Elbow dysplasia is a disease that has an early onset in dogs. When a small puppy the disease crops up but continues to trouble the animal for the rest of its life. It is an inherited disease that affects intermediate as well as large breed dogs like German Shepherds. It happens to be the cause of front leg lameness in German Shepherd dogs (approximately 15-20% of dogs are victims of elbow dysplasia).
How elbows are graded, and the number to ask a breeder for
Unlike hips, which have a seven-point scale, elbows are graded on a short one. OFA sets it out as follows (OFA, retrieved 2026-08-12):
| Grade | What the radiologist sees |
|---|---|
| Grade I | “Minimal bone change along anconeal process of ulna (less than 2mm)” |
| Grade II | “Additional bone proliferation along anconeal process (2-5 mm) and subchondral bone changes (trochlear notch sclerosis)” |
| Grade III | “Well developed degenerative joint disease with bone proliferation along anconeal process being greater than 5 mm” |
A normal elbow gets no grade at all. Grades I to III describe increasing amounts of arthritic change, and they are measured in millimetres of new bone.
The age rule matters when you are buying a puppy. OFA states that “the OFA will not certify a normal elbow until the dog is 2 years of age” (retrieved 2026-08-12). So a breeder showing you elbow results on an eighteen-month-old dog is showing you a preliminary reading, not a certification. That is not dishonest, but it is worth knowing which one you are looking at.
On the imaging itself, OFA “requires the extreme flexed medial to lateral view” (retrieved 2026-08-12). It is a specific positioning, which is why elbow screening is a deliberate procedure rather than something read off a general X-ray taken for another reason.
It is not one disease, it is three
This is the thing that confuses most owners, and getting it straight makes every later conversation easier.
The Orthopedic Foundation for Animals describes elbow dysplasia as “a general term used to identify an inherited polygenic disease in the elbow”, adding that “three specific etiologies make up this disease and they can occur independently or in conjunction with one another” (OFA, retrieved 2026-08-12).
The three OFA lists are:
| Abbreviation | What it is |
|---|---|
| FCP | Pathology involving the medial coronoid of the ulna, usually called a fragmented coronoid process |
| OCD | Osteochondritis of the medial humeral condyle in the elbow joint |
| UAP | Ununited anconeal process |
So “elbow dysplasia” tells you which joint is affected. It does not tell you what is wrong inside it, and a dog can have more than one of the three at once.
Two practical consequences. First, ask your vet which of these your dog has, because the surgery and the outlook differ. Second, if you have already read our article on osteochondritis dissecans, note that OCD in the elbow is simultaneously its own condition and one of the three components of elbow dysplasia. That is not a contradiction, it is just how the naming works.
The word “polygenic” matters
OFA calls elbow dysplasia an “inherited polygenic disease” (retrieved 2026-08-12). Polygenic means many genes contribute rather than one, which has two consequences worth understanding.
There is no DNA test for elbow dysplasia the way there is for degenerative myelopathy or hemophilia A. You cannot swab a cheek and get an answer. Screening is done by X-ray, on the actual joint.
And because environment contributes too, two puppies from the same litter can end up in different places depending on growth rate, weight and exercise. Genetics loads the dice. It does not throw them for you.
Elbow Dysplasia Explained
Elbow dysplasia, as the name suggests, relates to abnormal development of the elbow , especially the joints are affected. In major cases, both elbows are affected but unilateral elbow dysplasia cannot be ruled out. The ultimate result is severe arthritic change following elbow incongruities and bony chips or fragments.
The lameness in the leg arises from three different kinds of conditions, viz: Fragmentation of Medial Coronoid Process (EMCP) Osteochondritis Dissecans of Medial Humoral Condyle Non-joining of Anconeus Process (NJAP)
Within the first few months (fifth to twelfth) the puppies are vulnerable to this disease. In the body of a puppy, there are innumerable bone pieces with cartilage separating them. The formation of the long bone of the limbs, as the puppy grows, is interesting. The cartilage starts changing into the bone and all other minute bone pieces fuse to form an entire bone. For example, the ulna bone in the forearm is the combination of 4 bone pieces fused into one.
It will be interesting to delve further deep. The elbow joint is primarily composed of three bones , the radius, the humerus, and the ulna. For proper elbow functioning, all these three needs to fit in perfectly. The radius is the main weight bearer of the arm. The ulna acts as a lever arm for the extensor muscles of the elbow joint. In a normal elbow, the medial coronoid process of the ulna bone sits either at level or slightly below the surface of the radius. But in the case of the dysplastic elbow, the ulna position is above the level of the adjacent radius. It creates a step that is incongruous and thereby restricts the smooth transition between the two bones. In such a position the ulna is forced to take the weight-bearing force and logically the pressure increases on the medial coronoid process. The ultimate result is the fragmentation of the coronoid. Usually, the fragmentation replicates the size of the rice grain. Incomplete fragmentation results in the formation of fissures. Lesions might be preset on the humeral articular surface as well OCD (Osteochondritis Dissecans) or cartilage flap. Bone joints covered by cartilage fail to rub smoothly since the joint fluid starts leaking through the cracks, fractures, and fissures of the cartilage. This leakage causes pain because lubrication lessens.
Clinical Signs and Symptoms
The clinical symptoms of the disease are intermittent lameness and severe crippling, depending on the degree of the disease. The front legs of the dog show an abnormal posture and gait. The elbows are either stuck out or tucked in and the dog stands in a position of feet rotated outward. Swelling and grating are the other signs of the disease.
Puppies with elbow dysplasia are tagged as lazy because they prefer idling; even if they play it for a short duration. If both legs hurt the limp is occasional because the puppy manages its gait and stance by manipulation of elbows by shifting weight from one elbow to the other.
Breed of Dogs Affected by the Disease
German Shepherd dogs along with Bernese Mountain Dog, Golden Retrievers, Rottweilers, and Labrador Retrievers top the list of patients. Many other breeds of dogs are affected too , they are Saint Bernard, Mastiff, Springer Spaniel, Newfoundland, Chow Chow, Shar-Pei, Australian Shepherd, Terrier, and Shetland Sheepdog.
Is the Disease Genetic?
Just like hip dysplasia, elbow dysplasia depends on the genetic makeup of the body. Genetic pattern decides the development of cartilage degeneration (osteochondritis) and poor elbow joint. Hormones too play a part and it has been seen that male dogs are affected more than females. The reason is testosterone which enhances bone growth and ossification.
Hence an examination preceding the breeding procedure is helpful since the disease is genetically transmitted. Dogs with the best elbows can be chosen for the purpose of breed propagation. Genetic technology is best utilized to bring down the number of afflicted patients in the canine population.
How to Find the Disease?
Radiograph X-ray technique helps diagnose the incongruity and abnormalities of the elbow joint. It can detect the smallest fragments, lesions, and joint modifications. Magnetic Resonance Imaging or scanning is ideal for assessing lesions affecting the cartilage.
Treatment of Elbow Dysplasia
Elbow dysplasia is usually treated through the combined action of medicines and surgery. The objective is to relieve pain and maintain the proper functioning of the limb. Surgery is suggested before arthritic change starts taking place. There are two options for surgery with similar results, the traditional one and arthroscopy. Medical therapy includes weight management, a moderate amount of exercise, and pain-killing, anti-inflammatory medicines (NSAIDs). Natural vitamin supplements are gaining popularity because many pet owners do not like to take the risk of liver failure associated with NSAIDs. Since the disease is progressive, one can expect improvement but not normality. Managed hydrotherapy can prove to be an effective treatment for canine elbow dysplasia.
Treatment has to be coupled with environmental factors; diet being one of the crucial aspects. Overfeeding and excess calcium intake (hyper-calcification) are not desirable. A deficiency of Vitamins is one of the major causes of the dysplastic elbow in GSD and other canine breeds.
What it looks like at home
Elbow dysplasia usually announces itself in the first year, and often in both front legs, which is precisely why it can be missed.
The bilateral trap. A dog lame on one leg limps obviously. A dog sore in both elbows does not limp; it just moves oddly. Owners describe a shortened, pottery stride, a dog that seems stiff rather than lame, or one that tires early and lies down at the park. Because there is no limp to point at, this often gets read as laziness or bad manners.
Things worth noticing:
- Stiffness after rest that eases as the dog warms up, then worsens again after a big day.
- Front-leg lameness that comes and goes, or swaps sides.
- Elbows held slightly out from the body, or paws turned outward when standing.
- Reluctance to go down stairs specifically. Descending loads the front legs hardest.
- Not wanting the elbow handled, or reacting when it is flexed fully.
What you can control while a puppy grows
You cannot change the genetics of the dog you already have. You can change the load on the joints while they form.
- Keep the puppy lean. This is the single biggest lever, and it stays true for the whole of the dog’s life.
- Use a large-breed puppy diet and follow the guide. As with OCD, VCA notes developmental joint disease is more common in dogs “receiving too much energy, protein and calcium in the diet” (VCA Animal Hospitals, retrieved 2026-08-12). Do not add calcium to a complete diet.
- Limit repeated high-impact work while growth plates are open. Long ball sessions, jumping out of cars and stair sprints all load young elbows.
- Provide traction indoors. Slipping on hard floors is repeated small trauma.
- Do not swing to the opposite extreme. A growing dog needs movement to build the muscle that supports its joints. Steady, moderate, varied.
If you are buying a puppy
- Ask for elbow results on both parents, with the certificate numbers. Numbers can be looked up; a photo of a form cannot.
- Check the dogs were at least 2 years old at certification, per OFA’s rule.
- Ask about hips in the same breath. They are screened separately and both matter in this breed. See our hip dysplasia guide.
- Ask what happened in previous litters. A breeder who follows up puppies will know.
- Do not accept “the parents are fine” as an answer. Fine is not a grade.
One last point that is easy to miss. Elbow dysplasia is frequently bilateral, so if one elbow is affected it is worth asking whether the other has been imaged as well. Treating one side while the other quietly deteriorates is a common way to end up disappointed with the result.
And if your dog is already diagnosed, that is not a catastrophe. Plenty of dogs with elbow dysplasia live comfortable lives with weight control, sensible exercise and pain relief when needed. What changes outcomes is starting that management early rather than after the arthritis has set in. Our care guide covers the long game.
Elbow and hip dysplasia are often discussed together. Read where both fit among the breed’s common problems.
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