A Proposed Radiologic Scoring System for Shoulder and Elbow Osteoarthritis in Geriatric Nonhuman Primates
American Association of Zoo Veterinarians Conference 2019
Megan E. Freeman1, DVM; Sophie Dennison2, BVM&S, DACVR; Cora L. Singleton3, DVM, DACZM
1Oradell Animal Hospital, Paramus, NJ, USA; 2TeleVet Imaging Solutions, PLLC, Oakton, VA, USA; 3San Diego Zoo, San Diego Zoo Global, San Diego, CA, USA


Shoulder and elbow osteoarthritis (OA) can be a debilitating and painful disease. In humans, pain experience is complex and multifactorial.4 Nonhuman primates are likely similarly affected by OA but radiologic assessment of OA is subjective and pain determination is challenging.

This study proposes a standardized index for objective radiologic evaluation of osteoarthritic changes of the shoulder joint and elbow joint of nonhuman primates. Ideal joint positioning for different imaging modalities is defined. After review of human OA scoring systems,1-3 four hallmark radiologic features are selected for evaluation of the shoulder and elbow joints: joint space narrowing, subchondral sclerosis, osteophyte formation, and intra-articular loose body formation. Each joint is scored for each of these four parameters on a five-point scale. Total score for each joint is used to classify the joint as having absent, mild, moderate, severe, or profound osteoarthritis.

A standardized OA scoring system will facilitate thorough evaluation and documentation of joint changes over time. Scores for shoulder and elbow OA can be combined with OA scores for hips, knees, and spine to give an overall assessment of degenerative changes that may cause pain and impact mobility. With heightened awareness of indicators of early OA, targeted medical, behavioral, environmental, and physical interventions may improve animal comfort and welfare and ideally slow the progression of this debilitating disorder.


The authors thank Dr. Melissa King-Smith and Dr. Emmanuelle Furst for their development of osteoarthritis scoring systems for the hips/knees and spine, respectively.

Literature Cited

1.  Adla DN, Stanley D. Primary elbow osteoarthritis: an updated review. Shoulder Elbow. 2011;3:41–48.

2.  Dalal S, Bull M, Stanley D. Radiographic changes at the elbow in primary osteoarthritis: a comparison with normal aging of the elbow joint. J Shoulder Elbow Surg. 2007;16:358–361.

3.  Hawi N, Magosch P, Tauber M, Lichtenberg S, Martetschlager F, Habermeyer P. Glenoid deformity in the coronal plane correlates with humeral head changes in osteoarthritis: a radiographic analysis. J Shoulder Elbow Surg. 2017;26:253–257.

4.  Pan F, Jones G. Clinical perspective on pain and pain phenotypes in osteoarthritis. Curr Rheumatol Rep. 2018;20:79.


Speaker Information
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Megan E. Freeman, DVM
Oradell Animal Hospital
Paramus, NJ, USA

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