Content continues after advertisement


Mary Sarah Bergh, DVM, MS, DACVS, DACVSMR, Iowa State University


|August 2015|Peer Reviewed

Sign in to Print/View PDF

Panosteitis is a disease of the medullary bone that begins with adipocyte degeneration, intramembranous ossification, and bony remodeling that results in medullary fibrosis and periosteal/endosteal new bone formation; it should be considered a differential for any lameness in a young dog.

Clinical Signs

Panosteitis usually affects rapidly growing large- and giant-breed dogs, typically between 5 and 12 months of age, although it has been reported in dogs as old as 5 years of age.1,2 Some studies have found that German shepherd dogs and male dogs are overrepresented.1-3

Panosteitis causes an acute onset of lameness unaffected by rest or activity. Lethargy and inappetence can be seen for a few days at onset. More than 1 bone may be affected at a time. Clinical signs can commonly regress spontaneously in 1 limb and then occur in other limbs, causing a characteristic shifting leg lameness.

Related Article: Top 5 Juvenile Orthopedic Conditions


A thorough physical and orthopedic examination is important, as other orthopedic diseases (eg, osteochondrosis, hypertrophic osteodystrophy) may be similar to signs of panosteitis and, in some cases, occur concurrently.

Pain on direct palpation of the diaphysis of long bones is characteristic of panosteitis. The ulna is most commonly affected, followed in frequency by the radius and humerus.1 Radiographs should be obtained to confirm diagnosis and rule out other pathologies.

Radiographic signs of panosteitis frequently lag days to weeks behind clinical signs.1,3 The earliest radiographic sign of panosteitis is a decrease in opacity around the nutrient foramen. Later signs include an increase in mineral opacity within the medullary canal of long bones and loss of the normal trabecular bone pattern (Figure 1). Smooth periosteal and endosteal new bone may also be seen in more severe cases (Figure 2). Radiographs of the affected limb may be compared with those of the contralateral limb to assist in diagnosis. Nuclear scintigraphy may assist in diagnosis in cases in which radiographic changes have not yet developed.4

Related Article: Medial Compartment Disease of the Elbow


Although the underlying pathogenesis of the condition is unknown, panosteitis is a self-limiting disease and resolves on its own. During episodes of pain and lameness, analgesia may be provided with NSAIDs, tramadol, narcotic analgesics, or gabapentin.

Related Article: Lyme Disease in Dogs


Episodes of pain and lameness from panosteitis last 2 to 5 weeks in each affected bone. It may recur until the patient is about 2 years of age, after which there are typically no long-term sequelae.1,3 For each recurrence of clinical signs, panosteitis should be confirmed through clinical examination and radiography to rule out other orthopedic causes.

References and Author Information

For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

All Clinician's Brief content is reviewed for accuracy at the time of publication. Previously published content may not reflect recent developments in research and practice.

Material from Clinician's Brief may not be reproduced, distributed, or used in whole or in part without prior permission of Educational Concepts, LLC. For questions or inquiries please contact us.


Clinician's Brief:
The Podcast
Listen as host Alyssa Watson, DVM, talks with the authors of your favorite Clinician’s Brief articles. Dig deeper and explore the conversations behind the content here.
Clinician's Brief provides relevant diagnostic and treatment information for small animal practitioners. It has been ranked the #1 most essential publication by small animal veterinarians for 9 years.*

*2007-2017 PERQ and Essential Media Studies

© 2023 Educational Concepts, L.L.C. dba Brief Media ™ All Rights Reserved. Terms & Conditions | DMCA Copyright | Privacy Policy | Acceptable Use Policy