JOHN P. PUNKE, DVM 1,2 , DON A. HULSE, DVM, Diplomate ACVS 1,2 , SHARON C. KERWIN, DVM, MS, Diplomate ACVS 1,2 , LAURA E. PEYCKE, DVM, MS, Diplomate ACVS 1,2 , and STEVEN C. BUDSBERG, DVM, MS, Diplomate ACVS 1,2 1 Department of Small Animal Medicine and Surgery, University of Georgia, College of Veterinary Medicine, Athens, GA; and 2 Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University, Coll Vet Surg 2009 Feb 38 2 209-212 ABSTRACT Objective—To document cartilage damage associated with elbow lameness in dogs without radiographic signs. Study Design—Case series. Animals—Dogs (n=16). Methods—Medical records (November 2004–January 2006) of dogs with undiagnosed forelimb lameness localized to the elbow but without radiographic signs that had lesions identified by either computed tomography (CT) or nuclear scintigraphy and confirmed by arthroscopy were included. Signalment, duration of clinical signs before admission, surgical diagnosis, and treatment were recorded. Results—Sixteen dogs (10 left, 6 right elbows) were identified. Median age was 30.1 months and median duration of clinical signs before admission was 15.6 months. CT or scintigraphy were strongly suggestive of elbow pathology before confirmation by arthroscopy. Medial coronoid pathology was identified in every abnormal elbow and osteochondrosis dissecans in 2 elbows. Conclusions—Elbow pathology not associated with radiographic changes can be identified by CT and scintigraphy. Coronoid pathology is the most likely diagnosis. Clinical Relevance— Absence of radiographic signs in elbows with clinical signs of lameness should be evaluated with advanced imaging techniques (CT, scintigraphy) and arthroscopy to identify the cause of lameness.