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Arthroscopy allows the direct inspection of the joint surfaces and remains the golden standard for the evaluation of cartilage lesions. However, some lesions may be missed: subchondral bone cracks may not show as a cartilage lesion and large displaced fragments may not be visible. The combination of CT and arthroscopy increases the diagnostic accuracy in many cases.
Because of the small size of the joint, ultrasonography (limited acoustic window) and MRI (limited bone detail and lack of distinction between the cartilage of the humerus, ulna and radius) are less useful in the diagnosis of MCD.
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Van Ryssen B, de Bakker E, Baumlin Y, Samoy Y, Van Vynckt D, Gielen I, van Bree H. Primary flexor enthesopathy of the canine elbow: imaging and arthroscopic findings in 8 dogs with discrete radiographic changes. Vet Comp Orthop Traumatol 2012;25:239-245.
Vermote K, Bergenhuyzen A, Gielen I, van Bree H, Duchateau L, Van Ryssen B. Elbow lameness in dogs of six years and older: arthroscopic and imaging findings of medial coronoid process disease in 51 dog. Vet Comp Orthop Traumatol 2010;23:43-50.
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An Urban Experience

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