Elbow disease is a problem of growing dogs and the clinical signs of the three main problems are somewhat similar. The earliest problem recognized was UAP. The German Shepherd Dog and the Basset Hound are the two main breeds involved, although any middle size or larger breed may be affected.

The anconeal process sometimes grows as a separate ossification centre and it is usually recognized as such at around 70 days. It is usually united to the main part of the ulna by about 140 days. However, dogs which have UAP do not necessarily show lameness. Thus dogs with elbow lameness and an UAP which are older than 140 days would be considered to be exhibiting signs relating to this condition. The radiological diagnosis is straightforward and there may be osteoarthritic change in addition to the presence of UAP. It is also possible that dogs with UAP could in addition have FCP and/or OCD.

Dogs with OCD or FCP may present with lameness earlier than UAP cases. There have been cases as young as 3-4 months, but the 5-8 months category would be more common. Cases continue to be presented up to 18 months or older, but dogs of some years presumably present with exacerbation of underlying osteoarthritis.

The forelimb lameness may be unilateral or bilateral. There is often pain on manipulation of the elbow and a reduction in range of movement. There may be swelling of the elbow joint. The specific diagnosis can sometimes be made on x-ray examination, but more frequently the diagnosis relies on the presence of osteoarthrosis of the elbow joining which is the result of either a primary FCP and/or OCD. A variety of views can be used to examine the elbow joint and they may pick up the primary problem. It is more likely that OCD will be identified rather than FCP. Despite high quality x-rays, it is impossible to identify all FCP and OCD lesions without using special techniques and the diagnosis is based on the clinical findings and the radiographic changes of osteoarthrosis.

Ununited anconeal process can be managed by either removing the UAP or attaching it firmly to the ulna using a lag screw. The former is the simplest and normally gives excellent results. Fragmented coronoid process and OCD lesions may produce a temporary lameness that responds to rest or medical treatment. If the lameness persists then surgery is indicated. This involves a medial approach to the elbow joint on the opposite side to surgery for UAP, and both the medial coronoid process of the ulna and the medial condyle of the humerus must be examined carefully. One or both lesions may be present and they can cause "kissing lesions" on the opposite side of the joint. The surgical results vary with breed and age, but many dogs will settle satisfactorily.

The monitoring of elbow disease has been undertaken for some years now in some parts of the world, particularly on the Continent of Europe. The breeds which have serious problems with hip dysplasia appear to have elbow disease as an equally important problem. There have been a number of papers suggesting the UAP has an inherited basis, but little has been done to control it. It was only when studies on elbow arthritis indicated that elbow disease was inherited that action began to be taken to monitor its incidence.

Early work documented the presence of elbow arthritis, the secondary osteoarthritic change, and various workers graded the degree of change similarly to what was happening with hip dysplasia The increasing international awareness of the importance of elbow lameness in growing dogs led to the formation of the International Elbow Working Group. The aims of this group were to establish an internationally accepted radiological interpretation system and to encourage research into the cause(s) of the development of the primary problems. The working group is independent but has held its meetings in conjunction with the World small animal Veterinary Association conferences. It is growing in membership and recently played the major role at the meeting organized by the WSAVA and reported in the VCA gazette by Dr. Robert Zammit, the ANKC representative at the meeting.