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Malekipour F, Whitton RC, Lee PVS. Advancements in Subchondral Bone Biomechanics: Insights from Computed Tomography and Micro-Computed Tomography Imaging in Equine Models. Curr Osteoporos Rep 2024:10.1007/s11914-024-00886-y. [PMID: 39276168 DOI: 10.1007/s11914-024-00886-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2024] [Indexed: 09/16/2024]
Abstract
PURPOSE OF REVIEW This review synthesizes recent advancements in understanding subchondral bone (SCB) biomechanics using computed tomography (CT) and micro-computed tomography (micro-CT) imaging in large animal models, particularly horses. RECENT FINDINGS Recent studies highlight the complexity of SCB biomechanics, revealing variability in density, microstructure, and biomechanical properties across the depth of SCB from the joint surface, as well as at different joint locations. Early SCB abnormalities have been identified as predictive markers for both osteoarthritis (OA) and stress fractures. The development of standing CT systems has improved the practicality and accuracy of live animal imaging, aiding early diagnosis of SCB pathologies. While imaging advancements have enhanced our understanding of SCB, further research is required to elucidate the underlying mechanisms of joint disease and articular surface failure. Combining imaging with mechanical testing, computational modelling, and artificial intelligence (AI) promises earlier detection and better management of joint disease. Future research should refine these modalities and integrate them into clinical practice to enhance joint health outcomes in veterinary and human medicine.
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Affiliation(s)
- Fatemeh Malekipour
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC, 3010, Australia.
| | - R Chris Whitton
- Equine Centre, Department of Veterinary Clinical Sciences, University of Melbourne, Werribee, VIC, 3030, Australia
| | - Peter Vee-Sin Lee
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC, 3010, Australia
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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 2024; 56:999-1007. [PMID: 37931621 DOI: 10.1111/evj.14023] [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: 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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Irandoust S, O'Neil LM, Stevenson CM, Franseen FM, Ramzan PHL, Powell SE, Brounts SH, Loeber SJ, Ergun DL, Whitton RC, Henak CR, Muir P. Comparison of radiography and computed tomography for identification of third metacarpal structural change and associated assessment of condylar stress fracture risk in Thoroughbred racehorses. Equine Vet J 2024. [PMID: 39143731 DOI: 10.1111/evj.14131] [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: 11/16/2023] [Accepted: 06/05/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Catastrophic injury has a low incidence but leads to the death of many Thoroughbred racehorses. OBJECTIVES To determine sensitivity, specificity, and reliability for third metacarpal condylar stress fracture risk assessment from digital radiographs (DR) and standing computed tomography (sCT). STUDY DESIGN Controlled ex vivo experiment. METHODS A blinded set of metacarpophalangeal joint DR and sCT images were prepared from 31 Thoroughbreds. Four observers evaluated the condyles and parasagittal grooves (PSG) of the third metacarpal bone for the extent of dense bone and lucency/fissure and assigned a risk assessment grade for condylar stress fracture based on imaging features. Sensitivity and specificity for detection of subchondral structural changes in the condyles and PSG, and for risk assessment for condylar stress fracture were determined by comparison with a reference assessment based on sCT and joint surface examination. Agreement between observers and the reference assessment and reliability between observers were determined. Intra-observer repeatability was also assessed. RESULTS Sensitivity for detection of structural change was lower than specificity for both imaging methods and all observers. For agreement with the reference assessment of structural change, correlation coefficients were generally below 0.5 for DR and 0.49-0.82 for sCT. For horses categorised as normal risk on reference assessment, observer assessment often agreed with the reference. Sensitivity for risk assessment was lower than specificity for all observers. For horses with a reference assessment of high risk of injury, observers generally underestimated risk. Diagnostic sensitivity of risk assessment was improved with sCT imaging, particularly for horses categorised as having elevated risk of injury from the reference assessment. Assessment repeatability and reliability was better with sCT than DR. MAIN LIMITATIONS The ex vivo study design influenced DR image sets. CONCLUSIONS Risk assessment through screening with diagnostic imaging is a promising approach to improve injury prevention in racing Thoroughbreds. Knowledge of sensitivity and specificity of fetlock lesion detection provides the critical guidance needed to improve racehorse screening programs. We found improved detection of MC3 subchondral structural change and risk assessment for condylar stress fracture with sCT ex vivo.
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Affiliation(s)
- Soroush Irandoust
- Department of Surgical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Linnea M O'Neil
- Department of Surgical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Christina M Stevenson
- Department of Surgical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Faith M Franseen
- Department of Surgical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | | | - Sabrina H Brounts
- Department of Surgical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Samantha J Loeber
- Department of Surgical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - David L Ergun
- Asto CT, 7921 UW Health Ct., Middleton, Wisconsin, USA
| | - R Chris Whitton
- Department of Veterinary Clinical Sciences, Melbourne Veterinary School, Faculty of Science, University of Melbourne, Werribee, Victoria, Australia
| | - Corinne R Henak
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Peter Muir
- Department of Surgical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Muir P, Whitton RC. Injury prevention in Thoroughbred racehorses. Equine Vet J 2024; 56:386-388. [PMID: 38578097 DOI: 10.1111/evj.14077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 02/09/2024] [Indexed: 04/06/2024]
Affiliation(s)
- Peter Muir
- School of Veterinary Medicine, Department of Surgical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - R Chris Whitton
- Equine Centre, Melbourne Veterinary School, Faculty of Science, University of Melbourne, Werribee, Victoria, Australia
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Bergstrom TC, Spriet M, Carpenter RS, Jacques KL, Stover SM. Condylar fracture location is correlated to exercise history in Thoroughbred racehorses. Equine Vet J 2024. [PMID: 38584321 DOI: 10.1111/evj.14091] [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: 08/01/2023] [Accepted: 03/14/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Condylar fractures are a major cause of morbidity and mortality in Thoroughbred racehorses. Condylar fractures have a variety of fracture configurations that suggest there may be differences in aetiopathogenesis. OBJECTIVE To determine if exercise history differs with condylar fracture location in a population of Thoroughbred racehorses. STUDY DESIGN Retrospective analysis of clinical and exercise data. METHODS Exercise history of Thoroughbred racehorses that had condylar fracture repair between 1 January 2018 and 28 February 2021 was compared between racehorses that had fractures located radiographically either within the parasagittal groove (PSG) or abaxial to the PSG (non-PSG). Age, sex, and last event (race, timed work) matched control groups were compared between the PSG and non-PSG groups. Additionally, exercise history variables of both groups were each compared with a group-specific control population, each consisting of three control racehorses of equivalent age and sex matched to each affected racehorse by last event (race or official timed work) before fracture. RESULTS Eighty-two horses with 84 fractures (45 PSG, 39 non-PSG) met inclusion criteria. Age was not different between groups (PSG: 3.4 ± 1.3 years [mean ± SD], non-PSG: 3.7 ± 1.3, p = 0.3). Number of races (PSG: 5.3 ± 7.1, non-PSG: 11.4 ± 8.9, p < 0.001), total race furlongs (PSG: 38.2 ± 54.7, non-PSG: 79.2 ± 64, p = 0.003), and number of active days (PSG: 304 ± 224, non-PSG: 488 ± 314, p = 0.003) before fracture were greater; while mean number of layups was fewer (PSG: 1.0 ± 1.2, non-PSG: 0.5 ± 0.7, p = 0.02) in horses with non-PSG fracture. Horses with non-PSG fracture had more differences compared with their respective control group than horses with PSG fractures. Outcomes following fracture repair were not different between groups. MAIN LIMITATIONS Retrospective study, one regional racehorse population, two-dimensional imaging and potential inherent bias for fracture localisation, low statistical power for return to performance analysis. CONCLUSIONS Thoroughbred racehorses with non-PSG condylar fractures have a more extensive exercise history than horses with PSG condylar fractures, suggesting differences in fracture aetiopathogenesis.
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Affiliation(s)
- Thomas C Bergstrom
- William R. Prichard Veterinary Medical Teaching Hospital, University of California, Davis, California, USA
| | - Mathieu Spriet
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
| | | | - Kevin L Jacques
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Susan M Stover
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
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Goetz JE, Brouillette MJ, Sakyi MY, Paulsen DP, Petersen EB, Fredericks DC. A New Method for Creating Impact-Induced Intra-Articular Fractures in a Rabbit Model Induces Severe Post-Traumatic Osteoarthritis. J Orthop Trauma 2024; 38:e133-e141. [PMID: 38206679 DOI: 10.1097/bot.0000000000002757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/30/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVES The objective of this work was to develop a model of intra-articular fracture (IAF) in a rabbit and document the speed and severity of degenerative joint changes after fracture fixation. METHODS With Institutional Animal Care & Use Committee approval, impact-induced IAFs were created in the distal tibia of 16 New Zealand White rabbits. Fractures were fixed with a plate and screws. Pain and function were monitored at regular postoperative intervals with limb loading analysis. Twelve or 26 weeks after fracture, animals were euthanized for histological assessment of cartilage degeneration and micro-computed tomography analysis of bone histomorphometry. RESULTS Eleven animals successfully completed the study. Maximum foot force in the fractured limb was 41% ± 21% lower than preoperative values ( P = 0.006) 12 weeks after fracture and remained 25% ± 13% lower ( P = 0.081) after 26 weeks. Cortical bone mineral density in micro-computed tomography images was 34% ± 13% lower 12 weeks after fracture ( P < 0.001) and remained (42% ± 8%) lower 26 weeks after fracture ( P < 0.001). Twelve weeks after fracture, Mankin scores of cartilage degeneration were significantly higher in the medial talus ( P = 0.007), lateral talus ( P < 0.001), medial tibia ( P = 0.017), and lateral tibia ( P = 0.002) of the fractured limb compared with the uninjured contralateral limb. Average Mankin scores in the talus increased from 12 to 26 weeks (5.9 ± 0.9 to 9.4 ± 0.4; P < 0.001 lateral; 5.4 ± 1.8 to 7.8 ± 2.0; P = 0.043 medial), indicating substantial and progressive joint degeneration. CONCLUSIONS The ankle joint of the New Zealand White rabbit provides the smallest available model of impact-induced IAF that can be treated with clinically relevant techniques and replicates key features of healing and degeneration found in human patients.
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Affiliation(s)
- Jessica E Goetz
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA
| | - Marc J Brouillette
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
| | - Maxwell Y Sakyi
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
| | - Danielle P Paulsen
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
| | - Emily B Petersen
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
| | - Douglas C Fredericks
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA; and
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Brabon A, Hughes KJ, Jensen K, Xie G, Labens R. Influence of screw configuration on reduction and stabilization of simulated complete lateral condylar fracture in equine limbs. Vet Surg 2024; 53:447-459. [PMID: 38380523 DOI: 10.1111/vsu.14077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/04/2023] [Accepted: 01/28/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE To determine the influence of screw configuration on the reduction and stabilization of simulated complete lateral condylar fracture. STUDY DESIGN Randomized experimental crossover study. METHODS A lateral condylar fracture was simulated in 18 cadaver limbs from nine horses. Each limb underwent repair with 4.5 mm diameter cortex screws, tightened to 4 Nm, in a linear and triangular configuration. Computed tomography (CT) of each repair was performed with the limbs in unloaded and loaded conditions. Fracture gaps were measured at the dorsal, palmar, and middle locations of the third metacarpal condyle. Fracture gap measurements were graded 0-4, based on voxels. Following descriptive analysis, a Bayesian network (BN) model was fitted to the data. RESULTS The median fracture grade was 0 (range: 0-4) for unloaded linear repairs and 2 (0-4) for loaded linear repairs. The median fracture grade was 0 (0-3) for unloaded triangular repairs and 1 (0-3) for loaded triangular repairs. Bayesian network sensitivity analysis showed that the construct configuration reduced the uncertainty in the measured fracture outcome by 0.8%. CONCLUSION Triangular screw configuration resulted in better fracture reduction and stability in comparison with linear screw configuration. However, the BN sensitivity analysis results showed that the effect of construct configuration on fracture outcome was weak. CLINICAL SIGNIFICANCE These findings indicate a low probability that triangular repair of lateral condylar fracture will result in improved outcomes, when compared with linear repair.
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Affiliation(s)
- Ashley Brabon
- School of Agricultural, Environmental and Veterinary Sciences, Faculty of Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Kristopher James Hughes
- School of Agricultural, Environmental and Veterinary Sciences, Faculty of Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Kelsey Jensen
- School of Agricultural, Environmental and Veterinary Sciences, Faculty of Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Gang Xie
- Quantitative Consulting Unit, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Raphael Labens
- School of Agricultural, Environmental and Veterinary Sciences, Faculty of Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia
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Bergstrom TC, Spriet M, O'Brion J, Carpenter R. Positron emission tomography assessment of metacarpal/metatarsal condylar fractures post surgical repair: Prospective study in 14 racehorses. Vet Surg 2024; 53:131-142. [PMID: 37732635 DOI: 10.1111/vsu.14031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/24/2023] [Accepted: 09/03/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVES To assess 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) findings associated with metacarpal/metatarsal condylar fractures at the time of fracture repair and through healing. STUDY DESIGN Prospective descriptive study. ANIMALS Fourteen Thoroughbred racehorses. METHODS 18F-NaF PET was performed within 4 days of surgical metacarpal/metatarsal condylar fracture repair, on both the injured and contralateral limb. Follow-up PET scans were offered at 3- and 5-months post fracture repair. Areas of abnormal uptake were assessed using a previously validated grading system. RESULTS Eight fractures were located in the parasagittal groove (PSG) (six lateral and two medial) and six fractures were located abaxial to the PSG (non-PSG) through the palmar/plantar condyle (all lateral). All horses in the latter group had uptake in the lateral palmar condyle of the contralateral limb suggestive of stress remodeling. Three horses with PSG fractures had uptake in a similar location in the contralateral limb. Horses with lateral condylar fracture only presented minimal or mild uptake in the medial condyle, which is considered atypical in the front limbs for horses in full training. Four horses developed periarticular uptake in the postoperative period suggestive of degenerative joint disease, three of these horses had persistent uptake at the fracture site. These four horses did not return to racing successfully. CONCLUSION The findings of this study provide evidence of pre-existing lesions and specific uptake patterns in racehorses suffering from metacarpal/metatarsal condylar fractures. CLINICAL SIGNIFICANCE PET has a possible role in the prevention, diagnosis, and postoperative monitoring of metacarpal/metatarsal condylar fractures in racehorses.
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Affiliation(s)
- Thomas C Bergstrom
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, California, USA
| | - Mathieu Spriet
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Julie O'Brion
- Southern California Equine Foundation, Arcadia, California, USA
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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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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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Steel C, Ahern B, Zedler S, Vallance S, Galuppo L, Richardson J, Whitton C, Young A. Comparison of Radiography and Computed Tomography for Evaluation of Third Carpal Bone Fractures in Horses. Animals (Basel) 2023; 13:ani13091459. [PMID: 37174496 PMCID: PMC10177357 DOI: 10.3390/ani13091459] [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: 03/13/2023] [Revised: 04/13/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
Radiographs underestimate the extent of bone injury in horses with third carpal bone (C3) fractures (Fx). We aimed to describe bone pathologies identified using computed tomography (CT) and compare the diagnostic value of digital radiography (DR) and CT in horses with C3 Fx. CT images of 15 racehorses with C3 Fx and 10 controls were reviewed (Part 1) then DR and CT images of 26 racehorses (24 Thoroughbred, 2 Standardbred) with C3 Fx (Part 2) were evaluated. Agreement on fracture geometry and concomitant bone lesions was tested between DR and CT using the kappa statistic (Part 2). For agreement analysis, 38 limbs were used (27 Fx carpi from 26 horses and 11 contralateral carpi). Intermodality agreement was good for recognition of displacement, fair for comminution, articular surface bone loss and osseous fragmentation, and poor-slight for recognition of whether the Fx was complete, additional fissures and lucencies. CT provides more detailed information than DR regarding bone pathology and fracture configuration in horses with C3 fracture. Correlation of CT findings with clinical information and outcome needs to be explored; however, the more accurate diagnosis possible with CT is likely valuable when deciding on the most appropriate management and for surgical planning.
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Affiliation(s)
- Catherine Steel
- Department of Veterinary Clinical Services, The Hong Kong Jockey Club, Sha Tin, New Territories, Hong Kong
| | - Benjamin Ahern
- Equine Specialist Hospital, The University of Queensland, Gatton, QLD 4343, Australia
| | - Steven Zedler
- Equine Specialist Hospital, The University of Queensland, Gatton, QLD 4343, Australia
| | | | - Lawrence Galuppo
- Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | | | | | - Alex Young
- Equine Specialist Hospital, The University of Queensland, Gatton, QLD 4343, Australia
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