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Faulkner JE, Joostens Z, Broeckx BJG, Hauspie S, Mariën T, Vanderperren K. Auxiliary osseous findings in fetlocks of non-racing sports horses with sagittal groove disease of the proximal phalanx on low-field magnetic resonance imaging. Equine Vet J 2024. [PMID: 38840437 DOI: 10.1111/evj.14111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 05/13/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Sagittal groove disease of the proximal phalanx in equine athletes is commonly considered a bone stress injury. Repetitive hyperextension of the fetlock under high load is thought to contribute to its development. Concurrent changes are often reported in the dorsal sagittal ridge of the third metacarpus/metatarsus (MC3/MT3). OBJECTIVES To describe the spectrum of associated osseous abnormalities that are present in the fetlock in a large group of horses diagnosed with sagittal groove disease on low-field magnetic resonance imaging (MRI). STUDY DESIGN Retrospective, cross-sectional. METHODS MRI images of horses diagnosed with sagittal groove disease at Equitom Equine Clinic between March 2014 and March 2023 were evaluated using semi-quantitative grading schemes and a sagittal groove disease MRI classification system. RESULTS MRIs of 132 limbs were evaluated, predominantly from warmbloods used for showjumping (n = 83) and dressage (n = 18). Osseous densification and bone oedema-like signal grades were higher in the dorsal sagittal ridge than palmarly/plantarly (p < 0.001 and p < 0.05, respectively). Grades of both osseous densification and bone oedema-like signal in the dorsal sagittal ridge did not significantly differ between the different sagittal groove disease MRI classifications (both p > 0.05). MAIN LIMITATIONS Inclusion based on original MRI reports, absence of control group, small numbers within some grading groups hindering statistical analyses. CONCLUSIONS Findings support the aetiological theories of chronic bone-stress due to loaded fetlock hyperextension however the severity of osseous changes of the dorsal sagittal ridge does not appear to be associated with the severity of sagittal groove disease classification.
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Affiliation(s)
- Josephine E Faulkner
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Zoë Joostens
- Equine Diagnostic Centre, Equitom Equine Clinic, Lummen, Belgium
| | - Bart J G Broeckx
- Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Stijn Hauspie
- Equine Diagnostic Centre, Equitom Equine Clinic, Lummen, Belgium
| | - Tom Mariën
- Equine Diagnostic Centre, Equitom Equine Clinic, Lummen, Belgium
| | - Katrien Vanderperren
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Lin ST, Bolas NM, Sargan DR, Restif O, Peter VG, Pokora R, Patrick H, Foote AK, Murray RC. Comparison of cone-beam and fan-beam computed tomography and low-field magnetic resonance imaging for detection of proximal phalanx dorsoproximal osteochondral defects. Equine Vet J 2024; 56:484-493. [PMID: 37488678 DOI: 10.1111/evj.13973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/28/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Dorsoproximal osteochondral defects commonly affect the proximal phalanx, but information about diagnosis on computed tomography (CT) and magnetic resonance imaging (MRI) is limited. OBJECTIVES To assess CT and MRI diagnoses of osteochondral defects, describe the lesions and compare sensitivity and specificity of the modalities using macroscopic pathology as gold standard. STUDY DESIGN Cross-sectional study. METHODS Thirty-five equine cadaver limbs underwent standing cone-beam CT (CBCT), fan-beam CT (FBCT), low-field MRI and pathological examination. CT and MR images were examined for proximal phalanx dorsomedial and dorsolateral eminence osteochondral defects. Defect dimensions were measured. Imaging diagnoses and measurements were compared with macroscopic examination. RESULTS Fifty-six defects were seen over 70 potential locations. On CBCT and FBCT, osteochondral defects appeared as subchondral irregularity/saucer-shaped defects. On MRI, osteochondral defects were a combination of articular cartilage defect on dorsal images and subchondral flattening/irregularity on sagittal images. Subchondral thickening and osseous short tau inversion recovery hyperintensity were found concurrent with osteochondral defects. Compared with pathological examination, the sensitivity and specificity of diagnosis were 86% (95% confidence interval [95% CI] 75%-93%) and 64% (95% CI 38%-85%) for FBCT; 64% (95% CI 51%-76%) and 71% (95% CI 46%-90%) for CBCT; and 52% (95% CI 39%-65%) and 71% (95% CI 46%-90%) for MRI. Sensitivity of all modalities increased with defect size. Macroscopic defect dimensions were strongly correlated with CBCT (r = 0.76, p < 0.001) and moderately correlated with FBCT and MRI (r = 0.65, p < 0.001). Macroscopic measurements were significantly greater than all imaging modality dimensions (p < 0.001), potentially because macroscopy included articular cartilage pathology. MAIN LIMITATIONS Influence of motion artefact could not be assessed. CONCLUSIONS Osteochondral defects could be visualised using both CT and MRI with sensitivity increasing with defect size. Diagnostic performance was best using FBCT, followed by CBCT then MRI, but CBCT-measured defect size best correlated with macroscopic examination. MRI provided useful information on fluid signal associated with defects, which could represent active pathology.
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Affiliation(s)
- Szu-Ting Lin
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | | | - David R Sargan
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Olivier Restif
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Vanessa G Peter
- Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK
| | - Rachel Pokora
- Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK
| | | | | | - Rachel C Murray
- Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK
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Faulkner JE, Joostens Z, Broeckx BJG, Hauspie S, Mariën T, Vanderperren K. Low-field magnetic resonance imaging of sagittal groove disease of the proximal phalanx in non-racing sport horses. Equine Vet J 2024. [PMID: 38566459 DOI: 10.1111/evj.14088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Injuries of the sagittal groove of the proximal phalanx (P1) in equine athletes are considered to predominantly occur due to chronic bone stress overload. OBJECTIVES To describe the range of abnormalities that is present in the sagittal groove in a large group of horses diagnosed with sagittal groove disease (SGD) on low-field MRI. STUDY DESIGN Retrospective, cross-sectional. METHODS Medical records were searched to identify initial MRI images of horses diagnosed with SGD and these were blindly evaluated using a semi-quantitative grading scheme and novel SGD MRI classification system reflecting potential pathways of pathological progression and severity of stress injury. RESULTS A total of 132 limbs from 111 horses were included in the study; predominantly warmbloods competing in showjumping (n = 83) and dressage (n = 18). SGD MRI classifications were: 0 (normal, n = 0), 1 (small subchondral defect, n = 2), 2 (osseous densification, n = 28), 3 (subchondral microfissure with osseous densification, n = 7), 4 (bone oedema-like signal within the subchondral ± trabecular bone and ± subchondral microfissure or demineralisation, n = 72), 5 (incomplete macrofissure/fracture, n = 23) and 6 (complete fracture, n = 0). Classification 4c (bone oedema-like signal with demineralisation) and 5 had higher proportions in the plantar third of hindlimbs (3% and 10%, respectively) compared with forelimbs (0% and 0%, respectively). SGD classification and extent of bone oedema-like signal were not significantly different between lame (n = 116) and non-lame limbs (n = 16) (both p > 0.05). Periosteal new bone and oedema-like signal were identified (either confidently or suspected) at the dorsoproximal aspect of P1 in 25% and 39% of limbs, respectively. MAIN LIMITATIONS Inclusion via diagnoses in original MRI reports, variable clinical history, small size of some classification groups. CONCLUSIONS The presence or absence of lameness is not a dependable measure of the severity of SGD. The periosteal oedema-like signal of P1 has not previously been described in MRI of SGD and further supports the concept of bone stress injury.
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Affiliation(s)
- Josephine E Faulkner
- Department of Morphology, Imaging, Orthopaedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | - Bart J G Broeckx
- Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | | | - Katrien Vanderperren
- Department of Morphology, Imaging, Orthopaedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Ciamillo SA, Wulster KB, Gassert TM, Richardson DW, Brown KA, Stefanovski D, Ortved KF. Prospective, longitudinal assessment of subchondral bone morphology and pathology using standing, cone-beam computed tomography in fetlock joints of 2-year-old Thoroughbred racehorses in their first year of training. Equine Vet J 2024. [PMID: 38247205 DOI: 10.1111/evj.14048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/30/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Catastrophic injuries of the fetlock joints occur in Thoroughbred racehorses and are preceded by stress-induced bone injury. Early detection of subchondral bone injury is essential to prevent irreversible damage or bone failure. OBJECTIVES To investigate the use of standing, robotic cone-beam computed tomography (CBCT) for assessing longitudinal changes in subchondral bone morphology and pathology of the fetlock joints associated with race training in young Thoroughbreds. STUDY DESIGN Observational cohort study. METHODS Forty-one 2-year-old Thoroughbred racehorses were recruited prior to the start of race training. Standing CBCT and radiographs of all 4 metacarpo-/metatarsophalangeal (MCP/MTP) joints were obtained at 0, 6 and 12 months. Hyperdensity, as an estimate of subchondral bone sclerosis, was measured in the distal third metacarpal (MC3)/metatarsal (MT3) bone and proximal phalanx (P1) at each time point on computed tomography. CBCTs were examined for subchondral bone pathology consisting of areas of hypodensity within regions of hyperdensity. RESULTS Subchondral bone sclerosis increased significantly over time in the medial and lateral MC3/MT3 condyles and in the medial and lateral parasagittal grooves of MC3/MT3. The presence of subchondral bone pathology increased significantly over time in the medial and lateral palmar condyles of MC3/MT3, the lateral parasagittal groove, the medial dorsal condyle and the medial and lateral ridges of P1. MAIN LIMITATIONS There was attrition of horses due to relocation, change in ownership, and retirement from racing. Husbandry, training regimens and racing schedules were not controlled for in the study. CONCLUSIONS Standing CBCT is an efficient and effective screening tool for assessing subchondral bone morphology and identifying pathology of the fetlock joint in young Thoroughbred racehorses. CBCT may facilitate early detection of bone pathology allowing for timely intervention and prevention of more serious injuries.
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Affiliation(s)
- Sarah A Ciamillo
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Kathryn B Wulster
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Taryn M Gassert
- Sports Medicine Associates of Chester County, Cochranville, Pennsylvania, USA
| | - Dean W Richardson
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Kara A Brown
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Darko Stefanovski
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Kyla F Ortved
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
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Bierau J, Cruz AM, Koch C, Manso-Diaz G, Büttner K, Staszyk C, Röcken M. Visualization of anatomical structures in the fetlock region of the horse using cone beam computed tomography in comparison with conventional multidetector computed tomography. Front Vet Sci 2024; 10:1278148. [PMID: 38260210 PMCID: PMC10802162 DOI: 10.3389/fvets.2023.1278148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/08/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Cone-beam computed tomography (CBCT) is regarded as a convenient and suitable alternative to conventional computed tomography. However, in the horse, the quality of obtained data sets needs to be evaluated. Therefore, the aim of this study was to compare the visibility and accessibility of clinically relevant anatomical structures displayed in CBCT and conventional multidetector computed tomography (MDCT). Materials and methods Twenty-nine limbs from horses euthanized for reasons unrelated to this study were used. Native and intraarticular contrast scans of the fetlock (CBCT vs. MDCT) were performed. The visibility and accessibility of selected anatomical structures were blindly scored by three independent experienced observers using a scoring system previously reported and adapted to the fetlock joint. Results Only minor differences between CBCT and MDCT were identified concerning the diagnostic quality of images for osseous structures. Soft tissue structures were better evaluated on MDCT images. In CBCT as well as in MDCT articular cartilage could only be visualized after intraarticular injection of contrast medium. Discussion/conclusion Cone beam computed tomography of the fetlock is a useful and reliable diagnostic tool when evaluating osseous structures and delineating articular cartilage with contrast medium. However, this modality is limited for assessing soft tissues structures.
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Affiliation(s)
- Jonathan Bierau
- Equine Clinic (Surgery, Orthopedics), Justus-Liebig-University Giessen, Giessen, Germany
| | - Antonio M. Cruz
- Equine Clinic (Surgery, Orthopedics), Justus-Liebig-University Giessen, Giessen, Germany
| | - Christoph Koch
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, Swiss Institute of Equine Medicine (ISME), University of Bern, Bern, Switzerland
| | - Gabriel Manso-Diaz
- Faculty of Veterinary Medicine, Department of Animal Medicine and Surgery, Universidad Complutense de Madrid, Madrid, Spain
| | - Kathrin Büttner
- Unit for Biomathematics and Data Processing, Justus-Liebig-University Giessen, Giessen, Germany
| | - Carsten Staszyk
- Institute of Veterinary-Anatomy, -Histology, and -Embryology, Faculty of Veterinary Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - Michael Röcken
- Equine Clinic (Surgery, Orthopedics), Justus-Liebig-University Giessen, Giessen, Germany
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Auth AK, Hinnigan GJ, Smith MA, Owen KR. Low-Field Magnetic Resonance Imaging Findings of the Fetlock Region of Nonracehorses. J Equine Vet Sci 2024; 132:104938. [PMID: 37832699 DOI: 10.1016/j.jevs.2023.104938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 10/02/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023]
Abstract
Low-field, magnetic resonance imaging (MRI) is an advanced imaging modality widely used to diagnose distal limb pathology in horses, but there are limited data regarding lesion distribution within the metacarpo/metatarsophalangeal joint (MCP/MTPJ) region in lame nonracehorses. The aim of this study was to describe the low-field MRI findings and lesion distribution in nonracehorses with MCP/MTPJ region pain. Clinical records from horses undergoing MRI of the MCP/MTPJ region between July 2016 and March 2023 were reviewed. Horses were included if pain causing lameness was localized to this region and conventional imaging failed to provide a definitive diagnosis. Eighty-four horses met the inclusion criteria. Soft tissues were affected in 76 (90.5%) horses, with suspensory ligament branch injuries being the most frequent (60.7%) soft tissue pathology identified. Osseous pathology was diagnosed in 51 horses. The subchondral bone (SCB) of the distal third metacarpal/metatarsal bone (MC3/MT3) was the osseous structure most frequently affected (40.5%), with 79.4% of these horses having lesions on the dorsal aspect of the bone. Osteoarthritis was present in 48 (57.1%) horses. The main limitations of the study were the lack of a standardized diagnostic analgesia pattern due to varying veterinary surgeon involvement, and the absence of bilateral magnetic resonance (MR) sequences in all limbs. MRI is a useful diagnostic tool to assess soft tissue structures in the MCP/MTP region, especially in horses with thick skin, which may make ultrasonographic imaging unreliable.
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Affiliation(s)
- Adel K Auth
- Oakhill Veterinary Centre, Goosnargh, Preston, UK.
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Faulkner JE, Joostens Z, Broeckx BJG, Hauspie S, Mariën T, Vanderperren K. Follow-Up Magnetic Resonance Imaging of Sagittal Groove Disease of the Equine Proximal Phalanx Using a Classification System in 29 Non-Racing Sports Horses. Animals (Basel) 2023; 14:34. [PMID: 38200766 PMCID: PMC10778323 DOI: 10.3390/ani14010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/05/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Evolution of magnetic resonance imaging (MRI) findings in horses with sagittal groove disease (SGD) of the proximal phalanx is relatively sparsely described. This retrospective, descriptive, longitudinal study describes the findings of sequential low-field MRI fetlock examinations in horses with SGD of the proximal phalanx using a classification system. Twenty-nine horses were included, predominantly warmbloods used for show jumping (79%). For 29 limbs re-examined during the initial rehabilitation period, classification remained constant (n = 18), increased (n = 2), decreased (n = 7), and fluctuated (n = 2). Notably, two limbs with initial classification 4b (bone oedema-like signal with subchondral microfissure) and one with 4c (bone oedema-like signal with subchondral demineralisation) progressed to classification 5 (incomplete macrofissure/fracture), highlighting their potential as prodromal or imminent fissure pathology. Following conservative (n = 28) and surgical (n = 1) treatment, 86% of the horses re-entered full training and competition with a mean ± sd recovery time of 9.4 ± 4.4 months. In total, 20% of horses in the study subsequently presented for repeat MRI due to recurrent lameness after resuming full work, with classification that was the same (n = 2), increased (n = 2), or decreased (n = 2) compared with the last scan. This study underscores the variability in progression of SGD MRI findings, emphasising the need for further larger-scale research into patterns of progression.
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Affiliation(s)
- Josephine E. Faulkner
- Department of Morphology, Imaging, Orthopaedics, Rehabilitation, and Nutrition, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - Zoë Joostens
- Equitom Equine Clinic, Paalstraat 8, 3560 Lummen, Belgium
| | - Bart J. G. Broeckx
- Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Heidestraat 19, 9820 Merelbeke, Belgium
| | - Stijn Hauspie
- Equitom Equine Clinic, Paalstraat 8, 3560 Lummen, Belgium
| | - Tom Mariën
- Equitom Equine Clinic, Paalstraat 8, 3560 Lummen, Belgium
| | - Katrien Vanderperren
- Department of Morphology, Imaging, Orthopaedics, Rehabilitation, and Nutrition, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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Nagy A, Boros K, Dyson S. Magnetic Resonance Imaging, Computed Tomographic and Radiographic Findings in the Metacarpophalangeal Joints of 40 Non-Lame Thoroughbred Yearlings. Animals (Basel) 2023; 13:3466. [PMID: 38003084 PMCID: PMC10668665 DOI: 10.3390/ani13223466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Most catastrophic injuries in Thoroughbred racehorses involve the fetlock. There is no description of comparative imaging in Thoroughbreds entering racehorse training. The aim was to describe MRI, CT and radiographic findings in the metacarpophalangeal joint of non-lame Thoroughbred yearlings. Forty Thoroughbreds underwent low-field MRI, fan-beam CT and radiographic examinations of both metacarpophalangeal joints. Images were assessed subjectively. A hypoattenuating lesion of the sagittal ridge of the third metacarpal bone (McIII) was identified in 33/80 limbs in CT reconstructions. Cone-shaped mineralisation in the sagittal ridge was detected in MR images (n = 17) and in CT images (n = 5). Mild hyperattenuation was common in trabecular bone in the dorsomedial (36/80) and palmarolateral (25/80) metacarpal condyles in CT reconstructions. A focal lesion in the subchondral bone was seen in the proximal phalanx (n = 19) and in McIII (n = 11). Enlarged vascular channels were detected in the metacarpal condyles in 57/80 limbs and in the proximal sesamoid bones in all limbs. Signs of bone modelling are seen in yearling Thoroughbred fetlocks. Sagittal ridge lesions were common and are likely associated with osteochondrosis or other developmental osteochondral defects. Focal lesions in the subchondral bone of McIII and proximal phalanx can indicate developmental abnormalities or subtle subchondral bone injuries.
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Affiliation(s)
- Annamaria Nagy
- Equine Department and Clinic, University of Veterinary Medicine Budapest, Doramajor, 2225 Ullo, Hungary;
| | - Koppány Boros
- Equine Department and Clinic, University of Veterinary Medicine Budapest, Doramajor, 2225 Ullo, Hungary;
| | - Sue Dyson
- The Cottage, Church Road, Market Weston, Diss IP22 2NX, UK;
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Lin ST, Bolas NM, Peter VG, Pokora R, Patrick H, Foote AK, Sargan DR, Murray RC. Comparison of cone-beam and fan-beam computed tomography and low-field magnetic resonance imaging for detection of palmar/plantar osteochondral disease in Thoroughbred horses. Equine Vet J 2023. [PMID: 37931621 DOI: 10.1111/evj.14023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/13/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Palmar/plantar osteochondral disease (POD) of the metacarpal/tarsal condyles is a common pathological finding in racehorses. OBJECTIVE To compare diagnoses, imaging details, and measurements of POD lesions between cone-beam computed tomography CT (CBCT), fan-beam CT (FBCT), and low-field magnetic resonance imaging (MRI) using macroscopic pathology as a gold standard. STUDY DESIGN Cross-sectional study. METHODS Thirty-five cadaver limbs from 10 horses underwent CBCT, FBCT, MRI, and macroscopic examination. CT and MR images were examined for presence of POD, imaging details of POD, and measurements of POD dimensions and areas. Imaging diagnoses, details, and measurements were compared with macroscopic examination and between modalities. RESULTS Forty-eight POD lesions were seen over 70 condyles. Compared with macroscopic examination the sensitivity and specificity of diagnosis were 95.8% (CI95 = 88%-99%) and 63.6% (CI95 = 43%-81%) for FBCT, 85.4% (CI95 = 74%-94%) and 81.8% (CI95 = 63%-94%) for CBCT, and 69.0% (CI95 = 54%-82%) and 71.4% (CI95 = 46%-90%) for MRI. Inter-modality agreement on diagnosis was moderate between CBCT and FBCT (κ = 0.56, p < 0.001). POD was identified on CT as hypoattenuating lesions with surrounding hyperattenuation and on MRI as either T1W, T2*W, T2W, and STIR hyperintense lesions or T1W and T2*W heterogeneous hypointense lesions with surrounding hypointensity. Agreement on imaging details between CBCT and FBCT was substantial for subchondral irregularity (κ = 0.61, p < 0.001). Macroscopic POD width strongly correlated with MRI (r = 0.81, p < 0.001) and CBCT (r = 0.79, p < 0.001) and moderately correlated with FBCT (r = 0.69, p < 0.001). Macroscopic POD width was greater than all imaging modality (p < 0.001). MAIN LIMITATIONS Effect of motion artefact in live horse imaging could not be assessed. CONCLUSIONS All imaging modalities were able to detect POD lesions, but underestimated lesion size. The CT systems were more sensitive, but the differing patterns of signal intensity may suggest that MRI can detect changes associated with POD pathological status or severity. The image features observed by CBCT and FBCT were similar.
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Affiliation(s)
- Szu-Ting Lin
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | | | - Vanessa G Peter
- Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK
| | - Rachel Pokora
- Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK
| | | | | | - David R Sargan
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Rachel C Murray
- Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK
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10
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Melly V, Ortved KF, Manzi TJ, Richardson DW, Stefanovski D, Wulster KB. Identification of a previously unreported site of subchondral bone injury in the dorsodistolateral calcaneus in Thoroughbred racehorses. Equine Vet J 2023; 55:1029-1037. [PMID: 36716290 DOI: 10.1111/evj.13928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/26/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Increasing accessibility and advancements in computed tomographic (CT) imaging improve understanding of the contributors to poor performance in the Thoroughbred racehorse. OBJECTIVES To characterise an unreported site of tarsal subchondral bone injury (SBI) in Thoroughbred racehorses. STUDY DESIGN Retrospective, cross-sectional analytical study. METHODS Tarsal CT scans of 108 horses were reviewed for evidence of SBI in the dorsodistolateral calcaneus (DDLC). Signalment, including age, breed, sex, and discipline of horses, was recorded. The association of DDLC SBI with Thoroughbred racehorse compared to other breeds/disciplines was calculated. Nuclear scintigraphic scans of the hindlimbs of Thoroughbreds between 2007 and 2022 were also reviewed for increased radiopharmaceutical uptake (IRU) suggestive of DDLC SBI. RESULTS Tarsal CT scans of 108 horses were analysed and lesion location and type were recorded. DDLC SBI was identified in 8/108 (7.3%) horses. All lesions were found in racing Thoroughbreds (Fischer's exact test p = 0.002) and in 20% (8/40) of racing Thoroughbreds that underwent tarsal CT. DDLC SBI was determined to be the primary cause of lameness in 3/8. Third tarsal bone fracture was considered the primary cause of lameness in 3/8 horses. A total of 1663 nuclear scintigraphic scans of 1603 Thoroughbred horses were reviewed. Increased IRU in the DDLC was present in 13 horses (0.9%). MAIN LIMITATIONS Study limitations include the retrospective nature of the study, incomplete medical records, lack of sensitivity/specificity data for lesion identification on various imaging modalities or comparison to histopathology, and limited substantive follow-up information. CONCLUSIONS The DDLC is a previously unreported site of SBI in the Thoroughbred racehorse. The lesion can be the primary source of lameness but may also be found in horses with other clinically relevant osseous injuries. This lesion may be underestimated in the Thoroughbred population. Further investigation is required to determine the true prevalence, clinical relevance, and prognosis in Thoroughbred racehorses with this injury.
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Affiliation(s)
- Virginia Melly
- Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA
| | - Kyla F Ortved
- Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA
| | - Timothy J Manzi
- Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA
| | - Dean W Richardson
- Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA
| | - Darko Stefanovski
- Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA
| | - Kathryn B Wulster
- Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA
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Stewart HL, Siewerdsen JH, Selberg KT, Bills KW, Kawcak CE. Cone-beam computed tomography produces images of numerically comparable diagnostic quality for bone and inferior quality for soft tissues compared with fan-beam computed tomography in cadaveric equine metacarpophalangeal joints. Vet Radiol Ultrasound 2023; 64:1033-1036. [PMID: 37947254 DOI: 10.1111/vru.13309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023] Open
Abstract
Cone-beam computed tomography (CBCT) is an emerging modality for imaging of the equine patient. The objective of this prospective, descriptive, exploratory study was to assess visualization tasks using CBCT compared with conventional fan-beam CT (FBCT) for imaging of the metacarpophalangeal joint in equine cadavers. Satisfaction scores were numerically excellent with both CBCT and FBCT for bone evaluation, and FBCT was numerically superior for soft tissue evaluation. Preference tests indicated FBCT was numerically superior for soft tissue evaluation, while preference test scoring for bone was observer-dependent. Findings from this study can be used as background for future studies evaluating CBCT image quality in live horses.
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Affiliation(s)
- Holly L Stewart
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Jeffrey H Siewerdsen
- Department of Imaging Physics, Neurosurgery, and Radiation Physics, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Kurt T Selberg
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Kathryn W Bills
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Christopher E Kawcak
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
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12
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Lin ST, Foote AK, Bolas NM, Peter VG, Pokora R, Patrick H, Sargan DR, Murray RC. Three-Dimensional Imaging and Histopathological Features of Third Metacarpal/Tarsal Parasagittal Groove and Proximal Phalanx Sagittal Groove Fissures in Thoroughbred Horses. Animals (Basel) 2023; 13:2912. [PMID: 37760312 PMCID: PMC10525482 DOI: 10.3390/ani13182912] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Fissure in the third metacarpal/tarsal parasagittal groove and proximal phalanx sagittal groove is a potential prodromal pathology of fracture; therefore, early identification and characterisation of fissures using non-invasive imaging could be of clinical value. Thirty-three equine cadaver limbs underwent standing cone-beam (CB) computed tomography (CT), fan-beam (FB) CT, low-field magnetic resonance imaging (MRI), and macro/histo-pathological examination. Imaging diagnoses of fissures were compared to microscopic examination. Imaging features of fissures were described. Histopathological findings were scored and compared between locations with and without fissures on CT. Microscopic examination identified 114/291 locations with fissures. The diagnostic sensitivity and specificity were 88.5% and 61.3% for CBCT, 84.1% and 72.3% for FBCT, and 43.6% and 85.2% for MRI. Four types of imaging features of fissures were characterised on CT: (1) CBCT/FBCT hypoattenuating linear defects, (2) CBCT/FBCT striated hypoattenuated lines, (3) CBCT/FBCT subchondral irregularity, and (4) CBCT striated hypoattenuating lines and FBCT subchondral irregularity. Fissures on MRI appeared as subchondral bone hypo-/hyperintense defects. Microscopic scores of subchondral bone sclerosis, microcracks, and collapse were significantly higher in locations with CT-identified fissures. All imaging modalities were able to identify fissures. Fissures identified on CT were associated with histopathology of fatigue injuries.
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Affiliation(s)
- Szu-Ting Lin
- Department of Veterinary Medicine, University of Cambridge, Madingley Rd., Cambridge CB3 0ES, UK;
| | - Alastair K. Foote
- Rossdales Veterinary Surgeons, Cotton End Rd., Exning, Newmarket CB8 7NN, UK; (A.K.F.); (V.G.P.); (R.P.); (R.C.M.)
| | - Nicholas M. Bolas
- Hallmarq Veterinary Imaging, Unit 5 Bridge Park, Merrow Lane, Guildford GU4 7BF, UK;
| | - Vanessa G. Peter
- Rossdales Veterinary Surgeons, Cotton End Rd., Exning, Newmarket CB8 7NN, UK; (A.K.F.); (V.G.P.); (R.P.); (R.C.M.)
| | - Rachel Pokora
- Rossdales Veterinary Surgeons, Cotton End Rd., Exning, Newmarket CB8 7NN, UK; (A.K.F.); (V.G.P.); (R.P.); (R.C.M.)
| | - Hayley Patrick
- Swayne and Partners Veterinary Surgeons, Western Way, Bury St Edmunds IP33 3SP, UK;
| | - David R. Sargan
- Department of Veterinary Medicine, University of Cambridge, Madingley Rd., Cambridge CB3 0ES, UK;
| | - Rachel C. Murray
- Rossdales Veterinary Surgeons, Cotton End Rd., Exning, Newmarket CB8 7NN, UK; (A.K.F.); (V.G.P.); (R.P.); (R.C.M.)
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13
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Spriet M. Clinical insights: Advances in imaging of the equine distal limb. Equine Vet J 2023; 55:167-170. [PMID: 36748732 DOI: 10.1111/evj.13916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 02/08/2023]
Affiliation(s)
- Mathieu Spriet
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
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14
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Spriet M, Arndt S, Pige C, Pye J, O'Brion J, Carpenter R, Blea J, Dowd JP. Comparison of skeletal scintigraphy and standing 18 F-NaF positron emission tomography for imaging of the fetlock in 33 Thoroughbred racehorses. Vet Radiol Ultrasound 2023; 64:123-130. [PMID: 36250620 DOI: 10.1111/vru.13169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 01/25/2023] Open
Abstract
This retrospective, methods comparison study aimed to compare skeletal scintigraphy and 18 F-NaF positron emission tomography (PET) for the detection of abnormalities in the fetlocks of Thoroughbred racehorses. Thirty-three horses (72 limbs) imaged with both scintigraphy and 18 F-NaF PET, for investigation of lameness or poor performance related to the fetlock, were included. Seven observers, including experienced racetrack practitioners, surgery and imaging residents, and a board-certified veterinary radiologist, independently reviewed all data for evidence of increased radiopharmaceutical uptake in 10 different regions of interest. The interobserver agreement was higher for PET (Kappa-weighted (K-w) 0.73 (0.51-0.84)) (median (range)) than for scintigraphy (0.61 (0.40-0.77)) (P < 0.0001). When scintigraphy and PET were compared, the agreement was fair (K-w 0.29). More sites of increased uptake were identified using PET compared with scintigraphy. Agreement between the two modalities was higher for the palmar/plantar metacarpal/metatarsal condylar regions (K-w 0.59) than for the proximal sesamoid bones (K-w 0.25). Increased radiopharmaceutical uptake was detected in the medial proximal sesamoid bone in 6.9% and 22.2% of limbs with scintigraphy and PET, respectively. The high interobserver agreement for PET, despite the recent introduction of this technique, demonstrates the ease of clinical interpretation of PET scans. The higher number of lesions detected with PET compared with scintigraphy can be explained by the higher spatial resolution and cross-sectional nature of this modality. Study findings supported using PET in a clinical population of racehorses, in particular for the assessment of the proximal sesamoid bones.
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Affiliation(s)
- Mathieu Spriet
- School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Stefanie Arndt
- School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Charlene Pige
- School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Jannah Pye
- School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Julie O'Brion
- Southern California Equine Foundation, Arcadia, California, USA
| | - Ryan Carpenter
- Southern California Equine Foundation, Arcadia, California, USA
| | - Jeff Blea
- Southern California Equine Foundation, Arcadia, California, USA
| | - Joseph P Dowd
- Southern California Equine Foundation, Arcadia, California, USA
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Brounts SH, Lund JR, Whitton RC, Ergun DL, Muir P. Use of a novel helical fan beam imaging system for computed tomography of the distal limb in sedated standing horses: 167 cases (2019–2020). J Am Vet Med Assoc 2022; 260:1351-1360. [DOI: 10.2460/javma.21.10.0439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Abstract
OBJECTIVE
To evaluate the diagnostic capabilities of a novel helical fan beam CT system used for imaging of horses with a range of clinical distal limb problems.
ANIMALS
167 horses.
PROCEDURES
Medical records were reviewed of horses presented for CT of the distal limb at 2 university-based veterinary hospitals. The following data were recorded: age, sex, breed, presenting complaint, sedation used for imaging, scanning time, procedure time, other diagnostic imaging methods performed, imaging diagnosis, clinical diagnosis, and complications during imaging.
RESULTS
Most horses were Thoroughbreds and Quarter Horses. Procedure times ranged from 15 to 40 minutes, with scanning completed in 15 to 45 seconds for each region of interest. The foot or pastern region was commonly scanned (88/167 [53%] horses), with navicular bone disease diagnosed in 42 of 88 (48%) horses. The fetlock region was also commonly scanned (42/167 [40%] horses), with palmar or plantar osteochondral disease diagnosed in 17 of 42 (40%) horses. Horses were compliant during scanning, and no complications with sedation or damage to the scanner occurred. A specific imaging diagnosis for the lameness was achieved more frequently with CT imaging (166/167 [99%]) than with planar digital radiography (26/58 [45%]).
CLINICAL RELEVANCE
The helical fan beam CT system could be used safely to scan sedated standing horses from the carpal or tarsal region distally. Subjectively, the machine was easy to operate, allowing CT to be incorporated into lameness investigations. CT imaging was very likely to result in a clinical diagnosis in horses with distal limb lameness.
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Affiliation(s)
- Sabrina H. Brounts
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI
| | - Jane R. Lund
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI
| | - R. Chris Whitton
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Australia
| | - David L. Ergun
- Department of Medical Physics, University of Wisconsin, Madison, WI
- Asto CT Inc, Middleton, WI
| | - Peter Muir
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI
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16
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Garrett KS. When radiography and ultrasonography are not enough: the use of computed tomography and magnetic resonance imaging for equine lameness cases. J Am Vet Med Assoc 2022; 260:1113-1123. [PMID: 35544423 DOI: 10.2460/javma.22.03.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
MRI and CT have enhanced our diagnostic abilities for equine lameness beyond what is available using radiography and ultrasonography. This has allowed veterinarians to better prognosticate and treat lameness conditions, improving patient outcomes. This article discusses the basic principles behind MRI and CT, their advantages and disadvantages, the different types of equipment available for clinical use in horses, the typical diagnostic workup prior to pursuing advanced imaging, and common regions where MRI and CT are used clinically. The companion Currents in One Health by Spriet, AJVR, July 2022, discusses even more advanced equine imaging in the form of positron emission tomography. Combined, these future directions of MRI, CT, and positron emission tomography may include improved ability to image standing horses or screen for injury prevention.
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Cianci JM, Wulster KB, Richardson DW, Stefanovski D, Ortved KF. Computed tomographic assessment of fracture characteristics and subchondral bone injury in Thoroughbred racehorses with lateral condylar fractures and their relationship to outcome. Vet Surg 2022; 51:426-437. [PMID: 35165910 DOI: 10.1111/vsu.13770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/27/2021] [Accepted: 01/01/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the effects of fracture characteristics and concurrent subchondral bone pathology identified with computed tomography (CT) on the racing performance of Thoroughbred racehorses with fractures of the MC3/MT3 lateral condyle. STUDY DESIGN Retrospective cohort study. SAMPLE POPULATION Thoroughbred racehorses (n = 50) with a fracture of the MC3/MT3 lateral condyle, which had preoperative CT and internal fixation performed. METHODS Medical records were reviewed for age, sex, limb, and surgical treatment. Computed tomography scans were evaluated to determine fracture characteristics including length, whether the fracture was incomplete or complete, and displacement. The presence of subchondral bone injury (SBI), sesamoid bone fracture, articular comminution, and fragmentation in the joint was noted. Racing data was obtained from an online database. Univariable and multivariable analyses determined associations between independent variables and outcomes. RESULTS Thirty-three (66%) horses raced after surgery. Horses with sesamoid bone fractures (P = .021), MC3/MT3 comminution (P = .016) and intra-articular fragmentation (P = .015) were less likely to race postoperatively. Concurrent SBI did not affect outcome. In the final multivariable model, sex (P = .015) and whether a fracture was incomplete or complete (P = .007) were the most significant predictors of racing postoperatively with females and horses with complete fractures being less likely to race. CONCLUSION The prognosis for racing after a lateral condylar fracture is favorable but is decreased in horses with complete fractures and certain concurrent joint pathology. CLINICAL SIGNIFICANCE Horses presenting with lateral condylar fractures commonly have concurrent joint pathology. Computed tomography can aid in preoperative evaluation and prognostication by enabling more complete fracture assessment.
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Affiliation(s)
- Justine M Cianci
- Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Kathryn B Wulster
- Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Dean W Richardson
- Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Darko Stefanovski
- Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Kyla F Ortved
- Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
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18
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Imaging and Gross Pathological Appearance of Changes in the Parasagittal Grooves of Thoroughbred Racehorses. Animals (Basel) 2021; 11:ani11123366. [PMID: 34944142 PMCID: PMC8697963 DOI: 10.3390/ani11123366] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/18/2021] [Accepted: 11/21/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Early detection of racehorses at risk of stress fracture is key to reducing the number of horses with catastrophic fractures while racing. Bone changes are often visible in the limbs of Thoroughbred racehorses in work, particularly in the fetlock region. However, it is currently unknown whether some of these changes indicate an impending fracture or are a healthy adaptation to high-speed exercise. This study looks at imaging and gross changes in a specific area (parasagittal grooves (PSGs) of the cannon bone) and the utility of X-ray, computed tomography (CT) and magnetic resonance imaging (MRI) to detect the changes. All fetlock joints were assessed from twenty horses that died during racing or training, including horses with and without fetlock fracture. Overall, X-ray was poor for detecting PSG changes. Some PSG changes on CT and MRI were common in Thoroughbred racehorses and possibly represent normal bone adaptation when seen in clinical cases. However, certain CT and MRI findings were more prevalent in horses with a fracture, possibly indicating microdamage accumulation and increased risk of fracture. Bilateral advanced imaging is recommended in clinical cases of suspected fetlock pathology. Abstract (1) Background: Parasagittal groove (PSG) changes are often present on advanced imaging of racing Thoroughbred fetlocks and have been suggested to indicate increased fracture risk. Currently, there is limited evidence differentiating the imaging appearance of prodromal changes in horses at risk of fracture from horses with normal adaptive modelling in response to galloping. This study aims to investigate imaging and gross PSG findings in racing Thoroughbreds and the comparative utility of different imaging modalities to detect PSG changes. (2) Methods: Cadaver limbs were collected from twenty deceased racing/training Thoroughbreds. All fetlocks of each horse were examined with radiography, low-field magnetic resonance imaging (MRI), computed tomography (CT), contrast arthrography and gross pathology. (3) Results: Horses with fetlock fracture were more likely to have lateromedial PSG sclerosis asymmetry and/or lateral PSG lysis. PSG lysis was not readily detected using MRI. PSG subchondral bone defects were difficult to differentiate from cartilage defects on MRI and were not associated with fractures. The clinical relevance of PSG STIR hyperintensity remains unclear. Overall, radiography was poor for detecting PSG changes. (4) Conclusions: Some PSG changes in Thoroughbred racehorses are common; however, certain findings are more prevalent in horses with fractures, possibly indicating microdamage accumulation. Bilateral advanced imaging is recommended in racehorses with suspected fetlock pathology.
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19
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Wulster K, Ortved K, Curtiss A, Richardson D. Response to Letter to the Editor: Validation of standing cone beam computed tomography for diagnosing subchondral fetlock pathology in the Thoroughbred racehorse. Equine Vet J 2021; 53:630-631. [PMID: 33834535 DOI: 10.1111/evj.13441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Kathryn Wulster
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA, USA
| | - Kyla Ortved
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA, USA
| | - Alexandra Curtiss
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA, USA
| | - Dean Richardson
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA, USA
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20
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Ramzan PHL. Letter to the Editor: Validation of standing cone beam computed tomography for diagnosing subchondral fetlock pathology in the Thoroughbred racehorse. Equine Vet J 2021; 53:628-629. [PMID: 33834532 DOI: 10.1111/evj.13433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 11/30/2022]
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