12-week-old male intact Heading Dog – American College of Veterinary Radiology

VD radiographic projection of the pelvis with the pelvic limbs extended
Lateral radiographic projection of the pelvis
Lateral radiographic projection of the right pelvic limb

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A 12-week-old, 6 kg, male entire Heading dog was presented to the local clinic for evaluation of altered hindlimb gait.
The puppy had been in the owner’s possession for 2 weeks and appeared mostly normal except for notably sitting down more when playing with other dogs. No history of trauma or other past pertinent health issues were found. The puppy was fed a regular commercial diet for puppy growth from weaning and was fully vaccinated and up to date with preventative anti-parasiticides.
The owner described the initial gait as expected of a developing puppy. However, by the second week of ownership the owner elected for veterinary evaluation. As the puppy had been bred as a working farm dog, hip dysplasia was the main concern.
On physical examination, the puppy was bright, alert, and responsive. All vital signs were within reference limits and no abnormalities were found on thoracic auscultation. Palpation of the pelvic limbs revealed muscular atrophy of the right thigh. No focal pain and no restricted range of motion was found. Gait analysis revealed a grade 2/6 right pelvic limb lameness characterised by a short stance phase. No abnormalities were noted on assessment of the stifle or tarsus.
Three-view radiographs were performed under sedation with 10 mcg/kg medetomidine (Domitor®; Jurox, Australia) and 0.2 mg/kg butorphanol (Buprelieve®; Jurox, Australia) IM.

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The right femoral head and neck were missing. A well-defined, irregularly marginated concavity was present within the medial aspect of the right proximal femur, where the femoralneck should have been). A small ovoid mineral opacity was seen adjacent to the proximomedial aspect of the right femur.
The adjacent right acetabula was remodeled. Several pinpoint mineral opacities were seen adjacent to the right acetabulum. The left acetabular fossa was shallow, with reduced coverage of the left femoral head by the dorsal acetabular rim.
Moderate subluxation of femoral head was seen. Medullary sclerosis was noted within the proximal femur).
There was moderate muscular atrophy and foreshortening of the right pelvic limb.

The differentials for the radiographic findings initially included (1) past femoral head and neck ostectomy, (2) previous trauma or (3)congenital abnormality such as proximal femoral focal deficiency (PFFD).
Left hip dysplasia was also suspected.

Given the confirmation that no prior trauma or surgery had occurred, the diagnosis of PFFD was made based on radiographic appearance. PFFD is a rare, well-documented congenital disease within human literature (1,2). However, there is paucity within the veterinary literature, with scant documentation. Only two accounts have been identified thus far, once in 1978 and again in 2008 (3,4). The aetiology is thought to be congenital with no exact known cause.

Hillmann, J. S., Mesgarzadeh, M., Revesz, G., Bonakdarpour, A. K. B. A. R., Clancy, M., & Betz, R. R. (1987). Proximal femoral focal deficiency: radiologic analysis of 49 cases. Radiology, 165(3), 769-773.
Anton, C. G., Applegate, K. E., Kuivila, T. E., & Wilkes, D. C. (1999). Proximal femoral focal deficiency (PFFD): more than an abnormal hip. In Seminars in musculoskeletal radiology (Vol. 3, No. 03, pp. 215-225). © 1999 by Thieme Medical Publishers, Inc.
Battison, J. R. (1978). Proximal femoral focal deficiency in a Dalmatian pup. The Veterinary record, 102(4), 86-87.
Salavati, M. (2008). Proximal femoral focal deficiency(PFFD) in a young Doberman pinscher. Journal of Small Animal Practice, 49(9), 486-486.