, and saffron stain; bar = 2 mm.

Citation: Journal of the American Veterinary Medical Association 234, 6; 10.2460/javma.234.6.794

Discussion

Degenerative disease of the DIJ is a slow, progressive process in calves. Clinical signs were similar for all calves reported here, with a typical gait that favored bearing weight on the front toes to avoid bearing weight on the heels. Signs of pain that were elicited when the hoof tester was applied to the heel region confirmed the origin of the pain. Signs of pains elicited during extension of the digit were attributed to compression of the deep digital flexor tendon on the reactive distal sesamoid bone. On the basis of our findings, all digits of the forelimbs should be examined carefully when degenerative disease of the DIJ is suspected.

The 4-point digital perineural anesthesia confirmed and localized the origin of the lameness. Six of 7 calves had notable improvement in their condition after the regional anesthesia. Anesthesia administered IV distal to a tourniquet could also be used to anesthetize the digits. However, the tourniquet may be an annoyance or cause pain and interfere with the interpretation of results of the lameness examination.

The slow and progressive character of the lameness, lack of external lesions on the digits, location of the lesions, and response to regional anesthesia ruled out common infectious conditions of the digit, such as septic arthritis of the DIJ or abscesses localized between the sole and the digital cushion. The lameness was not sufficiently severe to include fracture of the distal phalanx as a differential diagnosis. Arthrocentesis was attempted in 3 calves but was successful in only 1. Although it may help in investigating the origin of the disease process, arthrocentesis is not essential to diagnose degenerative disease of the DIJ.

Radiographic lesions were similar among calves. Typical changes included bridging osteoproliferative reaction at the palmaroabaxial aspect of the affected digits and subchondral sclerosis and cyst-like lesions that were easily recognized on conventional and computed radiographs. Bone details were enhanced with computed radiography because of the sharpening algorithm used to reconstruct images. Oblique projections were the most useful to evaluate the bone changes and remodeling of the heel region (Figure 1); this was especially true in calves in which bony proliferation was not detected.

The triangular shape and apparent displacement of the distal sesamoid bone in severely affected digits were interesting findings. The sesamoid bone appeared reduced in size abaxially and displaced axially. These changes in the sesamoid bone may have developed in utero or may have developed during bone growth in association with the progression of the interphalangeal bridging proliferation. The reason that the radiographic changes were limited to the proximity of the sesamoid bone and were not evident in the remainder of the DIJ is not known.

Computed tomography was useful in providing a better definition of the extent of the changes as well as the shape of the sesamoid bone. Subchondral sclerosis and cyst-like lesions were particularly obvious on reformatted sagittal planes (Figure 2). Computed tomography can be used clinically in small calves in which changes may not be clearly evident on radiographs.

Although the origin of the process described in the present study remains unknown, the clinical history and results of physical, radiographic, CT, and histologic examinations suggested a developmental disease. A congenital or developmental malformation, such as joint dysplasia or osteochondrosis, that subsequently induces degenerative joint disease was suspected. The presence and extent of the cyst-like lesions were supportive of osteochondrosis. A high-energy diet and rapid growth rate have been incriminated as potential causes of degenerative joint disease by altering and weakening the articular cartilage.20 Review of the pedigrees of the calves reported here did not reveal relationships among their lineages, and DIJ lesions were not reported in any of their offspring. Therefore, it is difficult to confirm whether this condition was congenital or developmental and whether the underlying process had a heritable component in these calves.

Deforming ankylosis of the DIJ was detected during the postmortem examination of 3 Simmental calves.13,14 The suspected pathogenesis was a failure of the ossification center of the distal sesamoid bone to separate from the middle or distal phalanx during embryologic development. A congenital origin of a bipartite distal sesamoid bone in a calf has also been reported.15 In that report,15 lesions detected by use of radiography and 3-dimensional CT were similar to the lesions in the calves in the present study.

Other potential causes considered for this specific joint disease included trauma to the DIJ with fracture of the sesamoid bone and secondary degenerative joint disease; septic arthritis was another possibility. However, trauma involving all 4 digits of both forelimbs in 3 of the calves in the present study seemed highly improbable. A resolving septic arthritis was also judged to be unlikely because there was no evidence of osteitis of the middle or distal phalanx. Moreover, the insidious onset of the condition and progression over multiple weeks were not supportive of a traumatic event or infection.

In other reports,13–15 treatment was not attempted in calves with this condition. The 3 beef calves in 2 of those reports13,14 were culled, and the dairy calf in the other report15 was apparently doing well several months later. It is interesting that with conservative treatment, the lameness may resolve over a period of several months, presumably as the result of progressive DIJ ankylosis. However, this was not confirmed with follow-up radiographs because the owners of calves that improved opted not to return their animals for long-term reevaluation.

In the study reported here, surgical treatment was effective in 3 calves in which conservative treatment was unsuccessful. Although the number of animals in this study was low, surgical treatment appeared to offer a promising alternative because calves that received surgical treatment had short convalescence periods and complete resolution of lameness. Bulbar and abaxial approaches were used to remove articular cartilage, and there was no difference evident in postoperative lameness. The abaxial approach is less invasive but does not allow access to the distal sesamoid bone. Less invasive methods could be used to induce arthrodesis of a joint. Chemical arthrodesis with monoiodoacetate or ethyl alcohol has been used in horses for tarsal joint arthrodesis,21,22 and hydrothermal energy was used to destroy articular chondrocytes in an ex vivo study.23

Pain management was provided by use of 2 methods. Relief from bearing weight was achieved by application of a wooden block on the radiographically normal digit or by use of half-limb casts for the calf with bilateral biaxial ankylosis. Pharmaceutical pain management was accomplished by administration of an NSAID (ie, phenylbutazone). Because only forelimbs were affected, epidural analgesia was not possible in these calves.

On the basis of the age of the calves, clinical examination findings, radiographic lesions, and histologic findings, a degenerative joint disease secondary to osteochondrosis should be considered as the origin of the lameness. More research is warranted to investigate the origin of the disease and whether there is a hereditary component. Radiographs should be obtained in newborn calves to determine whether this condition develops in utero or as a developmental disorder. Degenerative joint disease should be considered in calves with lameness originating from the DIJ.

Abbreviations

CT

Computed tomography

DIJ

Distal interphalangeal joint

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a.

Professional Veterinary Laboratories, Winnipeg, MB, Canada.

b.

HiSpeed ZX/i, General Electric Medical Systems, Mississauga, ON, Canada.

c.

AW 4.0, General Electric Medical Systems, Mississauga, ON, Canada.

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Depocilline, Intervet Canada Ltd, Whitby, ON, Canada.

  • Figure 1—

    Dorsomedial-palmarolateral oblique computed radiographic view of the DIJ of the medial digit from a calf with forelimb lameness. Smooth bridging osteoproliferation (arrowhead) is evident between the middle and distal phalanges along their palmar and abaxial surfaces. The palmar aspect of the distal phalanx and the distal aspect of the middle phalanx are irregular. The adjacent portions of the subchondral plates are irregular and sclerotic (white arrow). This irregularity extends into the bridging osteoproliferation (ie, formation of new bone). The corresponding sesamoid bone (black arrow) is deformed, with a small abaxial portion.

  • Figure 2—

    Sagittal CT image of the DIJ of the medial digit from a calf with forelimb lameness. Marked osteoproliferation (arrowhead) is apparent along the palmar border of the DIJ. Notice the prominent subchondral cyst-like hypodensities (black arrow) with adjacent sclerosis that involve the middle and distal phalanges. The abaxial tip of the sesamoid bone (white arrow) is small.

  • Figure 3—

    Three-dimensional CT surface rendering of the distal portion of a forelimb from a calf with lameness. Bridging osteoproliferation (arrowheads) between the middle and distal phalanges is clearly visible. The sesamoid bones (S) are misshapen. Some of the subchondral cyst-like lesions are also visible (arrows).

  • Figure 4—

    Photograph of an axial section of the DIJ from a calf with forelimb lameness. An osteocartilaginous bridge is evident on the palmar aspect of the articulation (arrowheads), and there is a subchondral cyst (arrow) at the distal end of the second phalanx.

  • Figure 5—

    Photomicrograph of a tissue section obtained from the DIJ of a calf with forelimb lameness. There is normal appearing cartilage at the dorsal aspects of the middle (a) and distal (b) phalanges. A large osteocartilaginous osteophyte (c) is evident at the palmar aspect of the articulation. There is no articular cartilage visible in this area. Hematoxylin, eosin, and saffron stain; bar = 2 mm.

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