Primary flexor enthesopathy

From Dog

Primary flexor enthesopathy (enthesitis) is a rare developmental disorder of tendon and ligament attachment within the canine elbow and is a contributory cause of elbow dysplasia.

This disease may present as a primary (less common, less severe) or secondary (concomitant) enthesopathy[1].

Affected dogs usually present with unilateral elbow pain, lameness and tenderness during elbow extension.

The disease involves the medial epicondyle, affecting the tendon attachments of the flexor muscles at the elbow.

Diagnosis is usually by ultrasonographic, arthroscopic, radiographic or CT examination[2], as well as exclusion of other elbow disorders such as fragmented coronoid process, osteochondritis dissecans, ununited anconeal process, incongruity, subtrochlear sclerosis, and osteoarthritis.

Treatment of primary enthesopathy is usually conservative in dogs with exercise restriction, use of NSAIDs such as carprofen or meloxicam.

Secondary enthesopathy is usually associated with other degenerative joint changes such as fractured coronoid process or ununited anconeal process and require surgical intervention[3].


  1. de Bakker E et al (2012) Radiographic features of primary and concomitant flexor enthesopathy in the canine elbow. Vet Radiol Ultrasound Oct 24
  2. Van Ryssen B et al (2012) Primary flexor enthesopathy of the canine elbow: imaging and arthroscopic findings in eight dogs with discrete radiographic changes. Vet Comp Orthop Traumatol 25(3):239-245
  3. de Bakker E et al (2012) Radiographic findings of the medial humeral epicondyle in 200 canine elbow joints. Vet Comp Orthop Traumatol 25(5):359-365