Ultrasonographic Evaluation of Dogs with Cranial Cruciate Ligament Rupture Undergoing to Arthrotomy


  • Luanna Ferreira Fasanelo Gomes Setor de Diagnóstico por Imagem, Hospital Veterinário, Universidade Federal do Mato Grosso (UFMT), Sinop, MT, Brazil.
  • Thales Bregadioli Setor de Diagnóstico por Imagem, Hospital Veterinário, Universidade Federal do Mato Grosso (UFMT), Sinop, MT, Brazil.
  • Stefano Carlo Filippo Hagen Setor de Diagnóstico por Imagem, Hospital Veterinário, Universidade Federal do Mato Grosso (UFMT), Sinop, MT, Brazil.




Background: The cranial cruciate ligament rupture (CrCLR) is the most common disease of the stifle joint in dogs. One of the major concerns in the assessment of these animals is diagnosing the presence of a medial meniscus tears, which is a frequent consequence due to the instability of the joint. Ultrasonography is indicated in the evaluation of the menisci from human and canine patients, and the results are similar to magnetic resonance imaging. The aim of this study was to compare the ultrasonography and the arthrotomy in the evaluation of the cranial cruciate ligament and medial meniscus of dogs with CrCLR undergoing surgery for stifle stabilization.

Materials, Methods & Results: Ultrasonographic examination was performed prior to arthrotomy in 23 dogs with diagnosis of complete CrCLR and five with suspected partial CrCLR undergoing for stifle joint stabilization surgery. The ultrasonography identified the complete rupture in 82.6% and the arthrotomy in 100% of the joints with this diagnosis. In the joints with suspected CrCLR during the clinical exam, arthrotomy and ultrasonography identified respectively three and four joints with partial CrCLR, and two and one with healthy ligaments. There was no difference between the two techniques in the assessment of the cranial cruciate ligament (P = 0.20). The ultrasonography identified medial meniscal tears in 39.3%, while arthrotomy was found in 21.4% (P = 0.0006) of the joints. The most frequent meniscal tear type observed in the arthrotomy was folded caudal horn. The ultrasonography was able only in differentiate presence and absence of meniscal injury. Besides the real tear that affects the meniscus morphology, the ultrasound also identified echogenicity and echotexture changes in the medial (5/28) and lateral (8/28) menisci. Other changes observed in all joints evaluated by ultrasound were the presence of effusion and synovial membrane thickening.

Discussion: The complete and almost complete CrCLR are diagnosed by clinical examination through the evaluation of instability of the stifle joint, which is not possible in partial CrCLR in stable joints. In this study of the five evaluated stable joints, the ultrasound correctly identified the partial CrCLR in three joints and the ligament integrity in one of the joints when compared to arthrotomy. In animals with stifle joint instability the meniscus assessment is fundamental as it is one of the main causes of persistent lameness in dogs subjected to conservative or surgical treatment. Ultrasonography cannot differentiate the types of meniscal tears but identified approximately 1.8 times more medial meniscus tears compared to arthrotomy. Despite the bucket handle being the most common tear of medial meniscus in dogs with CrCLR, four of the six meniscal tears identified by arthrotomy were folded caudal horn. This lesion causes cranial displacement of the caudal horn which may have facilitated its identification by minimally invasive arthrotomy, being the probable reason for its high incidence in this study. Echogenicity and echotexture changes without affecting the meniscus morphology were related with intrasubstance degeneration described in human medicine. Ultrasonography is not the better technique to assess the CrCL but can assist in identifying partial ruptures. Because it has results similar to magnetic resonance imaging, ultrasonography is an important tool in the diagnosis of meniscus tears.


Download data is not yet available.


Arnault F., Cauvin E., Viguier E., Kraft E., Sonet J. & Carozzo C. 2009. Diagnostic value of ultrasonography to assess stifle lesions in dogs after cranial cruciate ligament rupture: 13 cases. Veterinary and Comparative Orthopaedics and Traumatology. 22(6): 479-485.

Beale B.S., Hulse D.A., Pozzi A. & Muir P. 2018. Arthroscopy and arthrotomy of the stifle., In: P. Muir (Ed). Advances in the Canine Cranial Cruciate Ligament. 2nd edn. Hoboken: Wiley-Blackwell, pp.171-184.

Bennett D. & May C. 1991. Meniscal damage associated with cruciate disease in the dog. Journal of Small Animal Practice. 32(3): 111-117.

Böttcher P., Brühschwein A., Winkels P., Werner H., Ludewig E., Grevel V. & Oechtering G. 2010. Value of low-field magnetic resonance imaging in diagnosing meniscal tears in the canine stifle: A Prospective study evaluating sensitivity and specificity in naturally occurring cranial cruciate ligament deficiency with arthroscopy as the gold standard. Veterinary Surgery. 39(3): 296-305.

Bourzac C., K., Rossier Y. & Laverty S. 2009. Comparison of radiography and ultrasonography for the diagnosis of osteochondritis dissecans in the equine femoropatellar joint. Equine Veterinary Journal. 41(7): 685-692.

Bruyn G.A.W., Naredo E., Damjanov N., Bachta A., Baudoin P., Hammer H.B., Lamers-Karnebeek F.B.G., Parera I.M., Richards B., Taylor M., Ben-Artzi A., D’Agostino M.A., Garrido J. & Iagnocco A. 2016. An OMERACT reliability exercise of inflammatory and structural abnormalities in patients with knee osteoarthritis using ultrasound assessment. Annals of the Rheumatic Diseases. 75(5): 842-846.

Cao J., Zheng B., Meng X., Lv Y., Lu H., Wang K., Huang D. & Ren J. 2018. A novel ultrasound scanning approach for evaluating femoral cartilage defects of the knee : comparison with routine magnetic resonance imaging. Journal of Ortophaedic Surgery and Research. 13(1): 178.

Crema M.D., Hunter D.J., Roemer F.W., Li L., Marra M.D., Nogueira-Barbosa M.H.,

Le Graverand M. P. H., Wyman B.T. & Guermazi A. 2011. The relationship between prevalent medial meniscal intrasubstance signal changes and incident medial meniscal tears in women over a 1-year period assessed with 3.0 T MRI. Skeletal Radiology. 40(8): 1017-1023.

D’Agostino M. A., Terslev L., Aegerter P., Backhaus M., Balint P., Bruyn G.A., Filippucci E., Grassi W., Iagnocco A., Jousse-Joulin S., Kane D., Naredo E., Schmidt W., Szkudlarek M., Conaghan P.G. & Wakefield R.J. 2017. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 1: definition and development of a standardised, consensus-based scoring system. Rheumatic and Musculoskeletal Diseases Open. 3(1): e000428.

Derchi L.E. & Rizzatto G. 2007. Technical Requirements. In: Bianchi S. & Martinoli C. (Eds). Ultrasound of the Musculoskeletal System. Berlin: Springer-Verlag, pp.3-16.

Dillon D.E., Gordon-Evans W.J., Griffon D.J., Knap K.M., Bubb C.L. & Evans R.B. 2014. Risk factors and diagnostic accuracy of clinical findings for meniscal disease in dogs with cranial cruciate ligament disease. Veterinary Surgery. 43(4): 446-450.

Dyall B. & Schmökel H. 2017. Tibial tuberosity advancement in small-breed dogs using TTA Rapid implants: complications and outcome. Journal of Small Animal Practice. 58(6): 314-322.

Fazio C.G., Muir P., Schaefer S.L. & Waller III K.R. 2018. Accuracy of 3 Tesla magnetic resonance imaging using detection of fiber loss and a visual analog scale for diagnosing partial and complete cranial cruciate ligament ruptures in dogs. Veterinary Radiology and Ultrasound. 59(1): 64-78.

Ferrigno C.R.A., Caquias D.F.I., Nina M.I.D., Cunha O., Ito K.C., Mariani T.C., Ferraz V.C.M. & Cotes L. 2012. Ruptura de menisco associada à ruptura de ligamento cruzado cranial em cães. Brazilian Journal of Veterinary Research and Animal Science. 49(4): 301-306.

Franklin S.P., Cook J.L., Cook C.R., Shaikh L.S., Clarke K.M. & Holmes S.P. 2017. Comparison of ultrasonography and magnetic resonance imaging to arthroscopy for diagnosing medial meniscal lesions in dogs with cranial cruciate ligament deficiency. Journal of the American Veterinary Medical Association. 251(1): 71-79.

Guimaraes J.B., Nevitt M.C., McCulloch C.E., Schwaiger B.J., Gersing A.S., Facchetti L., Bucknor M.D., Chanchek N., Liu F., Joseph G.B. & Link T.M. 2018. Association of weight change with progression of meniscal intrasubstance degeneration over 48 months: Data from the Osteoarthritis Initiative. European Radiology. 28(3): 953-962.

Hart J.L., May K.D., Kieves N.R., Mich P.M., Goh C.S.S., Palmer R.H. & Duerr F.M.. 2016. Comparison of owner satisfaction between stifle joint orthoses and tibial plateau leveling osteotomy for the management of cranial cruciate ligament disease in dogs. Journal American Veterinary Medical Association. 249(4): 391-398.

Hayashi K., Manley P. & Muir P. 2004. Cranial cruciate ligament pathophysiology in dogs with cruciate disease: a review. Journal of the American Animal Hospital Association. 40(5): 385-390.

Henderson H.A. & Milton J.L. 1978. The Tibial Compression Mechanism: A Diagnostic Aid in Stifle Injuries. Journal of the American Animal Hospital Association. 14(4): 474-479.

Kaufman K., Beale B.S., Thames H.D. & Saunders W.B. 2017. Articular cartilage scores in cranial cruciate ligament-deficient dogs with or without bucket handle tears of the medial meniscus. Veterinary Surgery. 46(1): 120-129.

Low A.K., Carmody D.J., Lucas P. & Hale D. 2008. Clinical significance of intrasubstance meniscal lesions on MRI. 52(3): 227-230.

Mahn M.M., Cook J.L., Cook C.R. & Balke M.T. 2005. Arthroscopic verification of ultrasonographic diagnosis of meniscal pathology in dogs. Veterinary Surgery. 34(4): 318-323.

Martig S., Konar M., Schmökel H.G., Rytz U., Spreng D., Scheidegger J., Höhl B., Kircher P.R., Boisclair J. & Lang J. 2006. Low-field mri and arthroscopy of meniscal lesions in ten dogs with experimentally induced cranial cruciate ligament insufficiency. Veterinary Radiology and Ultrasound. 47(6): 515-522.

Neal B.A., Ting D., Bonczynski J.J. & Yasuda K. 2015. Evaluation of meniscal click for detecting meniscal tears in stifles with cranial cruciate ligament disease. Veterinary Surgery. 44(2): 191-194.

Plesman R., Gilbert P. & Campbell J. 2013. Detection of meniscal tears by arthroscopy and arthrotomy in dogs with cranial cruciate ligament rupture: A retrospective, cohort study. Veterinary and Comparative Orthopaedics and Traumatology. 26(1): 42-46.

Pozzi A., Hildreth III B.E. & Rajala-Schultz P.J. 2008. Comparison of arthroscopy and arthrotomy for diagnosis of medial meniscal pathology: An ex vivo study. Veterinary Surgery. 37(8): 749-755.

Ralphs S.C. & Whitney W.O. 2002. Arthroscopic evaluation of menisci in dogs with cranial cruciate ligament injuries: 100 cases (1999-2000). Journal of the American Veterinary Medical Association. 221(11): 1601-1604.

Stoller W., Martin C., Crues III J.V., Kaplan L. & Mink J.H. 1987. Meniscal Tears : Pathologic correlation with MR imaging. Radiology. 163(3): 731-735.

Stone E.A., Betts C.W. & Rudy R.L. 1980. Folding of the Caudal Horn of the Medial Meniscus Secondary to Severence of the Cranial Cruciate Ligament. Veterinary Surgery. 9(4): 121-124.



How to Cite

Fasanelo Gomes, L. F., Bregadioli, T., & Filippo Hagen, S. C. (2019). Ultrasonographic Evaluation of Dogs with Cranial Cruciate Ligament Rupture Undergoing to Arthrotomy. Acta Scientiae Veterinariae, 47(1). https://doi.org/10.22456/1679-9216.93776




Most read articles by the same author(s)