Diagnosis of FCP can be challenging. Initially, careful orthopaedic examination will usually reveal varying degrees of joint thickening, pain on joint manipulation and loss of range of motion. However, occasionally no abnormalities will be present on examination. Xrays (radiographs) will often reveal early changes consistent with osteoarthritis.
However, X-rays rarely actually show the FCP or fissure itself and sometimes therefore are of limited value in the diagnosis of FCP. By the time there are significant changes on x-rays there may already be damage to the cartilage within the joint. In fact, recent studies have confirmed that there can be severe cartilage damage in a joint despite normal x-rays. The FCP fragment or fissure can almost always be seen on a CT scan.
We recently installed a CT scanner and this procedure can now be performed in house. However, a CT scan is purely an aid to diagnosis and does not provide an opportunity for treatment. Furthermore, a CT scan does not reveal the condition of the cartilage within the joint. Arthroscopic view of FCP (arrow) CT scan of elbow showing FCP.
Arthroscopy (insertion of a videoendoscopic camera) of the elbow is an ideal method to investigate elbow lameness and aids the diagnosis of FCP/fissure. Unlike a CT scan, it allows accurate visual inspection of the cartilage and treatment (usually removal) of the FCP. Sometimes, traditional surgery to diagnose FCP can be utilised and a small incision allows inspection of the area of the coronoid process. If the coronoid process is deemed to be diseased then it may be then removed through the small surgical incision.