Comparison of three distraction methods and conventional radiography for early diagnosis of canine hip dysplasia

Analysis of a Laxity Index Database and Comparison with the Fédération Cynologique Internationale Grades of This Population

OBJECTIVE

 This study aimed to analyse the distribution of the laxity indices (LI) in a dog population, to compare the LI with the Fédération Cynologique Internationale (FCI) grades and to search for differences of LI between breeds.

STUDY DESIGN

 The database was composed of all dogs presented to the University Hospital of the Faculty of Veterinary Medicine in Ghent for obligatory hip screening between January 2016 and February 2019, and all patients presented to orthopaedic consultation between January 2017 and January 2019 for a complaint of hindlimb lameness, which underwent both a standard extended ventrodorsal radiograph of the hips and a stress radiograph revealing hip joint laxity. The latter was obtained by means of the Vezzoni-modified Badertscher distension device and the LI was calculated. For each dog of the population, the LI was then compared with the FCI grade.

RESULTS

 The LI values ranged between 0.15 and 1.04, with a mean of 0.46. The LI and the FCI grade increased together, and showed a moderate-to-good correlation. There was a highly significant overall difference in the mean value of LI per FCI grade group (p < 0.001). The mean LI of the Labrador Retrievers was slightly but significantly lower than the mean LI of the Golden Retrievers (p < 0.01).

CONCLUSION

 The LI calculated on a stress radiograph taken with the Vezzoni-modified Badertscher distension device shows a good correlation with the FCI grade assigned on a standard extended ventrodorsal projection. A wide range of passive hip joint laxity exists in dogs considered to be phenotypically normal based on the FCI grading method.

Canine hip dysplasia screening: Comparison of early evaluation to final grading in 231 dogs with Fédération Cynologique Internationale A and B

OBJECTIVES

This study aimed to verify if a significant difference exists between parameters in the early evaluation of normal and near-normal hip joints, to evaluate the influence of age and breed on the parameters, and to clarify the usefulness of a total score for differentiating between Fédération Cynologique Internationale (FCI) grade A and B hips.

METHODS

A total of 231 dogs were classified according to whether they had FCI A or B hips at adulthood, with measurements obtained at 14-28 weeks of age. The total score was calculated by the summation of the following quantitative parameters: angle of subluxation (AS), angle of reduction (AR), laxity index (LI), and dorsal acetabular rim slope (DARS). Logistic regression analysis was performed to establish the probability of the study population to develop an FCI B hip based on the total score. This was repeated for the highest score in combination with the worst-rated hip and once more for breeds.

RESULTS

No correlation between age and the parameters was found in the cohort, or for FCI A and B. The values of all the parameters were significantly lower in the FCI A group than in the FCI B group (AR: 4.42° ± 6.0° vs 7.62° ± 7.2°; AS: 0.45° ± 1.9° vs 1.55° ± 3.8°; LI: 0.32 ± 0.1 vs 0.36 ± 0.1; DARS: 3.30° ± 1.8° vs 3.77° ± 1.9°; TS: 11.47 ± 8.3 vs 16.65 ± 10.9). Labrador Retrievers and Golden Retrievers showed significant differences between parameters for both FCI grades. The range, where FCI A and B hips can be predicted on the basis of the total score, was different when assessed for the entire cohort, Labrador Retrievers, and Golden Retrievers.

CLINICAL SIGNIFICANCE

Our results show that even in normal and near-normal hips, the parameters significantly differed in the early evaluation. Moreover, cutoff values should be set for different breeds in the prediction of the FCI grade during early evaluation for a better breeding selection regarding canine hip dysplasia, one of the most common orthopedic diseases among large and giant breed dogs.

Protein biomarkers in serum and urine for determining presence or absence of hip dysplasia in a canine model

This study compares serum and urine concentrations of relevant protein biomarkers among adult dogs with or without radiographic canine hip dysplasia (CHD). Adult (≥2 years of age), client-owned dogs (n = 74) radiographically categorized as having at least "good" hips (n = 49) or having "mild," "moderate," or "severe" hip dysplasia (n = 25) by the Orthopedic Foundation for Animals (OFA). Urine and serum samples were obtained from each dog at a single time-point and processed and analyzed for relevant protein biomarkers. Urinary concentrations of CTX-II (p < 0.001) and TIMP-1 (p = 0.002) were significantly lower in dogs with CHD compared to dogs with no CHD. ROC curve analyses were successful in establishing a panel of four biomarkers (urinary CTX-I and II, serum MMP-9, and serum PIICP) with high discriminatory capability for the presence or absence of hip dysplasia in adult dogs (AUC = 0.89). Urine and serum biomarkers can distinguish adult dogs with radiographic CHD from those with no CHD with a sensitivity of 0.95 and specificity of 0.77 using ROC analysis with AUC 0.89. Clinical Significance: This finding suggests that this simple, minimally invasive diagnostic technique has potential for discriminating dysplastic dogs from dogs with normal hips, with possible translational application to humans based on similar etiopathogenesis. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:1-5, 2019.

Static and dynamic ultrasonography for the early diagnosis of canine hip dysplasia

OBJECTIVE

To determine the feasibility of sonographical examination of hip joints in non-sedated puppies and to assess the value of static and dynamic ultrasonography for the early diagnosis of canine hip dysplasia (CHD).

METHODS

Prospective study was carried out. Five hundred and sixty-six puppies between the ages of 16 and 49 days underwent sonographical determination of the α-angle, joint laxity and distraction value (DV). Sonographical parameters were correlated to conventional radiographic CHD classification in the adult dogs.

RESULTS

α-Angles between 74° and 89° (X±sd=82·8°±2·31°) were measured. Despite the feasibility of sonographical hip assessment in puppies, no statistically significant correlation was found between sonographical determinations of the α-angle, joint laxity, DV and conventional radiographic hip joint classification at the age of 12 to 24 months.

CLINICAL SIGNIFICANCE

Results of our study suggest that static and dynamic ultrasonography of hip joints in puppies between 16 and 49 days of age is technically feasible but cannot be recommended for detecting puppies that will develop CHD between the ages of 12 and 24 months.

Puppy line, metaphyseal sclerosis, and caudolateral curvilinear and circumferential femoral head osteophytes in early detection of canine hip dysplasia

Ventrodorsal extended hip radiographs were analyzed from Foxhounds, Irish setters, Greyhounds, and Labrador retrievers radiographed four to seven times between 8 and 110 weeks of age. Occurrence in these 91 dogs of a puppy line, an ill-defined zone of proximal femoral metaphyseal sclerosis, a femoral neck linear sclerosis, or circumferential linear femoral head osteophytosis at 15-17 weeks of age were compared with hip joint laxity, as measured by distraction index, and to later findings of caudal curvilinear femoral neck osteophytes, circumferential femoral head osteophytes, hip incongruity consistent with hip dysplasia and degenerative joint disease by 52 weeks of age. A puppy line and/or femoral metaphyseal sclerosis was common at 15-17 weeks of age for dogs at mimimal risk (Greyhounds) and high risk (Foxhounds) of developing early degenerative joint disease associated with canine hip dysplasia. Though 44% of Greyhound hips had puppy lines and 28% had femoral metaphyseal sclerosis at 15-17 weeks of age, no Greyhound had a caudolateral curvilinear osteophyte or circumferential femoral head osteophyte at 24-27 or 52 weeks of age. No significant relationship was found between occurrence of a puppy line, a circumferential femoral head osteophyte or femoral metaphyseal sclerosis at 15-17 weeks and canine hip dysplasia or degenerative joint disease incidence at 42-52 weeks. Presence of a caudolateral curvilinear osteophyte in at least one hip at 24-27 weeks was significantly related to the diagnosis of canine hip dysplasia by 42-52 weeks. When both a caudolateral curvilinear osteophyte and a circumferential femoral head osteophyte were present in a hip at 24-27 weeks, degenerative joint disease was evident in all such hips by 42-52 weeks of age.

Passive hip laxity in Estrela Mountain Dog--distraction index, heritability and breeding values

Two hundred and fifteen Estrela Mountain Dogs (EMD) were examined using the PennHIP method between 2002 and 2006. Passive hip laxity (PHL) was estimated calculating the distraction index (DI). Pedigree information was obtained from the Portuguese Kennel Club. The heritability and breeding values were estimated using the linear Animal Model. The DI, using as reference the worst joint of each animal, ranged from 0.15 to 1.12 (0.55 +/- 0.19). The PHL was equal in right and left sides, and was higher in females than in males (P > 0.05 and P <0.01 in the t-test, respectively). The estimated heritability was 0.83 +/- 0.11. The mean breeding values for PHL were stable in EMD born between 1991 and 2003, and showed an improvement in 2004 and 2005. The data confirm high PHL in breeds with high prevalence and severity of canine hip dysplasia. The high heritability indicates that the DI could be reduced in the breed if PHL were used as a selection criterion. The early favourable evolution of DI breeding values could be related with the increase of voluntary radiographic hip screening in the last years, and the subsequent introduction of hip quality as a breeding criterion.

Early hip laxity examination in predicting moderate and severe hip dysplasia in Estrela mountain dog

OBJECTIVES

To determine the reliability of early passive hip laxity examination in predicting moderate and severe hip dysplasia.

METHODS

The passive hip laxity of 104 Estrela Mountain dogs was evaluated using the Ortolani method, conventional hip-extended radiography and the PennHIP method, when the animals were between four and 12 months of age. After the age of one, dogs were re-examined for hip dysplasia using the Fédération Cynologique Internationale scoring system. The passive hip laxity results were subsequently compared with the Fédération Cynologique Internationale scores for sensitivity, specificity, positive predictive value, negative predictive value and accuracy.

RESULTS

The PennHIP method achieved the best results in specificity (93 per cent), positive predictive value (91 per cent) and accuracy (88 per cent), and the Ortolani method was the best in sensitivity (92 per cent) and negative predictive value (92 per cent).

CLINICAL SIGNIFICANCE

The Fédération Cynologique Internationale grades D and E can be predicted with confidence even before animals are one year old.

Influence of femoral head and neck conformation on hip dysplasia in the German Shepherd dog

We investigated the prevalence of an anatomic variant of the proximal femur, termed the broomstick-like femoral head and neck formation, and its influence on the Féderation Cynologique Internationale (FCI) hip dysplasia score in 294 German Shepherd dogs. One-hundred and eighty (61%) of the 294 dogs in our study had this anatomic variant. The calculated area of the femoral heads in dogs with a broomstick-like conformation was 4.5 +/- 0.6 cm2 on the hip-extended view. In dogs with a normal femoral head, the calculated area of the femoral head was significantly larger at 4.8 +/- 0.6 cm2 (P < 0.05). In the frog-leg view, there was no significant difference in femoral head area between dogs with the broomstick-like conformation and normal dogs. There was no difference in the antetorsion angle between dogs with broomstick-like conformation and normal dogs. There was also no difference in the distraction ratio between the two phenotypes. The official FCI hip score was similar in dogs with and without the broomstick-like conformation. The average heritability of the broomstick-like conformation was 0.3 +/- 0.1, suggesting heritable influence. We conclude that the broomstick-like conformation is a common finding in the German shepherd dog and has genetic base. The broomstick-like conformation does not appear to be associated with the presence of canine hip dysplasia and it can therefore be assumed to be a normal anatomic variant.

Assessment of the hip reduction angle for predicting osteoarthritis of the hip in the Labrador Retriever

Hip palpation has been used to provide semiquantitative information regarding passive joint laxity and susceptibility to hip dysplasia. The purpose of this study was to: (1) evaluate the intra- and inter-examiner repeatability of the hip reduction angle measured at 4 months of age by three examiners using manual goniometry and an electromagnetic tracking system; (2) compare the hip reduction angle measured with manual goniometry to the hip reduction angle measured with the electromagnetic tracking system; and (3) evaluate the hip reduction angle, distraction index and Ortolani manoeuvre at 4 months of age as predictors of the development of hip osteoarthritis at 12 months of age in 11 Labrador Retriever dogs. Intra- and inter-examiner repeatability was demonstrated for both the manual and electromagnetic goniometric measurement of the hip reduction angle (coefficient of variation < 4.3% and < 6.1%; and P = 0.163 and P = 0.836 respectively). The hip reduction angle measured by manual goniometry was moderately correlated to the hip reduction angle measured by the electromagnetic tracking system (r = 0.603, P < 0.0000). The hip reduction angle measured by manual and electromagnetic goniometry was a poor predictor of osteoarthritis at 12 months of age (r = 0.231, P < 0.062, and r = 0.321, P < 0.01). The distraction index was moderately correlated with the development of osteoarthritis by 12 months of age (r = 0.493, P < 0.0000). The Ortolani sign was sensitive (100%) but not specific (41%) for the development of osteoarthritis at 12 months of age. The hip reduction angle did not further quantify the Ortolani manoeuvre as a predictor of osteoarthritis in Labrador Retrievers.

Comparison of estimates of hip dysplasia genetic parameters in Estrela Mountain Dog using linear and threshold models

Genetic parameters, breeding values, and genetic trends of hip dysplasia in Estrela Mountain Dogs were estimated using a linear model (LM) and a threshold model (TM). A database with 313 animals was used. Right and left hip joints were individually scored, according to the Fédération Cynologic Internationale grading rules of the canine hip dysplasia system, as normal (1), borderline (2), slight (3), moderate (4), and severe (5 and 6). The estimate of repeatability was lower in LM (0.86) than in TM (0.90). The same tendency was verified with the heritability because its estimate in LM was 0.38 and in TM was 0.43. However, these results did not establish any statistical differences between the models. The genetic trend of canine hip dysplasia for LM and TM showed a similarity in shape, but considerable individual differences were found in the EBV ranking lists. Therefore, the selection of breeding animals would not be the same with the 2 methodologies. To select the best method for genetic evaluation of hip dysplasia, further studies using more data and other dog breeds are required.

Repeatability and reproducibility of distraction indices in PennHIP examinations of the hip joint in dogs

Repeatability and reproducibility of Distraction Index (DI) measurements in the PennHIP method were evaluated in 100 dogs. The PennHIP distraction views sent to the PennHIP Analysis Center (PAC) were duplicated, digitalised, and identified with a code, and an adequate computer software was used for DI measurements. One examiner performed two DI measurement sessions, evaluating individually 200 hip joints. The scoring repeatability and reproducibility were estimated calculating the Intraclass Correlation Coefficient (ICC) between the two DI measurement sessions and between the second DI measurement session and the DI in PAC reports, respectively. The ICC for repeatability was 0.97 [95% confidence interval (CI), 0.96 to 0.98], and the ICC for reproducibility was 0.95 (95% CI, 0.93 to 0.96). The results suggest that the DI measurement method described is repeatable and can reproduce the PAC reports with confidence. Distraction indices measured in different PennHIP studies, using this DI measurement method and performed by trained researchers, can be considered interchangeable.