Épicondylite médiale de l'humérus chez le chat: une cause sous-diagnostiquée de boiterie
L'épicondylite médiale de l'humérus (MHE) est une affection orthopédique courante mais souvent méconnue chez le chat, provoquant une boiterie chronique du membre thoracique.
Source: Clinician's Brief. Medial humeral epicondylitis (MHE) is an underdiagnosed orthopedic condition in cats caused by degeneration and mineralization of a tendon at the inner aspect of the elbow joint. Recent research suggests that approximately 10% of cats may be affected, yet the condition is frequently overlooked because cats are masters at hiding pain. MHE can affect cats of any age, including indoor cats with no history of trauma.
Points Clés
- MHE affects approximately 10% of cats but is frequently undiagnosed
- It causes chronic, progressive forelimb lameness — not sudden injury
- Indoor cats with no trauma history can still develop MHE
- X-rays may miss early cases; ultrasound or CT scans are more sensitive
- Mild cases may respond to rest and anti-inflammatory medication
- Surgery is often needed for moderate to severe cases and has good outcomes
What Is Medial Humeral Epicondylitis?
MHE involves degeneration and mineralization of the flexor carpi ulnaris tendon where it attaches to the medial epicondyle — a bony bump on the inner side of the elbow. Over time, the tendon deteriorates and calcium deposits form, causing pain and reduced mobility. In some cases, small mineralized fragments can break loose inside the joint, worsening inflammation and discomfort. Unlike a sudden injury, MHE develops gradually, which is why it's often missed until it becomes severe.
Signs to Watch For
The most common sign is a slow, progressive forelimb lameness that worsens over weeks to months. Your cat may be reluctant to jump, favor one leg, or show pain when the inner elbow area is touched. Some cats show thickening or a firm bump below the inner elbow. Cats with MHE may also have pain when bending or rotating the wrist. Because cats are adept at masking discomfort, many owners only notice when the lameness becomes pronounced. Indoor cats are just as susceptible as outdoor cats.
Diagnosis and Treatment
Your veterinarian will start with a physical examination and X-rays of the elbows. However, X-rays can miss early or mild MHE — ultrasound can detect fluid and early mineralization before X-ray changes appear, and CT scans can identify loose mineralized bodies inside the joint that influence treatment decisions. Mild cases may be managed with rest, anti-inflammatory medications, weight management, and restricted jumping for 2-4 weeks. If there's no improvement, or if the changes are moderate to severe, surgery is recommended to remove mineralized tissue and any loose bodies from the joint. Most cats recover well after surgery, with the majority becoming free of lameness within 8-12 weeks.
Long-Term Outlook
The prognosis for cats with MHE depends on the severity at diagnosis. Cats with mild radiographic changes have the best response to conservative management. For surgical cases, outcomes are generally excellent — studies show that approximately 77% of cats were completely free of lameness after surgery. Some cats may have residual mild lameness if concurrent osteoarthritis is present. Early detection is key, so don't dismiss a subtle limp in your cat as 'just getting older.'
Quand Aller chez le Vétérinaire
- Your cat has a persistent limp that lasts more than a few days
- Your cat is reluctant to jump or has stopped going to high places
- You notice swelling or a firm bump near the inner elbow
- Your cat flinches or pulls away when you touch the leg
- Indoor cats with unexplained forelimb stiffness
- Any forelimb lameness in a cat with no history of trauma
Comment le Centre Royal Peut Aider
RVC's experienced orthopedic team can diagnose and treat medial humeral epicondylitis and other joint conditions in cats using advanced imaging and surgical techniques. If your cat is showing signs of lameness, don't wait — early diagnosis leads to better outcomes. Call +853 6677 6611.
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