Treatment of Proximal Hind-Limb Lameness in Cattle

Symposium on Bovine Lameness and Orthopedics

Treatment of Proximal Hind-Li mb Lameness in· Cattle

Dale R. Nelson, D.VM., M.S.,* and Stephen K. Kneller, D.V.M., M.S. t

The diagnosis and treatment of lameness in the more proximal regions of the hind limb always present a challenge to the veterinarian because of the difficulties involved in using clinical skills and ancillary tests in such a heavily muscled region. Hind-limb lamenesses are more common. Complete knowledge and understandin g of the mechanics and anatomy of the region are required in order to arrive at an accurate diagnosis. This article is organized to present the salient features of lameness in the various regions of the upper hind limb.

PELVIS

Fractures Fractures of the pelvis, except for the fractures of the tuber coxae, are rare in cattle. 6 •10· 15 The "'knocked-down hip," or fractured tuber coxae, rarely causes problems after the acute stages unless a sequestrum is produced. Removing the bone fragment eliminates the cause for the draining tract. For fractures to occur at other sites, there must be severe trauma, because the massive size of the bovine pelvis provides considerable protection to the bony elements. 6 Pelvic fractures should not be overlooked in "downer" cows, however. Rectal palpation and radiography aid diagnosis. Radiography of the Bovine Pelvis If a coxofemoral or pelvic injury is suspected, radiography can be very useful in establishing a prognosis to determine managemen t procedures. The large tissue mass causes some difficulty, but this difficulty can be overcome with diligence. If high-output equipment is available (at least 200 rnA From the Department of Veterinary Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana, Illinois *Associate Professor tDiplomate, American College of Veterinary Radiology; Associate Professor

Veterinary Clinics of North America: Food Animal Practice-Vol. 1, No. 1, March 1985

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Figure 1. A, A ventrodorsal pelvic radiograph of a 19-month-old Chianina bull that developed sudden lameness in the right rear limb. Separation and malalignment of the capital femoral epiphysis is evident because of the lack of continuity with the femoral neck (white arrow) compared with the same site on the left femur (black arrow). No clinical improvement was observed after 6 weeks. (The white artifacts are due to straw fragments in the cassette.) B, An oblique view of the right coxofemoral joint in part A. The malalignment of the femoral head with the neck is evident (arrow).

and 100 kVp) and high-efficiency screens, such as rare earth screens, are used, most cattle pelves can be radiographed rather easily. It is possible to build exposure with smaller machines by using multiple exposures, providing the animal does not move during the procedure or is in exactly the same position on all exposures. Because of the large mass, scatter radiation is considerable and will produce poor contrast on the radiograph. This can be alleviated somewhat by using a grid. Also, lesions in this area are often easy to interpret, which somewhat decreases the significance of lqss of contrast. Because of scatter radiation, these procedures produce higher radiation exposure in the immediate area; therefore, strict radiation safety procedures (for example, the clinician should wear a protective apron and maintain maximum distance from the radiation site during exposure) must be followed. Ropes and mechanical positioning aids are necessary. In small cattle, it is possible to prove coxofemoral luxation with a standing lateral view, but, most commonly, the animal must be placed in dorsal recumbency for radiography. A large udder presents additional soft-tissue interference, which can be minimized with oblique views. Femoral head and neck fractures, coxofemoral luxation, and pelvic fractures are rather easily confirmed by radiography (Figs. 1 to 7).

COXOFEMORAL JOINT Coxitis Inflammation of the coxofemoral joint is usually a result of degenerative joint disease and is rarely due to infections. 15 A slaughterhouse survey indicated that coxofemoral disease was second to stifle disease as a cause of hind-limb lameness. 48

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Figure 2. An oblique view of the right coxofemoral joint of a yearling Salers bull that was lame in the right rear limb for 8 months. Crepitation in the coxofemoral joint was evident on palpation. The right femoral head is misshapen and the acetabulum is shallow and irregular. These changes are most often the result of femoral head fracture of long duration.

Older cattle are affected with the degenerative form, and lameness can be present for months or years. Younger bulls may have coxofemoral degenerative joint disease, but hip dysplasia is usually the underlying cause. 46 Bilateral involvement is common. Muscle wasting is evident; however, disuse atrophy of muscles is common to many lamenesses. When standing, the stifles are rotated outward, whereas the hocks are turned inward. 15 There is a "rolling gait" with excessive lateral movement of the hind quarters and dragging of the hooves. 15•46 Crepitation may be felt over the greater trochanter or palpated by rectal examination when the animal walks or the leg is manipulated. Crepitation originating in the stifle must be distinguished from that in

Figure 3. An oblique radiograph of the left coxofemoral joint of a 6-year-old Holstein cow with acute lameness of the left rear limb. A pelvic injury was suspected because of softtissue swelling in the periacetabular area that was felt on rectal examination, although no crepitation was felt. The femoral head and neck lie beside the ilial shaft separated from the femoral shaft, indicating a coxofemoral dislocation as well as fracture of the femoral neck. Although lame, the cow was functioning adequately in the herd 4 months later.

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Figure Figure4.4. AAventrodorsal ventrodorsalpelvic pelvicradioradiograph graphofofananadult adultAyrshire Ayrshirecow cowthat thatwas wasprepresented sentedininrecumbency recumbencyand andunable unabletotorise. rise.The The right rightupper upperlimb limbexhibited exhibitedananabnormal abnormalrange range ofofmotion motionononpalpation palpationwith withnonoevidence evidenceofof crepitation. crepitation.The Theempty emptyacetabulum acetabulumis isvisible visible (arrows). (arrows). The Thefemoral femoralhead headis iscaudal caudaltotothe the acetabulum. acetabulum.

Figure Figure 5. 5. A, A, A A ventrodorsal ventrodorsal pelvic pelvic radiograph radiographofofan an8-month-old 8-month-oldPolled PolledHereford Herefordbull bull that that was was acutely acutely lame lame 11 month month previous previous toto admission; admission; itit gradually graduallyimproved improvedbut butwas wasstill still significantly significantly lame. lame. Gluteal Gluteal muscle muscle atrophy atrophywas wasevident evidenton onthe theleft leftside. side. The The left left femoral femoral head head compared compared with with the the right, right, isisnot notfully fullyininthe theacetabulum, acetabulum,and andthe the acetabulum acetabulum appears appears irregular. irregular. This This radiograph radiographwas was made madewith withthe thefemurs femursextended extendedcaudally. caudally. Note Note the the normal normal open open sutures sutures inin the the pubis pubisoverlying overlyingthe thecaudal caudalvertebra vertebraand andrectal rectalcontents contents (small (small arrows); arrows); also also note note those those asas inin the the acetabulum acetabulum between betweenthe theischium ischiumand andilium ilium(large (large arrows). arrows). B, B, A A ventrodorsal ventrodorsal view view of ofthe the left left coxofemoral coxofemoraljoint jointseen seenininpart partA.A.Note Notethat thatthe the femur femur is is cranial cranial in in aa "frog-leg" "frog-leg" position, position, which whichpermits permitsbetter bettervisualization visualizationofofthe thefemoral femoralneck neck as well well as as the the acetabulum. acetabulum. The The femoral femoral neck neckisisirregular irregularand andshortened, shortened,and andthere thereisismalalignmalalignment with with the the femoral femoral head. head. These Thesechanges, changes,along alongwith withthe theacetabulum acetabulumchanges changesand andsubluxation, subluxation, indicate indicate aa grave grave prognosis prognosis for for return return totofunction. function. The Theshape shapechange changeisissuspected suspectedtotobebedue duetoto a previous previous fracture fracture of of the the femoral femoral neck. neck.

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severe.4646 moresevere. becomesmore suddenlybecomes lamenesssuddenly moderatelameness Occasionally,aamoderate the hip. Occasionally, thehip. 46 48 • well.46,48 lesionsasaswell. degenerativelesions havedegenerative mayhave stifle,may thestifle, particularlythe joints,particularly Other Otherjoints, rapid. is course the and sudden is onset the form, the onset is sudden and the course is rapid. septic form, the septic With the With Infection felt. Infection notfelt. crepitationisisnot butcrepitation painful, but jointisispainful, hipjoint the hip ofthe Manipulation of Manipulation reticulamastitis, reticulometritis, mastitis, ofmetritis, resultof spread asas aa result may spread and may isis hematogenous hematogenous and one beone maybe jointmay hipjoint thehip calves, the Incalves, joints.1515In limbjoints. lowerlimb from lower orfrom peritonitis, peritonitis, or omphalophlebitis. byomphalophlebitis. affected by joints affected severaljoints ofseveral of Dysplasia Hip Dysplasia Hip Angus, Hereford, Angus, the Hereford, bullsofofthe beefbulls youngbeef lameness inin young hip lameness bilateral hip AA bilateral Kingdom, UnitedKingdom, theUnited observedininthe beenobserved hasbeen breedshas Charolaisbreeds andCharolais Galloway, and Galloway, 5 19 20 49 sporadic. and sporadic. lowand incidence isis low The incidence • • · The Australia.5 ,19,20,49 North and Australia. America, and North America, rapid whererapid husbandry,where intensivehusbandry, underintensive areunder involvedare animals involved the animals Usually, the Usually, 4646 Degenerative joint disease develops life. early in reached are gains weight weight gains are reached in early life. Degenerative joint disease develops usually areusually ageare yearsofofage under22years Bullsunder acetabulum.Bulls theacetabulum. ofthe dysplasiaof ofdysplasia becauseof because and geneand dominantgene bya adominant penetranceby incompletepenetrance withincomplete heritablewith affected. ItItisisheritable affected. 5 19 49 limited • • males.5 ,19,49 limited toto males.

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Luxation The femoral head may be displaced craniodorsally or caudoventrally to the acetabulum. 15•4°Craniodorsalluxation is more common. 15•40 Traction during dystocia frequently causes hip luxation in calves, whereas injury from slipping and falling is a common cause in adults. The affected leg appears shortened with craniodorsal dislocation, and the hock is higher than the opposite hock. The limb is rotated outward, and weight-bearing may be minimal. The gluteal region may be asymmetric and the distance between the greater trochanter and the ischium may be increased, but this can be hard to evaluate. Occasionally, the animal is recumbent and reluctant to get up. The animal may lie with the leg abducted. The femoral head is lodged in the obturator foramen with a caudoventral luxation. The leg may be rigidly extended and abducted from muscle spasm. Usually, affected cattle are "downers." Manipulation of the leg seems more painful than with caudodorsal luxation, and flexing of the leg is resisted. If the cow is raised with a hip lift, the affected leg is severely abducted and extended. Palpating over the greater trochanter while manipulating the lower leg may reveal crepitation and a greater range of motion of the proximal femur. In order to detect the femoral head grinding on the pelvis, sometimes pressure must be applied by cupping the hands over the greater trochanter while someone moves the leg. If the pelvis is palpated through the rectum during this procedure, crepitation may be felt more easily. Also, it may be possible to detect the femoral head in the obturator foramen from a caudoventral luxation. Evaluation of the leg length is difficult in adult cattle. Treatment of coxofemoral luxation will rarely be successful in "downer" animals. Cattle must be ambulatory before treatment for a successful outcome. This is true for many fractures, dislocations, and other leg injuries in this species. Closed reductions have been attempted for many years, but the success rate has been low. After 24 hours, the prognosis is increasingly guarded. 15 Failure in closed reduction has been attributed to the inability to confirm that the femoral head was actually replaced in the acetabulum. 10•40 Also, improper seating of the femoral head in the shallow acetabulum was caused by tissue fragments, fibrin, and blood clots. 4° Coxofemoralluxations in five calves and one cow were successfully replaced by open reductions. 40 An incision along the cranial border of the biceps femoris and superficial gluteal muscles and retraction of the muscles allow visualization of the coxofemoral joint. The joint capsule is incised, and tissue, fibrin, and blood are removed from the acetabulum. To effect reduction, traction is placed on the lower leg while the limb is rotated and abducted. The surgeon applies pressure to the greater trochanter in a caudoventral direction, and a bone skid is placed medial to the femoral head for leverage. Replacement of the caudoventral luxation has poor results, especially in adults, because it is mechanically difficult to apply traction in the proper direction to remove the femoral head from beneath the pelvis. 30•40 Slipped Capital Femoral Epiphysis Separation of the epiphysis is commonly associated with forced traction in dystocia10•17 and was the cause in 21 of 28 cases. 17 Breeds of beef cattle

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such as Charolais, Maine-Anjou, and Simmental that have greater muscle development and birth weight and, consequently, a greater risk of dystocia are particularly vulnerable. 46 Less frequently, slipped capital femoral epiphysis (SCFE) occurs in older animals because of trauma. A hip problem in a 19-month-old Chianina bull proved to be SCFE (see Fig. 1). 26 Calves may demonstrate a lameness of variable severity at birth. The animal will carry or drag the leg with minimal weight-bearing. Crepitus is palpable over the greater trochanter and, in chronic cases, there is muscle atrophy and sometimes varus deformity of the opposite leg. Treatment has included stall rest, excision arthroplasty, and open reduction with insertion of Knowles pins. 10, 17 Open reduction with Knowles pins has proved encouraging. 10 Fracture of the Femoral Neck Fracture of the femoral neck is not a common birth injury. Upper leg injuries resulting from forced traction in dystocia usually include SCFE, coxofemoral luxation, and fracture of the femur. Older calves are more commonly affected, and, occasionally, adults may be involved. Clinical signs resemble those of SCFE. Recent fractures may be treated successfully by placing a lag screw(s) across the fracture site. 37 STIFLE Anatomy The three patellar ligaments (medial, middle, and lateral) are tendons of insertion of the quadriceps femoris muscle. A large fat pad separates the ligaments and the joint capsule. The patella moves in the trochlear groove, although its shape does not conform to the groove, and the medial patellar ligament does not ride over the proximal end of the medial trochlear ridge during full extension as it does in horses. 15, 24 The collateral ligaments provide mediolateral stability to the stifle joint. The medal ligament is easily palpated behind the medial patellar ligament, whereas the lateral ligament is more difficult to locate, especially in beef cattle. The stifle joint is one of the weakest because of the incongruity of the bony surfaces and in no position are the bones in more than partial contact. 14 The menisci perform an important load-transmitting and energy-absorbing function, transmitting about 65 per cent of the weight-bearing load. 17 The horns of the medial meniscus are attached closely together in front of and behind the tibial spine. The horns of the lateral meniscus are more widely separated in attachment. The medial meniscus is less mobile owing to a firm attachment to the medial collateral ligament and a more prominent caudal meniscotibial capsular attachment. 21 However, the attachment to the medial collateral ligament may make it more vulnerable to injury than the lateral meniscus. 14 The lateral meniscus is more mobile for several reasons: the femoral ligament of the meniscus attaches to the femur, the action of the popliteal muscle, and there is a less extensive caudal meniscotibial capsular attachment. 21 The lateral side of the stifle joint has greater stability than the

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medial because of (1) the insertion of the long digital extensor muscle on the front of the lateral condyle, (2) the popliteal muscle, (3) the lateral collateral ligament, and (4) the attachment of the lateral patellar and lateral femoropatellar ligaments to the insertion of the biceps femoris muscle. The cranial cruciate liga1nent, which is lateral to the caudal ligament, originates on the anterior edge of the tibial plateau and attaches posteriorly in the femoral intercondyloid fossa. The caudal ligament begins at the posterior tibial plateau and inserts in the anterior region of the intercondyloid fossa. The cranial ligament is thinner and flattened, whereas the caudal ligament is thicker, shorter, and round. The joint capsule consists of two compartments (femoropatellar and femorotibial) that communicate through the medial femorotibial space. 13 •47 The lateral femorotibial space does not always communicate with the other spaces. 13· 15 Distension of the joint capsule with excessive synovial fluid may cause a bulge between the patellar ligaments despite the fat pad. Extensive diverticula extend proximally between the quadriceps femoris muscle and the femur and distally surround the tendon of the long digital extensor and peroneus tertious muscles. 9 Increased joint fluid may produce swellings of the diverticula that appear unrelated to the stifle joint. Arthrocentesis Two sites are necessary because the lateral femorotibial space does not always communicate with the other compartments. 15 The lateral space is entered behind the lateral patellar ligament with the needle directed caudally. 15 The other compartments may be sampled by inserting a long needle below the patella between the medial and middle patellar ligaments and directing it down toward the medial trochlear ridge. 15 A long needle (12 to 15 em) is necessary because of the fat pad. Another method is to insert the needle between the middle and medial patellar ligaments slightly above the tibial crest and direct it upward and backward. The normal quantity of synovial fluid is about 15 to 20 ml. 47 In rupture of the cranial cruciate ligament, 500 to 1000 ml may be removed. Visual examination and a Giemsa-stained film are most useful. 47 Color, turbidity, viscosity, and quantity and types of cells can be determined. A Gram stain of a centrifuged sample may reveal bacteria. A cloudy sample or clot indicates infection. Hemorrhage from trauma may cause a red or brown color, but the viscosity is normal. The total cell count is normally below 1000 cells per ml; polymorphonuclear cells usually constitute less than 10 per cent. 47 Radiography of the Stifle Lateromedial and posteroanterior views are preferred. The anteroposterior view is of limited value because the bony structures are closer to the anterior stifle surface and the machine, and positioning of the cassette is more difficult. Obtaining diagnostic radiographs can be difficult in adult cattle because the thickness of the joint and associated muscles requires more exposure; also, the relationship of the adjacent abdomen and udder causes problems in positioning the cassette in standing animals. Animals that are reluctant to bear weight on the affected limb are difficult to evaluate radiographically because weight-bearing is usually necessary to demonstrate mal-

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Figure 8. A, A lateral stifle radiography of an 11-month-old Guernsey heifer with a non-weight-bearing lameness of 3 days' duration. No drawer sign was elicited with the heifer standing because of swelling, pain, and lack of weight-bearing on the leg. Nearly all of the femoral condyles sit caudal to the tibial spines (arrow), indicating cranial cruciate ligament damage. This radiograph was made with forced weight-bearing on the limb that is not usually possible in larger cattle. B, A lateral view of the same stifle seen in part A that was made on the same day. In this figure, however, the animal was not bearing weight on the limb. Note that the femoral condyles sit in a more normal position centered over the tibial spines. Except for soft-tissue swelling, there is no evidence of degenerative or other diseases. The appearance of the tibial crest is normal in a young animal. Because of the radiographic evidence of cranial cruciate ligament rupture, imbrication was performed. The heifer was retained in the herd for several years.

alignment of the bones (Fig. 8). Also, there is increased muscle thickness in the flexed limb. It is preferable to place these animals in lateral recumbency and hold the leg in extension. Tranquilization is beneficial. A medialateral view may be a better choice in lateral recumbency. Upward Fixation of the Patella Because the medial patellar ligament in the cow does not normally lock over the proximal end of the medial trochlear ridge during extension of the limb as it does in the horse, abnormal conditions, such as sudden overextension of the stifle, are necessary to produce upward fixation. 15•24 Upward fixation, although it occurs infrequently in cattle in North America, is common in areas of the world where cattle are used as work animals. The limb will "catch" while it is fully extended; this is followed by an exaggerated motion during flexion that causes a jerky gait similar to stringhalt in horses. Normal steps may be interspersed with abnormal steps. If the animal is backed, the limb is dragged while held in extension. 15·24 Rarely, the leg will become locked in extension, as it does in ponies and horses. Occasionally, stretching of the patellar ligaments or muscle injury may produce mild, temporary signs and, in these animals, laxity of the patella can be determined by palpation. Normally, the patella is difficult to move by palpation in adult cattle.

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A medial patellar desmotomy is done in the standing animal to correct upward fixation. The ligament is transected near its insertion. Lateral Luxation of the Patella Lateral luxation is rare in cattle and is usually congenital. However, it must be differentiated from the luxation caused by atrophy of the quadriceps femoris muscle due to femoral nerve injury at birth. One or both legs can be affected, although unilateral involvement may not be obvious for some days after birth. A crouching stance with inward rotation of the stifles characterizes bilateralluxations. Some calves are unable to stand without help. In some, the patella can be repositioned easily, whereas in others, the leg must be fully extended to return the patella to its normal position. Surgical repair has involved imbrication of the medial femoropatellar ligament, but results have varied because of lateral tension on the patella from the biceps femoris tendon. 27 A procedure successfully used in foals and calves overcomes this problem by transecting the insertion of the biceps femoris muscle and origin of the lateral patellar ligament and releasing them from the patella. 27 However, this procedure will not correct luxations caused by atrophy of the quadriceps femoris muscle. Femoral Nerve Paralysis The femoral nerve is most commonly injured following forced traction in dystocia (usually anterior presentation); overstretching of the nerve results. 39 Less frequently, abscesses, neoplasia, incomplete vertebral fractures, and spondylomelitic lesions may damage the nerve. 39 The large beef breeds, such as the Charolais, Simmental, and Maine-Anjou breeds and their crossbreeds, are prone to dystocia from fetal oversize. One hypothesis proposes that the fetal stifles catch on the pelvic brim and the femurs are overextended, which causes severe stretching of the quadriceps femoris muscle and its neural and vascular supplies. 39 Usually, only one leg is affected. Calves are unable to support weight on the leg, and the hock and stifle are flexed while walking. Patellar luxation, either spontaneous or inducible, is observed. 30•39 Atrophy of the quadriceps muscle is evident by the sixth day a~d becomes progressively more apparent by 2 months of age. 34 This atrophy produces a '"hollowed-out" appearance between the femur and the tensor fascia latae muscle. Little can be done for nerve injury following dystocia, although regeneration of nerve and muscle tissue has been recognized in a calf by the sixth month after neuroectomy of the femoral nerve. 34 Degenerative Joint Disease Degenerative joint disease, or gonitis, is a chronic condition that is characterized by degeneration of articular cartilage accompanied by subchondral bone sclerosis and marginal osteophyte formation. 28 •42 It is most commonly seen in older cattle, especially bulls. Excessively straight-hocked animals are predisposed to stifle problems. 3 Straight stifles accompany straight hocks and '"use trauma" as well as aging make the stifle joint particularly vulnerable to degenerative changes.

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Manipulation of the affected joint is difficult and is usually accompanied by arthralgia with or without crepitus. Gross distension of the joint capsule is not a constant feature. 42 The periarticular tissues have gross thickening, which is evident if the width of the joint is compared. 44 The history may indicate an acute lameness, whereas radiographic changes are chronic. 3 Lameness may be evident in only one limb, but degenerative changes may have similar severity in both stifles. In horses, lameness is more often related to joint capsule pathology than to cartilage degeneration. 28 Gross pathologic changes have been described. 4 •28 •42 •47 Destruction of articular cartilage is the primary event in degenerative joint disease. Articular cartilage becomes yellow and soft and vesicles form and rupture, which results in depressions or erosions. Eburnation exposes subchondral bone. Grooving results from continued wear. Osteophytes and exostoses develop on the articular margins of the trochlea, condyles, patella, and tibial plateau. Mineralization also may occur at the insertions of the meniscal and cruciate ligaments. The joint capsule is thickened and may have areas of mineralization. The synovial villi are hypertrophied. Various degrees of meniscal damage may be seen. Radiographic changes are characterized by exostoses and osteophytes at the articular margins. 3 •4 Defects in the subchondral bone are sometimes visible. Mineralization of the joint capsule, the meniscal attachments, and cranial cruciate ligament insertions are seen. The pathogenesis of degenerative joint disease has been studied in bulls. 4 Initially, the meniscal attachments (usually of the lateral meniscus) tear and the meniscus is shredded. Loss of the meniscus allows instability of the joint. Degenerative changes in the articular cartilage follow. Subsequent damage to the other meniscus produces further joint instability. Cartilage degeneration becomes more severe, osteophytes develop at the articular margins, and mineralization of the joint capsule and ligaments occurs. The cranial cruciate ligament may rupture because of joint laxity. Clinical signs may be mild or absent until the cranial cruciate ligament ruptures when severe signs suddenly appear. Clinical signs suggest an acute injury, whereas joint lesions are very chronic. The disease is progressive. Aspirin and phenylbutazone may alleviate pain and reduce lameness. Infectious Gonitis Infection of the stifle joint is rare in adult cattle. Occasionally, a single stifle joint is infected in calves, but more often it is one of several joints that are infected as a result of omphalophlebitis or other systemic diseases. Out of 106 lame limbs from slaughtered feedlot cattle, 50 per cent were due to injury; 20 joints, mostly stifles, had fibrinous arthritis, and 25 joints had purulent arthritis. 22 In valuable animals, treatment consists of systemic and intra-articular antibiotics and joint lavage. If a single joint is involved, intensive therapy, including joint lavage, is more feasible and rewarding.

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Figure 9. A lateral radiograph of the stifle of a yearling Chianina bull purchased 8 weeks previously and lame in the right rear limb for 6 weeks. The right stifle was swollen. Irregular bone lysis is evident on the lateral epicondyle of the femur (black arrows). There also appears to be fragmentation of the lateral epicondyle (white arrows). These findings are typical of osteochondrosis. Based on the findings, the seller provided a replacement for the bull.

Osteochondrosis Osteochondrosis is a disturbance of cell differentiation in metaphyseal growth plates and articular cartilage. 32 Chondrocytes divide but do not mature and vesiculate, and the cartilage matrix does not calcify. The articular cartilage is thickened and may develop necrotic areas. Secondary changes occur in adjacent bone (Fig. 9). It is a disease that affiicts rapidly growing individuals, more commonly males. 32 Lesions have been reported on the humeral head, 35 distal radius, 35 lateral femoral trochlear ridge, 35 •50 lateral femoral condyle, 35 femoral and tibial condyles, 23 and occipital condyles. 23 Lesions are often bilateral. Lesions at the margins of joints often develop cartilage flaps, which may undergo ossification (osteochondtitis dissecans). Detachment of the flap produces a loose body within the joint (joint mouse). Elevated, depressed, or flap-like areas with intact surface cartilage are lesions of osteochondrosis, whereas degenerative joint disease lesions are roughened, fibrillated, eroded, or ulcerated. 50 Clinical signs, if present, are of a nonspecific stifle lameness. Lesions may heal or progress to degenerative joint disease. Surgical curettage of the lesions in the fe1noral trochlear ridge has been done in horses. 33 •38 Cranial Cruciate Ligament Rupture Rupture of the cranial cruciate ligament most commonly results from acute traumatic injury in adult dairy cows. In old cattle, particularly bulls, cranial cruciate ligament rupture (CCLR) is usually secondary to chronic degenerative joint disease. Young cattle seldom have CCLR. Lameness is usually moderate (lame, but weight-bearing). Cattle tend to stand with the fetlock slightly flexed and the heel raised. Weight-bearing is on the tip of the toe. The feet may be placed under the body. (These signs are also observed with foot diseases.) Sliding of the femoral condyles over the tibial plateau may be heard or felt when the animal is walking. There is excessive rotary motion in the stifle when the lower leg is manipulated. The tibial crest is more prominent, and periarticular swelling may be present.

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Joint fluid is increased in quantity (the color can be yellow, red, or brown), but viscosity is normal. A drawer sign can be used for diagnosis. A technique used in horses can be used in cattle. 1 Standing behind the animal, the hands are clasped over the tibial crest. Bracing the hock with the knees, the tibia is pulled backward with a quick motion to return the bones to their normal positions. A distinct movement of 2 to 3 em indicates the cranial cruciate ligament is ruptured. 47 In young or small cattle, the stifle can easily be pulled into an overextended position, and this can be mistaken for CCLR. The test is difficult to apply in standing animals if they will not support weight on the injured leg. The test may be done in lateral recumbency under tranquilization. 12 With the leg uppermost and held in moderate extension by an assistant, the tibia is pulled backward for a drawer sign. Severe distention of the joint capsule with synovial fluid may prevent a drawer movement until the fluid is drained to reduce pressure. Radiography aids in diagnosis of CCLR but is particularly important for prognosis. The animal may be radiographed while standing, but it must place weight on the leg to displace the joint alignment. Otherwise, tranquilization and lateral recumbency are necessary (see Fig. 8). On lateral view, both femoral condyles must be positioned so that they are superimposed or it will be misleading. The femoral condyles should be positioned behind the tibial spine in CCLR. A posteroanterior view may show changes in joint width, which indicates damage to the meniscus or collateral ligaments, but caution is needed for interpretation because of positioning variations. Mineralization of the joint capsule, meniscal attachments, and cranial cruciate ligament may be seen. Surgical procedures have been developed. Skin and fascial implants have been used for replacement of the cranial cruciate ligament. 16•18 The implants are drawn through channels that are drilled through the femur and tibia. The implants become firmly attached in the bone canals and maintain adequate size and strength to be functional as a ligament replacement. 16 An imbrication procedure has been used to reduce the laxity of the stifle joint after CCLR. 31 A series of Lembert sutures placed parallel to the lateral and medial patellar ligaments force the femur to maintain its position posteriorly on the tibial plateau. Medial Collateral Ligament Injury Injury to the medial collateral ligament is caused by acute trauma, such as slipping or being ridden during estrus. Medial collateral ligament injury seems more common in young cattle, particularly dairy heifers, whereas CCLR appears more commonly in adults. 30 Often the ligament is stretched rather than torn. The medial meniscus becomes detached from the medial collateral ligament, and the joint capsule is stretched. Laxity of the medial side of the stifle joint allows excessive movement of the medial meniscus and subsequent damage to the meniscus and the articular surfaces. Clinical signs of stifle injury with moderate lameness are seen. In addition, there are specific signs of medial meniscus and medial collateral ligament instability. The limb is kept in an abducted position to relieve pressure on the medial side of the stifle, and weight is placed on the medial

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claw when walking. If the leg is manually abducted, the width of the joint space is increased on the medial side. The medial collateral ligament is usually intact but is lengthened. The medial meniscus, palpated between the medial patellar ligament and medial collateral ligament, has excessive movement. The meniscus will move in and out of the joint when the lower leg is manipulated. In some, a finger may be inserted between the medial collateral ligament and medial meniscus. The joint space on the medial side may be increased if the limb is abducted for posteroanterior radiographs. Usually, no significant radiographic lesions are found. Stall rest for 4 to 6 weeks will usually improve less serious injuries. If there is no improvement, surgery may be attempted. 29 The medial joint space is incised, and the meniscus is secured with sutures to the joint capsule at the tibial articular margin. After the joint capsule is closed, the retinaculum is imbricated, and carbon fiber is implanted over the medial collateral ligament. Lateral Collateral Ligament Injury Injury to the lateral collateral ligament is much less common than to the medial collateral ligament. No age or sex incidence has been determined. Clinical signs of stifle injury are seen. There is a tendency to keep the leg adducted and to put weight on the lateral claw. If the lower leg is manipulated, lateral to medial movement is increased over the medial to lateral movement. Palpation of the lateral collateral ligament is difficult, so widening of the joint may not always be detected. Posteroanterior radiographs may show a wider lateral joint if the lower leg is adducted. Avulsion of the lateral collateral ligament from the femoral epicondyle has occurred in a Holstein heifer. 30 The stifle joint is stabilized by imbrication of the fascia over the lateral side. Usually, two rows of Lembert sutures over the lateral collateral ligament are adequate. Rupture of the Peroneus Tertious Muscle The peroneus tertious muscle inserts on the tarsus and proximal metatarsus and acts as a flexor of the hock. 13 Rupture occurs on the lateral side of the proximal tibia at or near the origin of the muscle. Overextension of the hock results. The stifle is "fixed" during movement, whereas the hock may be extended, and the foot is pulled forward with difficulty. Weight is supported on the leg while standing. A localized swelling may develop on the lateral side of the proximal tibia. By pulling the leg to the rear, the hock can be overextended; the tibia, metatarsus, and phalanges will form a straight line at a 90° angle to the femur. 15 The gastrocnemius tendon will be slack. Improvement often occurs with rest. A firm swelling may persist on the lateral side of the stifle and cause a slight lameness. Peroneal Nerve Paralysis The peroneal nerve innervates the flexor muscles of the hock and the extensor muscles of the digits. 13 The nerve is subcutaneous over the lateral

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femoral condyle and fibula; thus, it is vulnerable to injury, especially in "down" cattle. Animals will stand with weight on the limb until moving forward, when they will knuckle over at the fetlock as the leg is brought forward. The hock will be overextended, and the top (front) of the fetlock contacts the ground when walking. Most injuries are temporary. Nonsteroidal anti-inflammatory drugs may reduce swelling caused by trauma. A cast or support wrap on the lower leg will prevent injury to the fetlock. If the nerve is permanently damaged, surgical ankylosis of the fetlock joint will prevent the fetlock from "knuckling." Epiphyseal Separation Traumatic injury may cause separation of the distal femoral epiphysis and the proximal tibial epiphysis. Ossification is complete by 3~ to 4 years of age; 15 however, the oldest animal we have treated has been 30 months of age. 30 Separation of the proximal tibia is characterized by a Salter-Harris Type II fracture. 36 Crepitation may be produced by manipulation, but pain is not as evident as it is with a true fracture. The end of the femoral diaphysis may be palpated, and the patella lies below the end of the diaphysis. There is a medial deviation of the stifle with a proximal tibial epiphyseal separation. Diagnosis is made by radiography. Satisfactory repair presents problems in large animals, because the epiphyseal fragments are small and near the joint. Intramedullary pins have been used in the femur with poor success. 30 Screws and compression plates have been used in the tibia. Use of a Thomas-Schroeder splint or a cast with proximal tibial separation will permit healing; usually, however, an unsatisfactory valgus deformity of the stifle results.

HOCK Rupture of Gastrocenemius Muscle Struggling to rise following treatment for hypocalcemia is a common cause of rupture of the gastrocnemius muscle in dairy cows. Usually, the muscle bellies are torn, but, occasionally, the tendon may rupture or separate from the tuber calcis. Supporting weight on the leg is difficult, and, occasionally, cows are "downers." The hock is considerably lower than the opposite hock ("dropped hock"). The stifle is extended, and the hock is more flexed. The gastrocnemius muscle is swollen. Pain is not severe. Healing of the muscle bellies often leaves them lengthened and weakened so that the hock never returns to its normal position. Immobilizing the leg with a Thomas-Schroeder splint has not been highly successful. 30 Ruptured tendons may be repaired with carbon fiber. Radiographic Anatomy of the Bovine Tarsus Using the more commonly radiographed equine tarsus for comparison, the normal adult bovine tarsus appears unusual and more difficult to interpret

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Figure 10. Normal dorsoplantar (A) and lateral (B) tarsal radiographs of an adult Holstein cow. The separate lateral malleolus (arrow) is more evident in oblique views and should not be misinterpreted as a fracture fragment. Slight obliquity obscures the distal·intertarsal joint spaces (compare with Fig. 11).

(Fig. 10). The bovine bones have more sharp or pointed margins that may be misinterpreted as new bone formation. The joint spaces are more curved, making it more difficult to project an x-ray beam directly through joint spaces to produce clearly defined margins. Also, the bovine tarsus has a different bone fusion pattern than does the equine tarsus. The lateral malleolus (distal end of the fibula) is a separate entity associated with the distal lateral tibia and may be mistaken for a fracture. Rather than being fused with the second tarsal bone, as it is in the horse, the first tarsal bone is a small separate entity on the medial plantar surface. The second tarsal bone, however, is fused with the third tarsal bone, which is a separate wide, flat structure in the horse. The central tarsal bone, which is a separate wide rather flat bone in the horse, is fused in the bovine with the large fourth tarsal bone. If the veterinarian is familiar with equine tarsal radiographs, these variations can easily cause misdiagnosis of fractures, degenerative joint disease, and developmental abnormalities. Radiography of the opposite tarsus for comparison is very helpful. To avoid misinterpretation of widened joint spaces when dealing with immature

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animals, one must remember that the cartilaginous portion of the bones is much wider than in the adult. In a study of infectious arthritis involving mostly immature cattle, widened joint space was rarely found and was difficult to interpret. 42 Narrowed joint space was rare in the tibiotarsal joint and proximal intertarsal joint, but was more common in the distal intertarsal and tarsometatarsal joints, where it was seen both diffusely and at single sites. New bone formation was seen relatively evenly throughout the tarsus. Because of delay in bone production, no bony changes may be seen on radiographs until the disease has progressed for 1 to 2 weeks. A rather common finding with severe infection is subchondral bone lysis. Older cattle will often have a considerable amount of bone production owing to degenerative joint disease, which may or may not produce significant lameness. Tarsal Hydrarthrosis Tarsal hydrarthrosis is a chronic distension of the tibiotarsal and proximal intertarsal synovial sacs due to excessive transudative synovial fluid. 43 Hydrarthrosis is common in ..postlegged" cattle. Also, cattle confined in stanchions with little or no exercise are prone to tarsal joint distension, especially if they stand directly on concrete floors. Usually, little or no lameness is associated with excessive synovial fluid accumulation. Occasionally, stanchioned animals may tread with the hind limbs and lie down more. Aspiration of the fluid and intra-articular injection of corticosteroids will provide relief for several weeks or months. 43 The preferred site for arthrocentesis is the anteromedial aspect of the hock. 41 The joint capsule will often bulge on the medial side of the extensor tendons. If the bulge is not evident, pressure applied on the lateral side of the extensor tendon will bulge the joint capsule on the anteromedial side of the hock. Placing rubber mats or plywood sheets over concrete floors will reduce or prevent problems in stanchioned animals. An increase in exercise is important. Tarsitis Noninfectious arthritis of the tarsal joint often results from poor conformation ... Postlegged" cattle may develop hydrarthrosis and degenerative joint disease. Confinement and lack of exercise are also factors. Osteochondrosis has been reported on the distal tibial articular surfaces. 45 Infectious tarsitis may be one of several joints infected as a result of omphalophlebitis in calves or of systemic diseases in which polyarthritis is common. Infection of a single joint most often results from direct penetration of the joint or extension from tarsal cellulitis. Severe lameness, joint stiffness, pain on palpation and flexion, hyperemia, swelling, and systemic disturbances are seen. 15, 45 Arthrocentesis and radiography help in diagnosis. Bacterial culture is often unrewarding. Systemic and intra-articular antibiotics as well as joint lavage are beneficial in tarsal joint infections. Tarsal Cellulitis Cellulitis generally involves the lateral side of the hock. The tissue reaction is from continued minor irritation or trauma to the bony surface of the lateral hock. A false bursitis may be present. 15 One or both hocks are

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affected. Usually, confined cattle are involved. Hard floors with inadequate bedding or stalls of improper size are major factors in causing continual irritation. Gross swelling of the hock may appear in a few days or gradually develop over a longer time. The swelling may be discrete and well defined or diffuse. The skin is thickened. The swelling is often firm, but occasionally a hygroma or abscess may develop. A core of tissue in the center of the firm swelling may become necrotic, and a cavity may result. In some, the enlargement becomes infected, producing pain, swelling, and hyperemia. Extension of infection into the tarsal joint produces signs of infectious tarsitis. Cellulitis may extend above and below the tarsal joint. No lameness is usually evident unless the lesion is markedly enlarged or the lesion or the tarsal joint are infected. Satisfactory treatment is often difficult to achieve. The lesions are often more disturbing to the owner than to the animal. Reducing the size of the fibrous mass is difficult. Abscesses may be drained and necrotic tissue removed. Systemic antibiotics, nonsteroidal, anti-inflammatory drugs, local stimulants, and hydrotherapy are used, but response to treatment can be slow. If a herd problem exists, the housing facilities should be examined and all causative factors should be removed. Spastic Paresis Spastic paresis is a heritable disease of unknown etiology15 in which the stifle and hock are in severe extension from spastic rigidity of the gastrocnemius muscle and tendon. Clinical signs usually appear in calves between 6 weeks to 6 months of age, but older cattle have been affected. 11 •25 Although the etiology is unknown, it is believed that the lesions involve the central nervous system rather than the muscles or peripheral nerves. 3 Spastic paresis is also known as "Elso-heel," because early cases were descendants of a Friesian bull, "Elso II. " 7 •11 The mode of inheritance appears to involve multiple recessive genes with a weak inheritance pattern. 2•25 Strong interaction seems to exist between the genotype and environment. 2 Animals have abnormally straight hind limbs. The hock is overextended with the angle of the front of the hock approaching 180°, and the tuber calcis is nearly in contact with the tibia. 11 The pastern is straight, and the toe appears pointed. The back is arched, and the tail is raised. 11 Both legs may be affected, but often one leg is more severely affected. 11 The leg appears shortened, and, when the animal walks, the entire leg will swing forward, pendulum-like, from the hip; only the tip of the toe will contact the ground. 11 The toes may be rounded from wear. The limb may occasionally extend posteriorly in spasms. The joints may be readily flexed but will return to the extended position. 11 Palpation of the gastrocnemius muscle will reveal it to be in spasm and very firm. The space between the tuber calcis and tibia is greatly reduced. Radiographs reveal hyperextension of the hock. 7 The angle between the tuber calcis and tibia is markedly decreased. The distal tibial epiphysis is displaced cranially, whereas the diaphysis is displaced caudally. Osteoporosis and periosteal proliferations are seen on the distal tibial physeal plate. The

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Figure ll. A, A lateral left tarsal radiograph of a 1-year-old Angus bull with a history of stiff rear limbs since its purchase 60 days previously. There was excessively straight conformation of the rear legs. Weight was borne on the tip of the toe while walking and standing. The gastronemicus muscle was very firm. The angle between the tibia and the calcaneous is very acute, and the physis of the tuber calcus is widened, which is typical for spastic paresis. B, A lateral right tarsal view of the same animal in part A. The calcaneous appears normal. There is a small amount of degenerative change on the dorsal aspect of the distal intertarsal joint (arrow). This appearance of the distal tibial physeal area is normal for an animal of this age.

physeal plate of the tuber calcis is widened from tension of the tendons (Fig. 11).

Because the condition is heritable, animals should not be kept for breeding. N euroectomy of the branches of the tibial nerve innervating the gastrocnemius muscle may relieve muscle spasm. 7 •15·25 Tenotomy procedures involving the gastrocnemius and/or superficial flexor tendons have also been used. 7 •11 •15•25 Recently, lithium chloride has been used to relieve clinical signs. 2

REFERENCES 1. Adams, O.R.: Differential diagnosis of stifle lameness in horses. In Proceedings of the Nineteenth Annual Meeting of the American Association of Equine Practitioners, 1973. 2. Arnault, G. A.: Bovine spastic paresis. Bovine Pract., 18:236-240, 1983. 3. Bartels, J.E.: Femoral-tibial osteoarthritis in the bull: I. Clinical survey and radiologic interpretation. J. Am. Radiol. Soc., 16:151-158, 1975. 4. Bartels, J.E.: Femoral-tibial osteoarthritis in the bull: II. Correlation of the radiographic and pathologic findings of the torn meniscus and ruptured cranial cruciate ligament. J. Am. Radiol. Soc., 16:159-172, 1975.

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5. Carnahan, D.L., Guffy, M.M., Hibbs, C.M., et al.: Hip dysplasia in Hereford cattle. J. Am. Vet. Med. Assoc., 152:1150-1157, 1968. 6. Cox, V.S.: Pelvic fracture in a cow. J. Am. Vet. Med. Assoc., 172:1316-1317, 1978. 7. Denniston, J.C., Shive, R.J., Friedli, U., et al.: Spastic paresis syndrome in calves. J. Am. Vet. Med. Assoc., 152:1138-1149, 1968. 8. DeWulf, M., and DeMoor, A.: Surgical and biochemical research in spastic paralysis. In Proceedings of the Twelfth World Congress on Diseases of Cattle, 1982. 9. Dyce, K.M., and Wensing, C.J.G.: Essentials of bovine anatomy. Philadelphia, Lea & Febiger, 1971. 10. Ferguson, J. G.: Management and repair of bovine fractures. Compend. Con tin. Ed. Pract. Vet., 4:S128-S136, 1982. 11. Formston, C., and Jones, E. W.: A spastic form of lameness in Friesian cattle. Vet. Rec., 68:624-627, 1956. 12. Fritsch, V. R.: Kreuzbandruptur beim Rind. Berl. Munch. Tiedirtzl. Wochenschr., 78:366-368, 1965. 13. Getty, R.: The anatomy of the domestic animals. Volume I. Edition 5. Philadelphia, W.B. Saunders Co., 1975. 14. Gloobe, H.: The menisci of the stifle in cattle. Southwest. Vet., 29:132-135, 1976. 15. Greenough, P.R., MacCallum, F.J., and Weaver, A.D.: Lameness in cattle. Edition 2. Bristol, Wright-Scientechnica, 1981. 16. Hamilton, G. F.: Cruciate ligament repair in cattle. In Proceedings of the Seventh International Congress on Diseases in Cattle, 1970. 17. Hamilton, G.F., Turner, A.S., Ferguson, J.G., et al.: Slipped capital femoral epiphysis in calves. J. Am. Vet. Med. Assoc., 172:1318-1322, 1978. 18. Hofmeyr, C. F. B.: Reconstruction of the ruptured anterior cruciate ligament in the stifle of a bull. The Vet., 5:89-92, 1968. 19. Howlett, C. R.: Inherited degenerative arthropathy of the hip in young beef bulls. Aust. Vet. J., 48:562-563, 1972. 20. Howlett, C. R.: Pathology of coxofemoral arthropathy in young beef bulls. Pathol., 5:135-144, 1973. 21. Hulse, D.A., and Shires, P. K.: The meniscus: Anatomy function and treatment. Com pend. Contin. Ed. Pract. Vet., 5:765-774, 1983. 22. Jensen, R., Lauerman, L.H., Park, R.D., et al.: Limb arthropathies and periarticular injuries in feedlot cattle. Cornell Vet., 20:329-343, 1980. 23. Jensen, R., Park, R.D., Lauerman, L.H., et al.: Osteochondrosis in feedlot cattle. Vet. Pathol., 18:529-535, 1981. 24. Johnson, R., and Ames, N. K.: Upward fixation of the patella in a Holstein cow. Agri-Pract., 4:13-16, 1983. 25. Keith, J.R.: Spastic paresis in beef and dairy cattle. Vet. Med. Small Anim. Clin., 76:1043-1047, 1981. 26. Kneller, S.K., and Nelson, D.R.: Unpublished data. 27. Leitch, M., and Kotlikoff, M.: Surgical, repair of congenital lateral luxation of the patella in the foal and calf. Vet. Surg., 9:1-4, 1980. 28. Mcllwraith, C.W.: Current concepts in equine degenerative joint disease. J. Am. Vet. Med. Assoc., 180:239-250, 1982. 29. Nelson, D.R.: Surgery of the stifle joint in cattle. Compend. Contin. Ed. Pract. Vet., 5:S300-S309, 1983. 30. Nelson, D.R.: Unpublished data. 31. Nelson, D. R., and Koch, D. B.: Surgical stabilization of the stifle in cranial cruciate ligament injury in cattle. Vet. Rec., 111:259-262, 1982. 32. Olsson, S.E.: Osteochondrosis in domestic animals. Acta Radiol. [Suppl.], 358:9-14, 1978. 33. Pascoe, J.R., Pool, R.R., Wheat, J.D., et al.: Osteochondral defects of the lateral trochlear ridge ofthe distal femur ofthe horse. Vet. Surg., 13:99-110, 1984. 34. Paulsen, D.B., Noordsy, J.L., and Leipold, H.W.: Femoral nerve paralysis in cattle. Bovine Pract., 2:14-26, 1981. 35. Reiland, S., Stromberg, B., Olsson, S.E., et al.: Osteochondrosis in growing bulls. Acta Radiol. [Suppl.] 358:179-196, 1978. 36. Salter, R.B., and Harris, R.: Injuries involving the epiphyseal plate. J. Bone Joint Surg., 45:587-622, 1963.

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37. Smyth, G.B., Hatch, P., and Mason, T.A.: Surgical repair of femoral neck fractures in two dogs and a calf. Vet. Rec., 105:248-251, 1979. 38. Trotter, G. W., Mcllwraith, C. W., and Norrdin, R. W.: A comparison of two surgical approaches to the equine femoropatellar joint for the treatment of osteochondritis dissecans. Vet. Surg., 12:33-40, 1983. 39. Tryphonas, L., Hamilton, G.F., and Rhodes, C.S.: Perinatal femoral nerve degeneration and neurogenic atrophy of the quadriceps femoris muscle in calves. J. Am. Vet. Med. Assoc., 164:801-806, 1974. 40. Tulleners, E. P.: Coxofemoral luxation in a calf. Com pend. Con tin. Ed. Pract. Vet., 5:S273-S278, 1983. 41. VanPelt, R.W.: Arthrocentesis and injection of the bovine tarsus. Vet. Med., 57:125-132, 1962. 42. VanPelt, R.W., and Langham, R.F.: Degenerative joint disease in cattle. J. Am. Vet. Med. Assoc., 148:535-542, 1966. 43. VanPelt, R. W.: Evaluation of intra-articular injection of synthetic steroids in tarsal hydrarthrosis in cattle. J. Am. Vet. Med. Assoc., 153:446-453, 1968. 44. Vaughan, L.C.: Osteoarthritis in cattle. Vet. Rec., 72:534-538, 1960. 45. Verschooten, F., and DeMoor, A.: Infectious arthritis in cattle: A radiographic study. J. Am. Vet. Radial. Soc., 15:60-69, 1974. 46. Weaver, A. D.: Hip lameness in cattle. Vet. Rec., 85:504-512, 1969. 47. Weaver, A.D.: Disease of the bovine stifle joint. Bovine Pract., 7:41-46, 1972. 48. Weaver, A. D.: Slaughterhouse condemnations for the hind leg disease in cattle. Vet. Rec., 100:172-175, 1977. 49. Weaver, A.D.: Hip dysplasia in beef cattle. Vet. Rec., 102:54-55, 1978. 50. Weisbrode, S.E., Manke, D.R., Dodaro, S.T., etal.: Osteochondrosis, degenerativejoint disease and vertebral osteophytosis in middle-aged bulls. J. Am. Vet. Med. Assoc., 181:700-705, 1982. Department of Veterinary Clinical Medicine College of Veterinary Medicine University of Illinois Urbana, Illinois 61801