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Giorio ME, Graham RJ, Berner D, O'Neill HD, Bladon BM. Presence and size of synovial masses within the navicular bursa correlate well between magnetic resonance imaging and bursoscopy and have a guarded prognosis. Equine Vet J 2024; 56:982-988. [PMID: 38131123 DOI: 10.1111/evj.14040] [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: 06/12/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Focal hyperintense lesions within the navicular bursa emanating from the dorsal border of the deep digital flexor tendon (DDFT) can be recognised on T1-weighted magnetic resonance images (MRI) and have been attributed to lameness in horses. Removal of these lesions, also referred to as synovial masses, by navicular bursoscopy is currently recommended. OBJECTIVES To investigate the correlation between MRI and navicular bursoscopic findings. It is hypothesised that the prognosis following surgery is proportional to the size of the DDFT lesion. STUDY DESIGN Retrospective analysis of clinical records. METHODS Horses undergoing standing low-field MRI and navicular bursoscopy with >1 year follow-up were included. A grading system was developed to classify the size of synovial mass(es) and lesion(s) of the DDFT on MRI and at surgery. Generalised estimating equations were used to evaluate the association between MRI findings and surgery and between outcome and severity of the tendon injury. RESULTS Fifty-nine horses presenting over a 15-year period (2006-2021) fulfilled inclusion criteria. Ninety navicular bursae were examined both on MRI and endoscopically. There was strong correlation between the size of synovial masses and tendon lesions on MRI and bursoscopy (p < 0.001, OR: 25.61, 95% CI 8.71-75.29 and p < 0.001, OR: 7.34, 95% CI 2.70-19.92, respectively). Size of tendon lesion and synovial mass had no impact on prognosis (p = 0.3, OR: 1, 95% CI 1-1 and p = 0.1, OR: 1, 95% CI 1-1, respectively), which was guarded (30.5% return to previous level of exercise). MAIN LIMITATIONS Performance data for conservatively treated horses with MRI-detected synovial masses was not considered, nor was the effect of navicular bursal effusion. Horses were not randomly assigned to treatment protocols. CONCLUSION There is good correlation between MRI and bursoscopic findings of DDFT lesions and synovial masses within the navicular bursa, with no false positives. Size of the synovial masses and DDFT lesions does not influence prognosis following navicular bursoscopy.
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Affiliation(s)
- Maria Elisabetta Giorio
- Equine Referral Hospital, Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Robyn J Graham
- Equine Hospital, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
| | - Dagmar Berner
- Equine Referral Hospital, Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
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Frietman SK, van Proosdij R, Rijkenhuizen ABM, van Veggel E. A novel transcoronal surgical technique for the treatment of cystic lesions of the distal phalanx: A cadaveric study. Vet Surg 2024; 53:1062-1072. [PMID: 38819517 DOI: 10.1111/vsu.14105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 03/16/2024] [Accepted: 04/26/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVE To assess the feasibility of a novel transcoronal approach for the treatment of axial type 3 cysts of the palmar/plantar aspect of the distal phalanx (P3). STUDY DESIGN Ex vivo, experimental study. SAMPLE POPULATION Ten cadaveric specimens, four forelimbs and six hindlimbs. METHODS All cadaveric specimens underwent radiographically guided drilling, followed by cortical screw placement. The cartilage was macroscopically assessed after disarticulation of the distal interphalangeal joint. The entry point and trajectory were evaluated with computed tomography. Results were categorized as: axial, near-axial and abaxial. The minimal distance from the outer margin of the drill hole and the proximal border of the subchondral bone plate was measured using frontal computed tomographic slices. RESULTS Eight of the 10 screws were in an axial to near-axial position and nine followed the desired axial to near-axial trajectory. One screw was inserted axially but continued in an abaxial trajectory. Iatrogenic damage to the joint cartilage, flexor cortex and solar canal of P3 was not observed. All cortical screws were placed close to the proximal subchondral bone-plate of P3. CONCLUSION The desired axial/near-axial drilling and screw placement, under radiographic guidance, was achieved in nine out of 10 specimens. CLINICAL SIGNIFICANCE This novel technique seems promising for the treatment of inaccessible P3 cysts. Additional studies are required to investigate its feasibility in clinical cases, and the long-term outcome following transcystic screw placement of type 3 P3 cysts.
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Affiliation(s)
- Sjoerd K Frietman
- Equine Department, Veterinary Clinic Den Ham, Den Ham, The Netherlands
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Byrne CA, Voute LC, Marshall JF. Interobserver agreement during clinical magnetic resonance imaging of the equine foot. Equine Vet J 2024. [PMID: 38946165 DOI: 10.1111/evj.14126] [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: 12/01/2023] [Accepted: 06/02/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Agreement between experienced observers for assessment of pathology and assessment confidence are poorly documented for magnetic resonance imaging (MRI) of the equine foot. OBJECTIVES To report interobserver agreement for pathology assessment and observer confidence for key anatomical structures of the equine foot during MRI. STUDY DESIGN Exploratory clinical study. METHODS Ten experienced observers (diploma or associate level) assessed 15 equine foot MRI studies acquired from clinical databases of 3 MRI systems. Observers graded pathology in seven key anatomical structures (Grade 1: no pathology, Grade 2: mild pathology, Grade 3: moderate pathology, Grade 4: severe pathology) and provided a grade for their confidence for each pathology assessment (Grade 1: high confidence, Grade 2: moderate confidence, Grade 3: limited confidence, Grade 4: no confidence). Interobserver agreement for the presence/absence of pathology and agreement for individual grades of pathology were assessed with Fleiss' kappa (k). Overall interobserver agreement for pathology was determined using Fleiss' kappa and Kendall's coefficient of concordance (KCC). The distribution of grading was also visualised with bubble charts. RESULTS Interobserver agreement for the presence/absence of pathology of individual anatomical structures was poor-to-fair, except for the navicular bone which had moderate agreement (k = 0.52). Relative agreement for pathology grading (accounting for the ranking of grades) ranged from KCC = 0.19 for the distal interphalangeal joint to KCC = 0.70 for the navicular bone. Agreement was generally greatest at the extremes of pathology. Observer confidence in pathology assessment was generally moderate to high. MAIN LIMITATIONS Distribution of pathology varied between anatomical structures due to random selection of clinical MRI studies. Observers had most experience with low-field MRI. CONCLUSIONS Even with experienced observers, there can be notable variation in the perceived severity of foot pathology on MRI for individual cases, which could be important in a clinical context.
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Affiliation(s)
- Christian A Byrne
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Lance C Voute
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - John F Marshall
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Zalig V, Vengust M, Blagus R, Berner D, Sandow C, Hanna A, Miklavcic M. The difference in radiographic findings in the distal limbs of working Lipizzan horses, used for dressage or driving. Front Vet Sci 2024; 11:1393325. [PMID: 38868502 PMCID: PMC11168202 DOI: 10.3389/fvets.2024.1393325] [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: 02/28/2024] [Accepted: 05/03/2024] [Indexed: 06/14/2024] Open
Abstract
Introduction Lameness originating from the distal limb is common in sport horses and can vary depending on the dynamics of movement and the surface, with differences in shoeing exacerbating this variability. Driving horses work primarily on hard surfaces (pavement), whereas dressage horses work primarily on soft surfaces (riding arenas with sand). Driving horses are traditionally shod with small fixed studs made of hard metal, which are attached to the horseshoe at 4 points, while dressage horses are shod with a simple horseshoe. We investigated the hypothesis that there is a difference in the pathological radiographic findings of the distal limbs between driving and dressage horses. The variability in the stable management and training program was minimized by including horses from the same farm. Methods Twenty horses in a driving training program and 20 horses in a dressage program were included in the study. Radiographs of the both front feet were obtained and quantitatively evaluated for radiographic changes by three surgery/diagnostic imaging specialists. Interrater reliability was measured, and multivariate analysis was performed to compare differences in pathological radiographic findings of the distal limbs between the two groups. Results Kendal's concordance coefficient indicated an agreement among raters (Kw ≠ 0) for all observations. Radiographic signs of degenerative joint disease of the distal interphalangeal joint were more common in the group of driving horses compared to dressage horses. Conclusion Our hypothesis was confirmed, as there were significant pathological differences between groups in distal articular margin of middle phalanx, joint space narrowing, and irregular joint surface of the middle phalanx.
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Affiliation(s)
| | - Modest Vengust
- Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Rok Blagus
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Cole Sandow
- Cole Sandow - Hagyard Equine Medical Institute, Lexington, KY, United States
| | - Ashley Hanna
- Washington State University, Pullman, WA, United States
| | - Mitja Miklavcic
- UC Davis School of Veterinary Medicine, Davis, CA, United States
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Lovett BA, Firth EC, Perrott MR, Munday JS, Pontre BP, Lydon AMP, Symonds JE, Preece MA, Herbert NA. Magnetic resonance imaging shows spinal curvature in Chinook salmon (Oncorhynchus tshawytscha) is associated with chronic inflammation of peri-vertebral soft tissues. JOURNAL OF FISH DISEASES 2024; 47:e13900. [PMID: 38058214 DOI: 10.1111/jfd.13900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023]
Abstract
Chinook salmon (Oncorhynchus tshawytscha) farmed in New Zealand are known to develop abnormal spinal curvature late in seawater production. Its cause is presently unknown, but there is evidence to suggest a neuromuscular pathology. Using magnetic resonance imaging (MRI), we evaluated the relationship between soft tissue pathology and spinal curvature in farmed Chinook salmon. Regions of interest (ROIs) presenting as pathologic MRI signal hyper-intensity were identified from scans of 24 harvest-sized individuals: 13 with radiographically-detectable spinal curvature and 11 without. ROIs were excised from individuals using anatomical landmarks as reference points and histologically analysed. Pathologic MRI signal was observed more frequently in individuals with radiographic curvature (92%, n = 12) than those without (18%, n = 2), was localized to the peri-vertebral connective tissues and musculature, and presented as three forms: inflammation, fibrosis, or both. These pathologies are consistent with a chronic inflammatory process, such as that observed during recovery from a soft tissue injury, and suggest spinal curvature in farmed Chinook salmon may be associated with damage to and/or compromised integrity of the peri-vertebral soft tissues. Future research to ascertain the contributing factors is required.
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Affiliation(s)
- Bailey A Lovett
- University of Auckland, Auckland, New Zealand
- Cawthron Institute, Nelson, New Zealand
| | | | | | | | | | | | | | - Mark A Preece
- The New Zealand King Salmon Company Limited, Nelson, New Zealand
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Germonpré J, Vandekerckhove LMJ, Raes E, Chiers K, Jans L, Vanderperren K. Post-mortem feasibility of dual-energy computed tomography in the detection of bone edema-like lesions in the equine foot: a proof of concept. Front Vet Sci 2024; 10:1201017. [PMID: 38249561 PMCID: PMC10797750 DOI: 10.3389/fvets.2023.1201017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 11/27/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction In this proof-of-concept study, the post-mortem feasibility of dual-energy computed tomography (DECT) in the detection of bone edema-like lesions in the equine foot is described in agreement with the gold standard imaging technique, which is magnetic resonance imaging (MRI). Methods A total of five equine cadaver feet were studied, of which two were pathological and three were within normal limits and served as references. A low-field MRI of each foot was performed, followed by a DECT acquisition. Multiplanar reformations of DECT virtual non-calcium images were compared with MRI for the detection of bone edema-like lesions. A gross post-mortem was performed, and histopathologic samples were obtained of the navicular and/or distal phalanx of the two feet selected based on pathology and one reference foot. Results On DECT virtual non-calcium imaging, the two pathological feet showed diffuse increased attenuation corresponding with bone edema-like lesions, whereas the three reference feet were considered normal. These findings were in agreement with the findings on the MRI. Histopathology of the two pathologic feet showed abnormalities in line with bone edema-like lesions. Histopathology of the reference foot was normal. Conclusion DECT virtual non-calcium imaging can be a valuable diagnostic tool in the diagnosis of bone edema-like lesions in the equine foot. Further examination of DECT in equine diagnostic imaging is warranted in a larger cohort, different locations, and alive animals.
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Affiliation(s)
- Jolien Germonpré
- Department of Morphology, Imaging, Orthopedics, Rehabilitation, and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Louis M. J. Vandekerckhove
- Department of Morphology, Imaging, Orthopedics, Rehabilitation, and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Els Raes
- Department of Morphology, Imaging, Orthopedics, Rehabilitation, and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Koen Chiers
- Department of Pathobiology, Pharmacology, and Zoological Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Lennart Jans
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
| | - Katrien Vanderperren
- Department of Morphology, Imaging, Orthopedics, Rehabilitation, and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Górecka-Bruzda A, Siemieniuch M, Lansade L, Stanley CR. How Useful Are Existing Protocols in the Quick Assessment of the Welfare of Semi-Feral Horses? Pilot Study on Konik Polski Horses Living in the Forest Sanctuary. Animals (Basel) 2023; 14:8. [PMID: 38200740 PMCID: PMC10778358 DOI: 10.3390/ani14010008] [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: 10/31/2023] [Revised: 12/02/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
Scientifically validated and standardised methods for the evaluation of the welfare of free-living horses are urgently needed by both the owners and managers of these populations and those responsible for implementing national welfare legislation. The aim of the study was to test the feasibility and usefulness of two welfare protocols that could be applied to semi-feral populations: a prototype of welfare assessment template (WAT) for Carneddau semi-feral ponies and the IFCE/INRAE Horse Welfare Protocol. Additionally, the body condition scale designed by Henneke (BCS-H) was employed. The study took place in July/August 2022 and April 2023 to evaluate the welfare of a pilot population of nineteen semi-feral Konik polski horses. The horses scored high or satisfactory under indicators across both protocols; only body condition scores were significantly lower in early spring (BCS-WAT: 1.11 ± 0.57; BCS-H: 3.84 ± 1.17) than in the summer (BCS-WAT: 1.58 ± 0.61; BCS-H: 5.63 ± 1.01). Our study confirmed the feasibility of utilising most of the WAT and IFCE/INRAE welfare indicators in semi-feral horses. Some adaptations, such as considering validation of scales, positive welfare indicators and animals' free-choice of conditions, have been suggested for future in-field application.
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Affiliation(s)
- Aleksandra Górecka-Bruzda
- Department of Animal Behaviour and Welfare, Institute of Genetics and Animal Biotechnology, Polish Academy of Sciences, 05-552 Magdalenka, Poland
| | - Marta Siemieniuch
- The Research Station of the Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Popielno, 12-222 Ruciane-Nida, Poland;
| | - Léa Lansade
- Unité Physiologie de la Reproduction et des Comportements, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, Centre National de la Recherche Scientifique, Institut Français du Cheval et d’Equitation, F-37380 Nouzilly, France;
| | - Christina R. Stanley
- Animal Behaviour & Welfare Research Group, Department of Biological Sciences, University of Chester, Chester CH1 4B, UK;
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Barrett MF, Goorchenko GE, Frisbie DD. Comparison of Ultrasound and Magnetic Resonance Imaging for Identifying Soft Tissue Abnormalities in the Palmar Aspect of the Equine Digit. Animals (Basel) 2023; 13:2328. [PMID: 37508105 PMCID: PMC10376038 DOI: 10.3390/ani13142328] [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: 06/05/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Damage to the soft tissue structures of the digit is a common source of equine lameness. While magnetic resonance imaging (MRI) allows for the most complete diagnostic imaging of the equine digit, ultrasound is more readily available and less expensive. This prospective diagnostic accuracy study compares ultrasound to MRI for the diagnosis of injuries visible with ultrasound within the digit, including the deep digital flexor tendon (DDFT), collateral sesamoidean ligament (CSL), and navicular bursa. Clinical patients underwent an MRI of the digit and a blinded ultrasound of the digit between the heel bulbs, and results of the two modalities were compared. A total of 70 ultrasound and MRI exams of 45 horses were included. Ultrasound had good sensitivity (85%), moderate specificity (60%), and accuracy of 70% for evaluating the dorsal tearing of the DDFT. Accuracy was lower for navicular bursa effusion (67%), navicular bursa proliferation (61%), and CSL enlargement (61%). Tearing of the DDFT distal to the navicular bone was identified with MRI in 27 limbs, 20 of which also had dorsal damage proximal to the navicular bone identified with ultrasound. Ultrasound evaluation remains a useful screening tool, particularly for the assessment of DDFT tearing proximal to the navicular bone but risks under-diagnosing pathology to the navicular bursa and CSL. Clinically significant concurrent damage to the distal DDFT and other osseous and soft tissues in the hoof capsule is unlikely to be identified without MRI.
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Affiliation(s)
- Myra F Barrett
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | | | - David D Frisbie
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
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Aßmann AD, Ohlerth S, Torgerson PR, Bischofberger AS. Sensitivity and specificity of 3 Tesla magnetic resonance imaging and multidetector computed tomographic tenography to identify artificially induced soft tissue lesions in the equine cadaveric digital flexor tendon sheath. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Anton D. Aßmann
- Vetsuisse‐Faculty, Equine Hospital University of Zürich Zürich Switzerland
| | - Stefanie Ohlerth
- Clinic of Diagnostic Imaging, Vetsuisse‐Faculty University of Zürich Zürich Switzerland
| | - Paul R. Torgerson
- Section of Veterinary Epidemiology, Vetsuisse‐Faculty University of Zürich Zürich Switzerland
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Hewitt‐Dedman CL, Biggi M, Van Zadelhoff C, Schwarz T, Reardon RJM, Taylor SE. Imaging findings and clinical outcome of foot pain attributable to insertional deep digital flexor tendon injury and/or fluid signal within the flexor surface of the distal phalanx. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C. L. Hewitt‐Dedman
- Royal (Dick) School of Veterinary Studies and Roslin Institute The University of Edinburgh Roslin UK
| | - M. Biggi
- VetCT St John’s Innovation Centre Cambridge UK
| | - C. Van Zadelhoff
- Royal (Dick) School of Veterinary Studies and Roslin Institute The University of Edinburgh Roslin UK
| | - T. Schwarz
- Royal (Dick) School of Veterinary Studies and Roslin Institute The University of Edinburgh Roslin UK
| | - R. J. M. Reardon
- Royal (Dick) School of Veterinary Studies and Roslin Institute The University of Edinburgh Roslin UK
| | - S. E. Taylor
- Royal (Dick) School of Veterinary Studies and Roslin Institute The University of Edinburgh Roslin UK
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Fairburn AJ, Sherlock CE, Partridge SM, Mair TS. A case‐control study of the morphological measurements of equine distal interphalangeal joints affected by osseous cyst‐like lesions. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - S. M. Partridge
- School of Veterinary Medicine Faculty of Health and Medical Sciences Vet School Main Building (VSM) Guildford Surrey UK
| | - T. S. Mair
- Bell Equine Veterinary Clinic Maidstone Kent UK
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Madsen LM, Gutierrez-Nibeyro SD, Stewart MC, McCoy AM, Schaeffer DJ. Kinetic Analysis in Horses With Deep Digital Flexor Tendinopathy Within the Digit Diagnosed by Magnetic Resonance Imaging. Front Vet Sci 2022; 9:893026. [PMID: 35711793 PMCID: PMC9195072 DOI: 10.3389/fvets.2022.893026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesTo determine the stance duration and ground reaction forces (GRF) of horses with deep digital flexor (DDF) tendinopathy at the level of the foot and compare the stance duration and GRF to those of clinically sound horses.DesignProspective clinical study.AnimalsSixteen horses (seven horses with bilateral forelimb lameness, four horses with unilateral forelimb lameness, and five horses with no lameness).ProceduresAnalyses of kinetic variables were performed on both forelimbs from sound horses and horses diagnosed with chronic DDF tendinopathy. Stance duration and longitudinal and vertical components of the GRF were determined for the limbs of clinically sound horses and limbs of horses with DDF tendinopathy. Separate Spearman correlation analyses were used to assess potential association within groups (combined left and right forelimbs of clinically sound horses, lamest limbs of horses with DDF tendinopathy, and contralateral limbs of horses with DDF tendinopathy) and with the set of kinetic variables. Analysis of variance on mean ranks of tied values was used to determine differences in kinetic variables between groups (PROC GLIMMIX) using the kinetic values of the clinically sound horses as the reference group.ResultsThere were a total of 11 lame horses. Seven horses had bilateral forelimb lameness and four had unilateral lameness. Of the 11 horses, there were 15 DDF tendinopathies. There were eight dorsal border DDF tendinopathies, five core DDF tendinopathies, and two sagittal/parasagittal splits DDF tendinopathies. The most lame limbs of horses with DDF tendinopathy had significantly smaller values for peak vertical force and time of peak braking force than did forelimbs of clinically sound horses. Also, the most lame limbs of horses with DDF tendinopathy had significantly larger values for the time of peak vertical force than did forelimbs of clinically sound horses.Conclusions and Clinical RelevanceHorses with chronic DDF tendinopathies develop certain alterations of GRF parameters. This information can be used in future studies to determine if particular kinetic variable changes in horses with DDF tendinopathies differ from those of horses with other pathologies within the foot and therefore could be diagnostic.
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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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Z-Bar Shoeing Demonstrates Potential for Long-Term Foot Pain Management during an Exercise Training Regimen in a Show Jumping Pony with Uniaxial Palmar Pain. Case Rep Vet Med 2022; 2022:8468403. [PMID: 35465448 PMCID: PMC9020972 DOI: 10.1155/2022/8468403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/13/2022] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Z-bar shoeing has been implemented to relieve uniaxial palmar pain arising from the structures in the affected region. However, there have been no reports on the long-term application of the z-bar shoe during exercise training regimens. A 10-year-old mixed-breed show jumping pony presented with an occasional short stride and abnormal rhythm while turning during routine exercise for three months. Gait analysis conducted by trotting off on both hard and soft surfaces showed no lameness in the straight line on both types of surfaces. However, right forelimb lameness was detected with moderate and slight pain accompanying hard surface lunging in clockwise and counterclockwise directions, respectively. Sequential examination of uniaxial perineural anaesthesia confirmed that the pony suffered from medial palmar pain on the right foreleg. Mild distal border irregularity of the navicular bone was also observed radiographically. The z-bar shoe was designed relative to the palmar digital anaesthesia and subsequently applied on the lame leg. The pony demonstrated a marked reduction in lameness severity immediately post-Z-bar shoeing. Physical exercise was resumed a few days after the shoeing practice. The pony underwent routine exercise training while continuously fitting with the Z-bar shoe for 24 weeks without recurrent lameness or complications. Application of z-bar shoe showed the potential for long-term foot pain management during an exercise training regimen in a show jumping pony with uniaxial palmar pain.
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Hewitt‐Dedman CL, O'Neill HD, Bladon BM. Arthroscopic removal of palmar intermediate carpal bone fracture fragments in four horses using a transthecal approach through the carpal flexor tendon sheath. Vet Surg 2022; 51:929-939. [PMID: 35403724 PMCID: PMC9544275 DOI: 10.1111/vsu.13813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 01/30/2022] [Accepted: 03/19/2022] [Indexed: 12/01/2022]
Abstract
Objective Study design Animals Methods Results Conclusion Clinical significance
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Aßmann AD, Ohlerth S, Suárez Sánchez-Andráde J, Torgerson PR, Bischofberger AS. Ex vivo comparison of 3 Tesla magnetic resonance imaging and multidetector computed tomography arthrography to identify artificial soft tissue lesions in equine stifles. Vet Surg 2022; 51:648-657. [PMID: 35289943 PMCID: PMC9314790 DOI: 10.1111/vsu.13798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 01/22/2022] [Accepted: 02/13/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the diagnostic performance of computed tomographic arthrography (CTA) and 3 Tesla magnetic resonance imaging (MRI) for detecting artificial meniscal, meniscotibial ligament (MTL) lesions and cruciate ligament (CL) lesions in horses. STUDY DESIGN Ex vivo controlled laboratory study. ANIMALS Nineteen stifles from adult horses. METHODS Stablike defects (n = 84) (16 mm long, 10 mm deep) were created in the menisci (n = 35), CLs (n = 24), and MTLs (n = 25) via arthroscopy prior to MRI and CTA (80 mL contrast at 85 mg/mL per joint). Two radiologists, unaware of the lesions, reached a consensus regarding the presence of lesions, based on 2 reviews of each study. Sensitivity and specificity of MRI and CTA were determined using arthroscopy as a reference and compared with McNemar's tests. RESULTS The sensitivity and specificity of MRI (41% and 86% respectively) and CTA (32% and 90% respectively) did not differ (P = .65). The sensitivity (MRI: 24%‐50%; CTA:19%‐40%) and specificity (MRI: 75%‐92%; CTA 75%‐100%) of imaging modalities did not differ when detecting lesions of the menisci, MTLs, and CLs (P = .1‐1.0). The highest sensitivities were achieved when MTLs were evaluated with MRI (50%) and CLs with both modalities (40%). CONCLUSIONS The diagnostic performance of CTA was comparable with that of MRI, with a low to moderate sensitivity and high specificity. CLINICAL SIGNIFICANCE Computed tomographic arthrography should be considered as an adjunct to diagnose CL injuries. This is important for equine clinicians, as the CL cannot be visualized adequately using basic imaging techniques preoperatively.
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Affiliation(s)
- Anton D Aßmann
- Equine Hospital, Vetsuisse-Faculty, University of Zurich, Zurich, Switzerland
| | - Stefanie Ohlerth
- Diagnostic Imaging Clinic, University of Zurich, Zurich, Switzerland
| | | | - Paul R Torgerson
- Section of Veterinary Epidemiology, Vetsuisse-Faculty, University of Zurich, Zurich, Switzerland
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17
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Lesca H, Fairburn A, Sherlock C, Mair T. The use of advanced vs. conventional imaging modalities for the diagnosis of subchondral bone injuries. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- H. Lesca
- CVS Group plc Bell Equine Veterinary Clinic Maidstone Kent UK
| | - A. Fairburn
- CVS Group plc Bell Equine Veterinary Clinic Maidstone Kent UK
| | - C. Sherlock
- CVS Group plc Bell Equine Veterinary Clinic Maidstone Kent UK
| | - T. Mair
- CVS Group plc Bell Equine Veterinary Clinic Maidstone Kent UK
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18
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Frietman SK, Aert CDMV, Braake F, Compagnie E, De Heer N. A detailed radiographic description and correlated magnetic resonance imaging findings of an infrequently identified articular indentation of the articular margin of the distal phalanx. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - F. Braake
- Veterinary Clinic Emmeloord Emmeloord The Netherlands
| | - E. Compagnie
- Veterinary Clinic Emmeloord Emmeloord The Netherlands
| | - N. De Heer
- Veterinary Clinic Emmeloord Emmeloord The Netherlands
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19
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McInturff C, Zanotto G, McInturff M, Hendrickson D. An Alternate Radiographic Guided Technique for Injection of the Equine Navicular Bursa Using a 40 mm (1.5-inch) 20-Gauge Needle: A Pilot Study. J Equine Vet Sci 2021; 108:103775. [PMID: 34800798 DOI: 10.1016/j.jevs.2021.103775] [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: 05/21/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 11/28/2022]
Abstract
Injection of the equine navicular bursa can be technically challenging, and inadvertent penetration of other synovial structures is common using previously described techniques. When injecting the navicular bursa, inadvertent penetration of other synovial structures and hoof configuration can affect success rate, especially when performed by inexperienced operators. The aim of this study is to describe an alternate radiographic guided technique for injection of the equine navicular bursa that consistently avoids penetration of the distal interphalangeal joint using a 40 mm (1.5-inch) 20-gauge needle. This ex vivo pilot study compared the success rate, needle redirection rate, and rate of inadvertent synovial penetration of a novel injection technique for the equine navicular bursa between operators with three differing levels of experience in equine veterinary medicine (1 year, 8 years, >30 years). There was no significant difference in success rate between operators regardless of level of experience or hoof configuration, and inadvertent penetration of other synovial structures was highly unlikely. Thus, using the described technique, injection of the navicular bursa can be performed by individuals of various experience levels in equine veterinary practice, and can be achieved with a high success rate with little chance of inadvertent penetration of other synovial structures regardless of hoof configuration.
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Affiliation(s)
- Colton McInturff
- Clinical Sciences Department, Colorado State University, Fort Collins, CO.
| | - Gustavo Zanotto
- Large Animal Clinical Sciences, Texas A&M University, College Station, TX
| | | | - Dean Hendrickson
- Clinical Sciences Department, Colorado State University, Fort Collins, CO
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20
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Hoaglund EL, Barrett MF. Magnetic resonance imaging changes of the navicular bursa following navicular bursoscopy in seven horses. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- E. L. Hoaglund
- Department of Environmental Health and Radiological Sciences Colorado State University Veterinary Teaching Hospital Fort Collins Colorado USA
| | - M. F. Barrett
- Department of Environmental Health and Radiological Sciences Colorado State University Veterinary Teaching Hospital Fort Collins Colorado USA
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21
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Evrard L, Joostens Z, Vandersmissen M, Audigié F, Busoni V. Comparison Between Ultrasonographic and Standing Magnetic Resonance Imaging Findings in the Podotrochlear Apparatus of Horses With Foot Pain. Front Vet Sci 2021; 8:675180. [PMID: 34291100 PMCID: PMC8287171 DOI: 10.3389/fvets.2021.675180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
This prospective study aimed to blindly compare the ultrasonographic and standing magnetic resonance imaging (sMRI) findings in deep digital flexor tendon (DDFT), navicular bone, and navicular bursa in horses with foot pain, positive digital analgesia, and without definitive radiographic diagnosis. Ultrasonography detected more DDFT abnormalities (32/34 feet vs. 27/34 with sMRI) but identified less palmar navicular abnormalities (23/34 feet vs. 30/34 with sMRI). In suprasesamoidean DDFT lesions, which were mainly dorsally located, changes in echogenicity did not correspond to a particular pattern of sMRI signal change. Transcuneal ultrasonography did not allow assessment of morphology and extent of distal DDFT lesions, and sporadically discriminated the affected lobe compared to sMRI. Defects of the palmar compact bone were identified with both modalities except a parasagittal defect, which was only seen at sMRI.
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Affiliation(s)
- Laurence Evrard
- Department of Clinical Sciences of Companion Animals and Equids, Equine Division, Diagnostic Imaging Section, University of Liège, Liège, Belgium
| | - Zoë Joostens
- Medical Imaging Department, Equitom Equine Clinic, Lummen, Belgium
| | - Maxime Vandersmissen
- Department of Clinical Sciences of Companion Animals and Equids, Equine Division, Diagnostic Imaging Section, University of Liège, Liège, Belgium
| | - Fabrice Audigié
- Centre d'Imagerie et de Recherche sur les Affections Locomotrices Equines, Ecole Nationale Vétérinaire d'Alfort, Goustranville, France
| | - Valeria Busoni
- Department of Clinical Sciences of Companion Animals and Equids, Equine Division, Diagnostic Imaging Section, University of Liège, Liège, Belgium
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22
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Wilson S, Spriet M, Mur PE, Anishchenko S, Beylin D, Katzman S, Galuppo L. 18 Fluorine-fluorodeoxyglucose positron emission tomography for assessment of deep digital flexor tendinopathy: An exploratory study in eight horses with comparison to CT and MRI. Vet Radiol Ultrasound 2021; 62:610-620. [PMID: 34148276 DOI: 10.1111/vru.13001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 04/11/2021] [Accepted: 04/18/2021] [Indexed: 11/28/2022] Open
Abstract
Lesions of the deep digital flexor tendon (DDFT) are a cause for foot lameness in horses. Positron emission tomography (PET) could provide valuable information regarding the metabolic activity of these lesions. The aims of this exploratory, prospective, methods comparison study were to assess the ability of 18 fluorine-fluorodeoxyglucose (18 F-FDG) PET to detect DDFT lesions and to compare the PET findings with CT and MRI findings. Eight horses with lameness due to pain localized to the front feet were included. Both front limbs of all horses were imaged with 18 F-FDG PET, noncontrast CT, and arterial contrast-enhanced CT; 11 limbs were also assessed using MRI. Two observers graded independently 18 F-FDG PET, noncontrast CT, arterial contrast CT, T1-weighted (T1-w) MRI, and T2-weighted (T2-w)/STIR MRI. Maximal standardized uptake values were measured. Lesions were found in seven of 16 DDFT on PET, 12 of 16 DDFT on noncontrast CT, six of 15 DDFT on arterial contrast CT, eight of 11 DDFT on T1-w MRI, and six of 11 DDFT on T2-w/STIR MRI. Positron emission tomography was in better agreement with arterial contrast CT (Kappa-weighted 0.40) and T2-w/STIR MRI (0.35) than with noncontrast CT (0.28) and T1-w MRI (0.20). Maximal standardized uptake values of lesions ranged from 1.9 to 4.6 with a median of 3.1. Chronic lesions with scar tissues identified on noncontrast CT or T1-w MRI did not have increased 18 F-FDG uptake. These results demonstrated that 18 F-FDG PET agreed more closely with modalities previously used to detect active tendon lesions, i.e. arterial contrast CT and T2-w/STIR MRI. 18 Fluorine-fluorodeoxyglucose PET can be used to identify metabolically active DDFT lesions in horses.
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Affiliation(s)
- Sabrina Wilson
- School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Mathieu Spriet
- School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Pablo Espinosa Mur
- School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Sergey Anishchenko
- LONGMILE Veterinary Imaging, Brain Biosciences Inc., Rockville, Maryland, USA
| | - David Beylin
- LONGMILE Veterinary Imaging, Brain Biosciences Inc., Rockville, Maryland, USA
| | - Scott Katzman
- School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Larry Galuppo
- School of Veterinary Medicine, University of California, Davis, Davis, California, USA
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23
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Acutt EV, Contino EK, Frisbie DD, Barrett MF. Deep digital flexor tendon lesions in the pastern are associated with the presence of distal tendinopathy. Equine Vet J 2021; 54:502-512. [PMID: 34050982 DOI: 10.1111/evj.13470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 04/01/2021] [Accepted: 05/20/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Correct diagnosis and characterisation of deep digital flexor tendon (DDFT) lesions in equine athletes allows targeted treatment and improved prognostication. OBJECTIVES To assess the prevalence and character of pathological change within the DDFT in the pastern with concurrent tendon injury distally. It is hypothesised that tendon lesions in the pastern will be associated with tendinopathy within the hoof capsule. STUDY DESIGN Retrospective descriptive case series. METHODS Cases with DDFT lesions in the pastern and magnetic resonance imaging (MRI) or ultrasonography of the foot were evaluated retrospectively. Lesion location and type were recorded. Odds ratios were calculated to determine the associations between more distal tendinopathy and the presence of different DDFT lesion types in the pastern. RESULTS Thirty-four MRI scans of 33 horses and 64 ultrasonographic exams of 58 horses were analysed. Lesion location and type were recorded. Distal DDFT lesions were found in 75% (95% CI: 66.0-84.0) of total cases of pastern DDF tendinopathy and in 97% (95% CI: 91.6-100.0) of cases with core lesions of the DDFT in the pastern. A core lesion in the pastern was significantly more likely (OR = 20.7, 95% CI: 2.2-191.0; P = .008) to be associated with injury in the foot than other types of pastern lesion. MAIN LIMITATIONS MRIs of the foot were not obtained on all included limbs which did not allow for fully inclusive evaluation of DDFT lesions distal to the navicular bone. CONCLUSIONS DDFT pathological change in the pastern, particularly core lesions, is associated with additional tendinopathy within the hoof capsule. When a DDFT lesion is found in the pastern, further imaging of the tendon within the foot is indicated to direct appropriate treatment and improve prognostication.
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Affiliation(s)
- Elizabeth V Acutt
- Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado, USA
| | - Erin K Contino
- Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado, USA
| | - David D Frisbie
- Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado, USA
| | - Myra F Barrett
- Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado, USA
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24
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Osborn ML, Cornille JL, Blas‐Machado U, Uhl EW. The equine navicular apparatus as a premier enthesis organ: Functional implications. Vet Surg 2021; 50:713-728. [PMID: 33710628 PMCID: PMC8251969 DOI: 10.1111/vsu.13620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 01/26/2021] [Accepted: 02/21/2021] [Indexed: 12/23/2022]
Abstract
Navicular syndrome has been traditionally characterized by progressive lameness with chronic degeneration of the navicular bone. Advances in imaging techniques have revealed that its associated soft tissue structures are also affected. This distribution of lesions is explained by conceptualizing the equine navicular apparatus as an enthesis organ that facilitates the dissemination of mechanical stress throughout the tissues of the foot. The navicular apparatus has the same structural adaptations to mechanical stress as the human Achilles tendon complex. These adaptations efficiently dissipate mechanical force away from the tendon's bony attachment site, thereby protecting it from failure. The comparison of these two anatomically distinct structural systems demonstrates their similar adaptations to mechanical forces, and illustrates that important functional insights can be gained from studying anatomic convergences and cross-species comparisons of function. Such a functional conceptualization of the equine navicular apparatus resolves confusion about the diagnosis of navicular syndrome and offers insights for the development of mechanically based therapies. Through comparison with the human Achilles complex, this review (1) re-conceptualizes the equine navicular apparatus as an enthesis organ in which mechanical forces are distributed throughout the structures of the organ; (2) describes the relationship between failure of the navicular enthesis organ and lesions of navicular syndrome; (3) considers the therapeutic implications of navicular enthesis organ degeneration as a form of chronic osteoarthritis; and based upon these implications (4) proposes a focus on whole body posture/motion for the development of prehabilitative and rehabilitative therapies similar to those that have already proven effective in humans.
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Affiliation(s)
- Michelle L. Osborn
- Department of Comparative Biomedical SciencesSchool of Veterinary Medicine, Louisiana State UniversityBaton RougeLouisianaUSA
| | | | - Uriel Blas‐Machado
- Department of PathologyCollege of Veterinary Medicine, University of GeorgiaAthensGeorgiaUSA
| | - Elizabeth W. Uhl
- Department of PathologyCollege of Veterinary Medicine, University of GeorgiaAthensGeorgiaUSA
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25
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Quam VG, Altmann NN, Brokken MT, Durgam SS. Zonal characterization and differential trilineage potentials of equine intrasynovial deep digital flexor tendon-derived cells. BMC Vet Res 2021; 17:138. [PMID: 33794882 PMCID: PMC8015054 DOI: 10.1186/s12917-021-02793-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/08/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Intrasynovial deep digital flexor tendon (DDFT) injuries occur frequently and are often implicated in cases of navicular disease with poor outcomes and reinjuries. Cell-based approaches to tendon healing are gaining traction in veterinary medicine and ultimately may contribute to improved DDFT healing in horses. However, a better understanding of the innate cellular characteristics of equine DDFT is necessary for developing improved therapeutic strategies. Additionally, fibrocartilaginous, intrasynovial tendons like the DDFT are common sites of injury and share a poor prognosis across species, offering translational applications of this research. The objective of this study is to isolate and characterize tendon-derived cells (TDC) from intrasynovial DDFT harvested from within the equine forelimb podotrochlear bursa. TDC from the fibrocartilaginous and tendinous zones are separately isolated and assessed. Flow cytometry is performed for mesenchymal stem cell (MSC) surface markers (CD 29, CD 44, CD 90). Basal tenogenic, osteogenic and chondrogenic markers are assessed via quantitative real time-PCR, and standard trilineage differentiation is performed with third passage TDC from the fibrocartilaginous (fTDC) and tendinous (tTDC) zones of DDFT. RESULTS Low-density plating isolated homogenous TDC populations from both zones. During monolayer passage, both TDC subpopulations exhibited clonogenicity, high in vitro proliferation rate, and fibroblast-like morphology. fTDC and tTDC were positive for MSC surface markers CD90 and CD29 and negative for CD44. There were no significant differences in basal tenogenic, osteogenic or chondrogenic marker expression between zones. While fTDC were largely restricted to chondrogenic differentiation, tTDC underwent osteogenic and chondrogenic differentiation. Both TDC subpopulations displayed weak adipogenic differentiation potentials. CONCLUSIONS TDC at the level of the podotrochlear bursa, that potentially could be targeted for enhancing DDFT injury healing in horses were identified and characterized. Pending further investigation, promoting chondrogenic properties in cells administered exogenously into the intrasynovial space may be beneficial for intrasynovial tendon regeneration.
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Affiliation(s)
- Vivian G Quam
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, USA
| | - Nadine N Altmann
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, USA
| | - Matthew T Brokken
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, USA
| | - Sushmitha S Durgam
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, USA.
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26
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Sullivan SN, Cole SL, Stewart MC, Brokken MT, Durgam S. Ex vivo effects of corticosteroids on equine deep digital flexor and navicular fibrocartilage explant cell viability. Am J Vet Res 2021; 82:125-131. [PMID: 33480274 DOI: 10.2460/ajvr.82.2.125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the effects of triamcinolone acetonide (TA) and methylprednisolone acetate (MPA) on the viability of resident cells within the fibrocartilage on the dorsal surface of the deep digital flexor tendon (FC-DDFT) and fibrocartilage on the flexor surface of the navicular bone (FC-NB) of horses. SAMPLE 12 to 14 explants of FC-DDFT and of FC-NB from grossly normal forelimbs of 5 cadavers of horses aged 9 to 15 years without evidence of musculoskeletal disease. PROCEDURES Explants were incubated with culture medium (control) or TA-supplemented (0.6 or 6 mg/mL) or MPA-supplemented (0.5 or 5 mg/mL) medium for 6 or 24 hours. Explant metabolic activity and percentage of dead cells were assessed with a resazurin-based assay and live-dead cell staining, respectively, at each time point. Drug effects were assessed relative to findings for the respective control group. RESULTS Application of TA (at both concentrations) did not significantly change the cell viability of FC-DDFT explants. For FC-NB explants, TA at 6 mg/mL significantly reduced the metabolic activity and increased the percentage of dead cells at both time points. With either MPA concentration, FC-DDFT and FC-NB explants had reduced metabolic activity and an increased percentage of dead cells at 24 hours, whereas only MPA at 5 mg/mL was cytotoxic at the 6-hour time point. CONCLUSIONS AND CLINICAL RELEVANCE In ex vivo explants, TA was less cytotoxic to equine FC-DDFT and FC-NB cells, compared with MPA. Further work is warranted to characterize the drugs' transcriptional and translational effects as well as investigate their cytotoxicity at lower concentrations.
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Risk Factors for the Occurrence of Desmopathy of the Collateral Ligaments of the Distal Interphalangeal Joint in Equines – A Cross-Sectional Study. ACTA VET-BEOGRAD 2020. [DOI: 10.2478/acve-2020-0032] [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] Open
Abstract
Abstract
Desmopathy of the collateral ligaments of the distal interphalangeal joint (CL-DIPJ) has been increasingly relevant in equine sports medicine. However, the risk factors for the development of such desmopathy are not well established. In the literature, what has been described about it, is based on the clinical conditions observed in animals diagnosed with this disorder. Considering this scenario, the aim of this study was to verify which possible extrinsic or intrinsic risk factors may influence the occurrence of disorders in the collateral ligaments of the distal interphalangeal joint in polo horses. Twenty-five horses from the same equestrian team, all competing in polo, were evaluated via ultrasonography. The outcome was defined as changes in echogenicity and/or boundaries of the CL-DIPJ of the thoracic limbs of the horses evaluated. The intrinsic factors considered in this study were age, the presence of angular deviations and gender. As extrinsic factors, the parameters taken into consideration were the handicap in which the animals played and the type of training to which these horses were previously submitted in their professional athletic career. The prevalence ratio was used to verify the association between risk factor and outcome. The result of this evaluation was considered significant when the confidence interval value did not involve the value 1. Positive and significant association was observed only for age. Playing in different handicaps did not influence the presence of ligament disorders. The other factors evaluated revealed a positive but not significant association. Thus, it was concluded that animals aged nine years or older present a higher risk of CL-DIPJ disorders.
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28
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Byrne CA, Marshall JF, Voute LC. Clinical magnetic resonance image quality of the equine foot is significantly influenced by acquisition system. Equine Vet J 2020; 53:469-480. [PMID: 32767582 DOI: 10.1111/evj.13330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/22/2020] [Accepted: 07/16/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Investigation of image quality in clinical equine magnetic resonance (MR) imaging may optimise diagnostic value. OBJECTIVES To assess the influence of field strength and anaesthesia on image quality in MR imaging of the equine foot in a clinical context. STUDY DESIGN Analytical clinical study. METHODS Fifteen equine foot studies (five studies per system) were randomly selected from the clinical databases of three MR imaging systems: low-field standing (LF St), low-field anaesthetised (LF GA) and high-field anaesthetised (HF GA). Ten experienced observers graded image quality for entire studies and seven clinically important anatomical structures within the foot (briefly, grade 1: textbook quality, grade 2: high diagnostic quality, grade 3: satisfactory diagnostic quality, grade 4: non-diagnostic). Statistical analysis assessed the effect of anaesthesia and field strength using a combination of the Pearson chi-square test or Fisher's exact test and Mann-Whitney test. RESULTS There was no difference in the proportion of entire studies of diagnostic quality between LF St (90%, 95% CI 78%-97%) and LF GA (88%, 76-95%, P = .7). No differences were evident in the proportion of diagnostic studies or median image quality gradings between LF St and LF GA when assessing individual anatomical structures (both groups all median grades = 3). There was a statistically significant difference in the proportion of entire studies of diagnostic quality between LF GA and HF GA (100%, 95% CI lower bound 94%, P = .03). There were statistically significant differences in median image quality gradings between LF GA (all median grades = 3) and HF GA (median grades = 1 (5/7 structures) or 2 (2/7 structures) for all individual anatomical structures (all P < .001). The reasons reported for reduced image quality differed between systems. MAIN LIMITATIONS Randomised selection of cases from clinical databases. Individual observer preferences may influence image quality assessment. CONCLUSIONS Field strength is a more important influencer of image quality than anaesthesia for magnetic resonance imaging of the equine foot in clinical patients.
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Affiliation(s)
- Christian A Byrne
- Weipers Centre Equine Hospital, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - John F Marshall
- Weipers Centre Equine Hospital, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Lance C Voute
- Weipers Centre Equine Hospital, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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29
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Berner D, Mader D, Groß C, Gerlach K. Effect of Scan Plane and Arthrography on Visibility and Interobserver Agreement of the Equine Distal Sesamoidean Impar Ligament on Magnetic Resonance Images. J Equine Vet Sci 2020; 94:103227. [PMID: 33077088 DOI: 10.1016/j.jevs.2020.103227] [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: 02/07/2020] [Revised: 06/29/2020] [Accepted: 08/10/2020] [Indexed: 11/27/2022]
Abstract
In magnetic resonance imaging (MRI) examinations, moderate to severe changes of the distal sesamoidean impar ligament (DSIL) were found in horses with lameness localized to their feet. Histologic abnormalities were detected more commonly in lame horses. Because of its heterogeneity and small thickness, evaluation of the DSIL in MRI can be challenging. The aim of the study was to determine the optimal sequence and the ideal transverse perpendicular angle for visualization of the DSIL before and after arthrography of the distal interphalangeal joint (DIPJ). Twenty-five cadaver forelimbs were examined with low-field MRI. Sagittal, frontal, and three different angled transverse planes were obtained before and after arthrography of the DIPJ. All planes were acquired in T1w (weighted) Gradient Recall Echo (GRE), T2∗w GRE, T2w Fast Spin Echo (FSE), and Short Tau Inversion Recovery (STIR) FSE and visualization of the DSIL was scored by two observers. Visualization of the DSIL was best on sagittal T2w FSE and STIR FSE images. All transverse planes were inferior compared with sagittal sequences. After arthrography of the DIPJ, visualization of the DSIL origin improved in sagittal T2w FSE sequences, and agreement between observers increased for sagittal T2w FSE and STIR FSE images. Sagittal T2w FSE and STIR FSE images allowed good visualization of the DSIL in low-field MRI. Visualization of the DSIL did not improve for altered angled transverse sequences but increased with arthrography of the DIPJ. Subjective influence between different observers was found but decreased with DIPJ arthrography.
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Affiliation(s)
- Dagmar Berner
- Department for Horses, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany; Equine Referral Hospital, Department of Clinical Science and Services, Royal Veterinary College, University of London, Hertfordshire, UK.
| | - Daniela Mader
- Department for Horses, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
| | - Claudia Groß
- Department for Horses, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
| | - Kerstin Gerlach
- Department for Horses, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
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Berner D, Brehm W, Gerlach K, Offhaus J, Scharner D, Burk J. Variation in the MRI signal intensity of naturally occurring equine superficial digital flexor tendinopathies over a 12-month period. Vet Rec 2020; 187:e53. [PMID: 32690762 DOI: 10.1136/vr.105800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 04/12/2020] [Accepted: 05/28/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Signal intensity (SI) of equine tendinopathies in MRI differs between the superficial digital flexor tendon (SDFT) and the deep digital flexor tendon (DDFT). In DDFT lesions, short tau inversion recovery (STIR) SI decreases earlier than T2-weighted (T2w) SI, while the latter decreases earlier in SDFT lesions, but long-term results using STIR sequences are lacking. METHODS Standing MRI of eight horses with naturally occurring SDFT lesions was performed at the day of treatment as well as 2, 6 and 12 months after treatment. RESULTS After 12 months, six horses were sound and showed complete resolution of increased SI in T2w fast spin echo (FSE) images, but increased SI was found in STIR images in three horses and persisted in T1w and T2*w gradient recall echo images of all horses. In contrast, hyperintense areas were still visible in the SDFT in T2w FSE images in two horses presenting with re-injury. In the six horses without re-injury, percentage of cross-sectional areas affected and SI decreased over time in all sequences. CONCLUSIONS This study suggests that SI in naturally occurring SDFT lesions decreases earlier in T2w FSE than in STIR images, in contrast to the DDFT.
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Affiliation(s)
- Dagmar Berner
- Equine Referral Hospital, Royal Veterinary College Clinical Services Division, Hatfield, UK .,Department for Horses, University of Leipzig Faculty of Veterinary Medicine, Leipzig, Sachsen, Germany
| | - Walter Brehm
- Department for Horses, University of Leipzig Faculty of Veterinary Medicine, Leipzig, Sachsen, Germany.,Saxon Incubator for Clinical Translation, University of Leipzig, Leipzig, Sachsen, Germany
| | - Kerstin Gerlach
- Department for Horses, University of Leipzig Faculty of Veterinary Medicine, Leipzig, Sachsen, Germany
| | - Julia Offhaus
- Department for Horses, University of Leipzig Faculty of Veterinary Medicine, Leipzig, Sachsen, Germany
| | - Doreen Scharner
- Department for Horses, University of Leipzig Faculty of Veterinary Medicine, Leipzig, Sachsen, Germany
| | - Janina Burk
- Institute for Veterinary Physiology, University of Leipzig Faculty of Veterinary Medicine, Leipzig, Sachsen, Germany.,Equine Clinic (Surgery), Justus-Liebig-University Giessen Faculty of Veterinary Medicine, Giessen, Hessen, Germany
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31
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Jones ARE, Ragle CA, Mattoon JS, Sanz MG. Use of non-contrast-enhanced computed tomography to identify deep digital flexor tendinopathy in horses with lameness: 28 cases (2014-2016). J Am Vet Med Assoc 2020; 254:852-858. [PMID: 30888281 DOI: 10.2460/javma.254.7.852] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe the use of non-contrast-enhanced CT to identify deep digital flexor (DDF) tendinopathy in horses with lameness attributed to pain in regions distal to the metatarsophalangeal or metacarpophalangeal joints. DESIGN Retrospective case series. ANIMALS 28 client-owned horses. PROCEDURES Medical records were searched to identify horses that underwent non-contrast-enhanced CT with or without high-field MRI as part of an evaluation for lameness localized to areas distal to the metacarpophalangeal or metatarsophalangeal joint in ≥ 1 limb. Horses were included in the study if they had ≥ 1 DDF tendon lesion (DDF tendinopathy) identified. Signalment, lameness examination findings and response to perineural anesthesia, imaging modality, anesthetic agents and duration of anesthesia, and imaging findings were recorded. Data were summarized descriptively. RESULTS Bilateral imaging was performed for all horses, irrespective of unilateral or bilateral lameness. Nine of 28 horses underwent both CT and MRI, and all DDF tendon lesions identified by one modality were identified by the other. Of 48 limbs with DDF tendinopathy, 46 (96%) had core lesions and 35 (73%) had dorsal border irregularities. Median anesthesia time for CT and CT followed by MRI was 15 and 110 minutes, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that non-contrast-enhanced CT was useful for identifying DDF tendinopathy in horses with lameness localized to the phalangeal regions, and this was supported by consistency of findings in a subset of horses that underwent MRI. Further research is needed to confirm these results.
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Norvall A, Spriet M, Espinosa P, Ariño-Estrada G, Murphy BG, Katzman SA, Galuppo LD. Chondrosesamoidean ligament enthesopathy: Prevalence and findings in a population of lame horses imaged with positron emission tomography. Equine Vet J 2020; 53:451-459. [PMID: 32491220 DOI: 10.1111/evj.13299] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 04/14/2020] [Accepted: 05/18/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Increased 18 F-Sodium Fluoride (18 F-NaF) uptake at the chondrosesamoidean ligament (ChSL) attachment on the distal phalanx was identified in an exploratory positron emission tomography (PET) study. The prevalence and significance of this lesion has not been previously investigated. OBJECTIVES The goal of this study was to assess the prevalence of this lesion, its association with other imaging findings and with clinical signs. STUDY DESIGN Retrospective cross-sectional analytical study. METHODS All horses with 18 F-NaF PET and computed tomography (CT) imaging of the feet performed between October 2016 and December 2017 were included in the study. All PET scans were independently assessed by two radiologists for increased uptake at the ChSL attachment site and concurrent imaging was reviewed. Clinical findings, treatment and outcome were retrieved from the medical records. RESULTS Fourteen of 30 horses (20/56 feet) had increased 18 F-NaF uptake in the region of interest. ChSL enthesopathy was the primary lesion in three horses. Other PET abnormalities included navicular bone uptake (13 feet) and ipsilateral palmar process uptake (9 feet). There was no significant association between ChSL enthesopathy and other lesions. ChSL enthesopathy was significantly associated with foot lameness. CT abnormalities at the ChSL attachment were initially identified in one foot, and retrospectively noted in another five following the results of PET imaging. MAIN LIMITATIONS The study is retrospective and there was a limited sample size. CONCLUSIONS PET led to identification of ChSL enthesopathy in a large proportion of horses with foot pain. This finding is most commonly associated with other lesions but may also represent the main abnormality. The axial border of the palmar processes of the distal phalanx should be carefully assessed on cross sectional imaging to identify this lesion. ChSL enthesopathy may be an important but previously not recognised component of foot pathology in horses.
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Affiliation(s)
- Amy Norvall
- Veterinary Medical Teaching Hospital, University of California, Davis, CA, USA
| | - Mathieu Spriet
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Pablo Espinosa
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA
| | | | - Brian G Murphy
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Scott A Katzman
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Larry D Galuppo
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA
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Koch DW, Barrett MF, Jackman BR, MacDonald D, Goodrich LR. Comparison of lameness outcomes in horses with acute or chronic digital lameness that underwent magnetic resonance imaging. N Z Vet J 2020; 68:283-288. [PMID: 32248754 DOI: 10.1080/00480169.2020.1750499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aims: To compare the outcome, in terms of lameness score or return to athletic function, of horses with acute vs. chronic digital lameness that underwent magnetic resonance imaging (MRI) of the distal limb and to compare the proportion of horses that received intra-articular therapy of the distal interphalangeal (DIP) joint and pattern of diagnostic analgesia in these groups. Methods: This is a retrospective study of horses (n = 95) with acute (≤12 weeks; n = 46) or chronic (>12 weeks; n = 49) digital lameness that underwent MRI of the distal limb from 2009-2016, at two equine referral centres in the USA. Criteria for inclusion in the study were that a majority of lameness localised distal to the fetlock, and that lameness assessments for ≥12 months following MRI could be obtained from the medical record or the owner could be interviewed regarding their horse's athletic function. Outcome was characterised by an improvement score where 2 = return to work at a previous or higher level or lameness improved by one grade or more, 1 = return to work at a lower level or lameness improved by less than one grade, and 0 = did not return to work or lameness grade worsened. Whether horses had received intra-articular therapy of the DIP joint and the pattern of diagnostic analgesia prior to MRI was also obtained from medical records or by interviewing the owner. Results: There was a difference (p = 0.004) in the proportion of horses assigned to improvement scores of 0, 1 and 2 between horses with acute or chronic lameness. There was no evidence of a difference in the likelihood of having received intra-articular therapy of the DIP joint prior to MRI between horses with chronic or acute lameness (p = 0.085). Similarly, there was no evidence of a difference in the pattern of diagnostic analgesia prior to MRI between the two groups (p = 0.94). Eighty-two percent of owners of horses with acute and 62% of those with horses with chronic lameness had a positive opinion of the utility of MRI as a diagnostic modality. Conclusion: In a population of horses with digital lameness undergoing MRI, a difference in the outcome, in terms of lameness score or return to athletic function was identified between horses with acute lameness compared to those with chronic lameness. Clinical relevance: Horses with digital lameness that undergo MRI when the lameness is acute may have an improved prognosis due to accurate diagnosis and earlier application of appropriate therapy.
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Affiliation(s)
- D W Koch
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - M F Barrett
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | | | | | - L R Goodrich
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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Martinelli MJ, Pool RR, Rantanen NW. Incomplete metacarpal fracture with exostosis or ‘blind splint’? EQUINE VET EDUC 2020. [DOI: 10.1111/eve.12990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - R. R. Pool
- Pathobiology College of Veterinary Medicine Texas A&M University College Station Texas USA
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Gutierrez-Nibeyro SD, Werpy NM, Gold SJ, Olguin S, Schaeffer DJ. Standing MRI lesions of the distal interphalangeal joint and podotrochlear apparatus occur with a high frequency in warmblood horses. Vet Radiol Ultrasound 2020; 61:336-345. [PMID: 32162431 DOI: 10.1111/vru.12855] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 01/12/2020] [Accepted: 01/19/2020] [Indexed: 11/30/2022] Open
Abstract
Foot pain is a common presenting complaint in Warmblood horses. The aim of this retrospective, cross-sectional study was to determine the spectrum of foot lesions detected by magnetic resonance imaging (MRI) in Warmblood horses used for dressage, jumping, and eventing. The medical records of 550 Warmblood horses with foot pain that were scanned using standing MRI were reviewed and the following data were recorded: signalment, occupation, lameness, diagnostic analgesia, imaging results, treatments, and follow-up assessments. Associations between standing MRI lesions and chronic lameness following treatment were tested. Abnormalities of the navicular bone (409 horses, 74%), distal interphalangeal joint (362 horses, 65%), and deep digital flexor (DDF) tendon (260 horses, 47%) occurred with the highest frequency. The following abnormalities were significantly associated (P < .05) with chronic lameness following conservative therapy: moderate to severe MRI lesions in the trabecular bone of the navicular bone, mild or severe erosions of the flexor surface of the navicular bone, moderate sagittal/parasagittal DDF tendinopathies, and moderate collateral sesamoidean desmopathies. Also, identification of concurrent lesions of the DDF tendon, navicular bone, navicular bursa, and distal sesamoidean impar ligament was associated with chronic lameness after conservative therapy. Development of effective treatment options for foot lesions that respond poorly to conservative therapy is necessary.
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Affiliation(s)
- Santiago D Gutierrez-Nibeyro
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois
| | | | | | - Silvia Olguin
- College of Veterinary Medicine, University of La Plata, La Plata, Buenos Aires, Argentina
| | - David J Schaeffer
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois
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Waselau M, McKnight A, Kasparek A. Magnetic resonance imaging of equine stifles: Technique and observations in 76 clinical cases. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13248] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- M. Waselau
- Equine Diagnostic Center Munich Equine Hospital Aschheim Aschheim Germany
| | - A. McKnight
- McKnight Insight LLC Chadds Ford Pennsylvania USA
| | - A. Kasparek
- Equine Diagnostic Center Munich Equine Hospital Aschheim Aschheim Germany
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Multimodal Imaging to Identify and Characterize a P3 Cystic Lesion and Pathologic Fracture. J Equine Vet Sci 2019; 86:102898. [PMID: 32067665 DOI: 10.1016/j.jevs.2019.102898] [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: 08/18/2019] [Revised: 12/11/2019] [Accepted: 12/16/2019] [Indexed: 11/23/2022]
Abstract
Lameness remains a common cause of retirement in the equine athlete and among hobby enthusiasts. The distal limb is one of the most frequently imaged areas, and recent advances in diagnostic imaging capabilities help practicing veterinarians differentiate normal variants from informative pathology. Although acute, non-weight-bearing lameness is commonly associated with etiologies, such as fractures, abscesses, and laminitis, other uncommon differentials such as cystic lesions and neoplasia might also be considered. This report describes the characterization of a large, cystic lesion in the third phalanx (P3), which resulted in an acute, pathologic fracture. The lesion was fully characterized with the use of postmortem magnetic resonance imaging, gross pathology, and histopathology.
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Factors associated with euthanasia in horses and ponies enrolled in a laminitis cohort study in Great Britain. Prev Vet Med 2019; 174:104833. [PMID: 31751854 DOI: 10.1016/j.prevetmed.2019.104833] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/04/2019] [Accepted: 11/04/2019] [Indexed: 12/16/2022]
Abstract
Euthanasia is a complex topic, with animal owners using multiple factors to shape their decision-making process. Previous epidemiological studies have described causes of equine mortality in specific populations, but there is limited evidence regarding factors contributing specifically to equine euthanasia in Great Britain (GB). This observational study used a prospective cohort design: the objectives were to describe owner-reported reasons for euthanasia, estimate the rate of euthanasia and identify associated factors in horses/ponies enrolled in a web-based epidemiological study of laminitis in GB. Self-selected horse/pony owners submitted regular management and health data over 29 months and reported dates and reasons for euthanasia during this period. The overall incidence of euthanasia was estimated and associated factors were identified using multivariable Cox regression modelling, adjusted for age, with variables retained in the final model if P ≤ 0.05. Data were available for 1070 horses/ponies contributing 1093 horse-years at risk (HYAR), with 80 owner-reported euthanasias. The incidence of euthanasia was 7.3 euthanasias per 100 HYAR (95 % confidence interval [CI] 5.9, 9.1). The most frequently reported health reasons contributing to euthanasia were laminitis-related consequences (25.0 % ; CI 16.8, 35.5 %), colic (21.3 % ; CI 13.7, 31.4 %), non-laminitic lameness (20.0 % ; CI 12.7, 30.1 %) and age-related deterioration, including owner-perceived compromised quality of life (20.0 % ; CI 12.7, 30.1 %). Health-related factors associated with significantly higher rates of euthanasia were colic (hazard ratio [HR] 26.4; CI 12.5, 55.8), pituitary pars intermedia dysfunction (HR 3.0; CI 1.7, 5.4) and lameness due to navicular syndrome (HR 5.9; CI 1.8, 20.0), soft tissue injury (HR 6.5; CI 2.7, 15.6) or laminitis (HR 2.7; CI 1.3, 5.7). Further factors included being pure bred (HR 1.7; CI 1.0, 2.8), female (HR 1.7; CI 1.0, 2.9), having poor owner-perceived hoof quality (HR 2.4; CI 1.1, 5.2), being entirely stabled (HR 5.0; HR 2.1, 12.0), being on loan or under temporary care of the study participant (HR 2.3; CI 1.2, 4.4) and participating in affiliated or professional competitions (HR 5.9; CI 2.4, 14.8). Euthanasia rates were significantly higher in the first two study years compared to the third (P < 0.001). Animals whose owners used the study's custom-designed weight tracker tool had significantly lower rates of euthanasia (HR 0.6; CI 0.3, 0.95). This study has identified a number of, arguably preventable, health-related factors associated with higher rates of euthanasia. Data on owners' decision-making process regarding euthanasia, including emotive and financial impacts, were not recorded but are important contributors to euthanasia that require better understanding.
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Argüelles D, Saitua A, de Medina AS, Muñoz JA, Muñoz A. Clinical efficacy of clodronic acid in horses diagnosed with navicular syndrome: A field study using objective and subjective lameness evaluation. Res Vet Sci 2019; 125:298-304. [PMID: 31351199 DOI: 10.1016/j.rvsc.2019.07.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 11/18/2022]
Abstract
Navicular syndrome, a common cause of equine forelimb lameness, is associated with pathological changes in the navicular bone. Consequently, administration of bisphosphonates (BPs) has been advocated in order to modify the rate of bone turnover. The present study aimed to assess the clinical efficacy of intramuscularly administered clodronic acid for the treatment of 11 horses with clinical and radiographic findings compatible with navicular syndrome. Magnetic resonance imaging was performed in 5 of the 11 horses. The animals were treated with an intramuscular dose of clodronic acid of 765 mg/horse, administered over three separate injection sites. Before and at 7, 30 and 90 days after treatment, horses were subjected to lameness and accelerometric evaluations. A clinical improvement was observed in 6 of the 11 horses. These 6 horses showed a mean reduction of two degrees in lameness score. Accelerometry in these horses revealed increased velocity, stride length, stride regularity and dorsoventral displacement of the gravity of centre together with a reduction in stride frequency, suggesting a gait improvement. This study demonstrates that intramuscular clodronic acid can be useful for lameness reduction in some horses with navicular syndrome.
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Affiliation(s)
- David Argüelles
- Department of Animal Medicine and Surgery, School of Veterinary Medicine, Autonomous University of Barcelona, Bellaterra, Barcelona, Spain; Veterinary Teaching Hospital, University of Córdoba, Spain
| | - Aritz Saitua
- Department of Animal Medicine and Surgery, School of Veterinary Medicine, Autonomous University of Barcelona, Bellaterra, Barcelona, Spain; Equine Sport Medicine Centre CEMEDE, School of Veterinary Medicine, University of Córdoba, Spain
| | - Antonia Sánchez de Medina
- Veterinary Teaching Hospital, University of Córdoba, Spain; Department of Animal Medicine and Surgery, School of Veterinary Medicine, University of Córdoba, Spain
| | - Juan A Muñoz
- Department of Animal Medicine and Surgery, School of Veterinary Medicine, Universidad Alfonso X el Sabio, Villanueva de la Cañada, Madrid, Spain
| | - Ana Muñoz
- Equine Sport Medicine Centre CEMEDE, School of Veterinary Medicine, University of Córdoba, Spain; Department of Animal Medicine and Surgery, School of Veterinary Medicine, University of Córdoba, Spain.
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Beasley B, Selberg K, Giguère S, Allen K. Magnetic resonance imaging characterisation of lesions within the collateral ligaments of the distal interphalangeal joint – 28 cases. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- B. Beasley
- Department of Large Animal Medicine College of Veterinary Medicine University of Georgia Athens Georgia USA
| | - K. Selberg
- Environmental and Radiological Health Sciences Colorado State University Fort Collins ColoradoUSA
| | - S. Giguère
- Department of Large Animal Medicine College of Veterinary Medicine University of Georgia Athens Georgia USA
| | - K. Allen
- Virginia Equine Imaging The Plains Virginia USA
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Kirkpatrick CJ, Ernst NS, Trumble TN. Palmar/plantar approach for radiographic-guided injection of the equine distal interphalangeal joint collateral ligament insertion. Vet Rec 2019; 184:527. [PMID: 30842259 DOI: 10.1136/vr.105027] [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: 05/21/2018] [Revised: 11/26/2018] [Accepted: 01/28/2019] [Indexed: 11/03/2022]
Abstract
There are limited radiographic-guided injection techniques of the insertion of the distal interphalangeal joint (DIPJ) collateral ligaments. The objective of this study was to develop and evaluate a palmar/plantar radiographic-guided injection of the collateral ligament insertion in cadavers. Fifty limbs were used to develop the technique and 24 additional limbs were used to evaluate accuracy. An 18 G, 9 cm spinal needle was placed in the depression between the palmar digital neurovascular bundle and arch of the ungular cartilage with dorsodistal advancement towards the distal phalanx collateral fossa. Radiographs verified ideal needle location on the proximal border of the distal phalanx at the collateral fossa. Dye was injected. Hoof walls were partially removed and collateral ligaments were dissected with needles in place to determine needle and dye location. Accuracy of needle placement into the insertion of the DIPJ collateral ligament was 41/48 (85 per cent), with lower accuracy of dye within the ligament (34/48; 71 per cent). Dye entered the DIPJ in 2/48 injections, but dye entered periligamentous structures in 22/48 (46 per cent) injections. A palmar/plantar radiographic-guided injection of the insertion of the DIPJ collateral ligament had high accuracy rate with low injection rate of the DIPJ in cadavers.
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Affiliation(s)
- C Jordan Kirkpatrick
- Veterinary Population Medicine, University of Minnesota College of Veterinary Medicine, St Paul, Minnesota, USA
| | - Nicolas S Ernst
- Veterinary Population Medicine, University of Minnesota College of Veterinary Medicine, St Paul, Minnesota, USA
| | - Troy N Trumble
- Veterinary Population Medicine, University of Minnesota College of Veterinary Medicine, St Paul, Minnesota, USA
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Evrard L, Audigié F, Bertoni L, Jacquet S, Denoix JM, Busoni V. Low field magnetic resonance imaging of the equine distal interphalangeal joint: Comparison between weight-bearing and non-weight-bearing conditions. PLoS One 2019; 14:e0211101. [PMID: 30689659 PMCID: PMC6349334 DOI: 10.1371/journal.pone.0211101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 01/08/2019] [Indexed: 11/28/2022] Open
Abstract
This descriptive study aimed to compare the magnetic resonance appearance of the distal interphalangeal joint articular cartilage between standing weight-bearing and non-weight-bearing conditions. Ten forefeet of live horses were scanned in a standing low-field magnetic resonance system (0.27 T). After euthanasia for reasons unrelated to the study, the non-weight-bearing isolated feet were scanned in a vertical positioning reproducing limb orientation in live horses. The same acquisition settings as during the weight-bearing examination were used. Thickness and cross-sectional area of the distal interphalangeal articular cartilage and joint space were measured on tridimensional T1-weighted gradient echo high resolution frontal and sagittal images at predetermined landmarks in both conditions and were compared using a linear mixed-effects model. Frontal images were randomized and submitted to 9 blinded readers with 3 different experience levels for identification of weight-bearing versus non-weight-bearing acquisitions based on cartilage appearance. Weight-bearing limbs had significantly thinner distal interphalangeal cartilage (p = 0.0001) than non-weight-bearing limbs. This change was greater in the distal phalanx cartilage than that of the middle phalanx. Blinded readers correctly identified 83% (range 65 to 95%) of the images as weight-bearing or non-weight-bearing acquisitions, with significantly different results observed among the different readers (p < 0.001) and groups (p < 0.001). These results indicate that distal interphalangeal articular cartilage and particularly cartilage of the distal phalanx thins when weight-bearing compared to the non-weight-bearing standing postmortem conditions and suggest that cartilage abnormalities may be more difficult to identify on weight-bearing standing magnetic resonance imaging.
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Affiliation(s)
- Laurence Evrard
- Department of Clinical Sciences of Companion Animals and Equids, Equine Division, Diagnostic Imaging Section, University of Liège, Liège, Belgium
- * E-mail:
| | - Fabrice Audigié
- Centre d’Imagerie et de Recherche sur les Affections Locomotrices Equines (CIRALE), Unité 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, Normandie Equine Vallée, Goustranville, France
| | - Lélia Bertoni
- Centre d’Imagerie et de Recherche sur les Affections Locomotrices Equines (CIRALE), Unité 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, Normandie Equine Vallée, Goustranville, France
| | - Sandrine Jacquet
- Centre d’Imagerie et de Recherche sur les Affections Locomotrices Equines (CIRALE), Unité 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, Normandie Equine Vallée, Goustranville, France
| | - Jean-Marie Denoix
- Centre d’Imagerie et de Recherche sur les Affections Locomotrices Equines (CIRALE), Unité 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, Normandie Equine Vallée, Goustranville, France
| | - Valeria Busoni
- Department of Clinical Sciences of Companion Animals and Equids, Equine Division, Diagnostic Imaging Section, University of Liège, Liège, Belgium
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Rovel T, Audigié F, Coudry V, Jacquet-Guibon S, Bertoni L, Denoix JM. Evaluation of standing low-field magnetic resonance imaging for diagnosis of advanced distal interphalangeal primary degenerative joint disease in horses: 12 cases (2010–2014). J Am Vet Med Assoc 2019; 254:257-265. [DOI: 10.2460/javma.254.2.257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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44
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Harcourt M, Smith C, Bell R, Young A. Magnetic resonance and radiographic imaging of a case of bilateral bipartite navicular bones in a horse. Aust Vet J 2018; 96:464-469. [DOI: 10.1111/avj.12760] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 06/26/2018] [Accepted: 07/25/2018] [Indexed: 11/30/2022]
Affiliation(s)
- M Harcourt
- Wollondilly Equine; Oakbank NSW Australia
| | - C Smith
- Agnes Banks Equine Clinic; Agnes Banks NSW Australia
| | - R Bell
- University Veterinary Teaching Hospital Camden; University of Sydney; Camden NSW Australia
| | - A Young
- School of Veterinary Science; University of Queensland; Gatton Queensland Australia
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Schiavo S, Cillán-García E, Elce Y, Liuti T, Taylor SE. Horses with solar foot penetration, deep digital flexor tendon injury, and absence of concurrent synovial sepsis can have a positive outcome. Vet Radiol Ultrasound 2018; 59:697-704. [PMID: 30159973 DOI: 10.1111/vru.12681] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 06/08/2018] [Accepted: 06/16/2018] [Indexed: 11/29/2022] Open
Abstract
Solar foot penetration is one of the causes of deep digital flexor tendon injuries in horses, however, limited information is available on the prognosis for return to soundness in the absence of synovial sepsis. Objectives of this retrospective observational study were to describe low-field magnetic resonance imaging (MRI) findings and long-term outcome for a group of horses with this combination of clinical problems. Horses were included if low-field standing MRI of the foot was performed following puncture wounds, injury of the deep digital flexor tendon was diagnosed, and sepsis was confirmed to be absent in all adjacent synovial structures (distal interphalangeal joint, navicular bursa, and digital flexor tendon sheath). Medical records were reviewed and MRI studies were re-interpreted. Follow-up information was obtained via a telephone questionnaire at a minimum of 6 months post-injury. A total of 11 horses met inclusion criteria. In three horses, the deep digital flexor tendon injury was only visible in the T2 fast spin echo sequence and contrast radiography improved diagnostic certainty. The most commonly affected area was between the distal border of the distal sesamoid bone and the facies flexoria of the distal phalanx (6/11, 55%). Six horses (60%) had an excellent outcome (5, show jumping; 1, general purpose) and returned to full athletic function. Five horses (40%) were sound but had not yet resumed full work at the time of follow-up. Findings indicated that the prognosis for return to soundness can be good for horses with solar penetration, deep digital flexor injury, and absence of synovial sepsis.
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Affiliation(s)
- Stefano Schiavo
- Easter Bush Veterinary Centre, Dick Vet Equine Hospital, University of Edinburgh, Midlothian, UK
| | - Eugenio Cillán-García
- Easter Bush Veterinary Centre, Dick Vet Equine Hospital, University of Edinburgh, Midlothian, UK
| | - Yvonne Elce
- Langford Vets, University of Bristol, Langford, BS40 5DU, UK
| | - Tiziana Liuti
- Easter Bush Veterinary Centre, Dick Vet Equine Hospital, University of Edinburgh, Midlothian, UK
| | - Sarah E Taylor
- Easter Bush Veterinary Centre, Dick Vet Equine Hospital, University of Edinburgh, Midlothian, UK
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Gutierrez-Nibeyro SD, McCoy AM, Selberg KT. Recent advances in conservative and surgical treatment options of common equine foot problems. Vet J 2018; 237:9-15. [PMID: 30089549 DOI: 10.1016/j.tvjl.2018.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 05/09/2018] [Accepted: 05/15/2018] [Indexed: 12/25/2022]
Abstract
Foot problems are very common causes of lameness in horses. With the recent diagnostic advances to evaluate and treat foot pathology as well as to monitor response to therapy, it is now possible to more accurately evaluate the effectiveness of many of these treatments. This review details some of the recent advances of the most common conservative and surgical treatment options for foot problems in horses, including an overview of evidence on the efficacy to support the use of these treatment options and on factors that may affect prognosis.
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Affiliation(s)
- S D Gutierrez-Nibeyro
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA.
| | - A M McCoy
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | - K T Selberg
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
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Quiney LE, Ireland JL, Dyson SJ. Evaluation of the diagnostic accuracy of skeletal scintigraphy for the causes of front foot pain determined by magnetic resonance imaging. Vet Radiol Ultrasound 2018; 59:490-498. [PMID: 29750846 DOI: 10.1111/vru.12627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/04/2017] [Accepted: 01/03/2018] [Indexed: 11/30/2022] Open
Abstract
There is good correlation between increased radiopharmaceutical uptake anywhere in the feet of sports or leisure horses and the presence of foot pain. However, low sensitivity of scintigraphy for identifying lesions contributing to foot pain as determined by magnetic resonance imaging (MRI) has been reported. The aim of this retrospective, cross-sectional, analytical study was to assess the accuracy of scintigraphy for identifying the cause(s) of foot pain, using MRI as the reference standard. Sports and leisure horses that underwent both skeletal scintigraphy and MRI of the front feet between March 2008 and December 2014 and for which a definitive diagnosis of the cause(s) of front foot pain was reached were included (121 feet of 70 horses). Imaging studies were evaluated retrospectively, blindly. Agreements between scintigraphic localization of increased radiopharmaceutical uptake and subjective categorization of lesions with MRI diagnosis were assessed using Kappa statistics (κ). Measures of diagnostic accuracy were calculated. Sensitivity of increased radiopharmaceutical uptake varied among regions (31.8-76.2%) but specificity was at least high for all (84.6-100%). Agreements between both scintigraphy measures and MRI diagnosis were substantial for the distal phalanx (palmar processes and body) (κ = 0.77 and κ = 0.74, respectively), and ungular cartilages and chondral ligaments (κ = 0.62, for both). When all regions were combined, agreements of increased radiopharmaceutical uptake (κ = 0.49) and relevance categorization (κ = 0.45) with MRI diagnosis were moderate. In conclusion, skeletal scintigraphy does not meet the minimum reliability level for a diagnostic test, but is reliable for identification of osseous trauma to the distal phalanx and ungular cartilages.
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Affiliation(s)
- Laura E Quiney
- Centre for Equine Studies, Animal Health Trust, Newmarket, Suffolk, CB8 7UU, UK
| | - Joanne L Ireland
- Centre for Equine Studies, Animal Health Trust, Newmarket, Suffolk, CB8 7UU, UK
| | - Sue J Dyson
- Centre for Equine Studies, Animal Health Trust, Newmarket, Suffolk, CB8 7UU, UK
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Does Diagnostic Analgesia in the Distal Aspect of the Limb of Horses Performed in a Clinical Situation Less Than 12 or 36 Hours Before Magnetic Resonance Imaging Result in Artifacts? J Equine Vet Sci 2018. [DOI: 10.1016/j.jevs.2017.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Aarsvold S, Solano M, Garcia-Lopez J. Magnetic resonance imaging following regional limb perfusion of gadolinium contrast medium in 26 horses. Equine Vet J 2018; 50:649-657. [PMID: 29417635 DOI: 10.1111/evj.12818] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 12/13/2017] [Accepted: 01/26/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND Systemic administration of gadolinium contrast medium is common in small animals to increase lesion conspicuity and determine vascularisation of lesions identified with magnetic resonance imaging (MRI); however, the large volume required for systemic administration limits its use in horses. OBJECTIVES The purpose of this study was to assess the feasibility of administering a low dose of contrast medium via venous regional limb perfusion. STUDY DESIGN Prospective clinical study. METHODS Distal limbs of 26 horses (one limb per horse) were imaged with MRI before and after administration of 5 mL of gadopentetate dimeglumine (Magnevist® ) diluted with 5 mL of physiological saline via a palmar/plantar digital vein with a tourniquet in place at the level of the mid aspect of the third metacarpal/metatarsal bone. Commonly assessed structures of the equine distal limb were examined for normal and abnormal contrast enhancement. RESULTS Twenty-five of 26 horses had adequate contrast enhancement of their distal limb. The lack of adequate contrast enhancement in one limb was likely associated with failure of the tourniquet. No adverse reactions were identified in any horse. One hundred thirty-two lesions were detected, of which, 69 contrast enhanced. Twelve lesions were detected exclusively following contrast enhancement. MAIN LIMITATIONS Case numbers and lesion variability yielded insufficient data to perform statistical analyses. Histopathology was not performed on sound horses to determine if the imaged structures were normal. CONCLUSIONS Regional limb perfusion is a feasible method to administer gadolinium contrast material to the equine distal limb for MRI. The enhancement pattern of the equine distal limb in sound horses is described. Contrast enhanced MRI of the distal equine limb helps to further characterise lesions identified with precontrast images, including adhesions and deep digital flexor tendinopathy. Contrast enhanced MRI also aids in identification of additional lesions, such as neovascularisation.
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Affiliation(s)
- S Aarsvold
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
| | - M Solano
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
| | - J Garcia-Lopez
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
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50
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Groom LM, White NA, Adams MN, Barrett JG. Accuracy of open magnetic resonance imaging for guiding injection of the equine deep digital flexor tendon within the hoof. Vet Radiol Ultrasound 2017; 58:671-678. [PMID: 28681515 DOI: 10.1111/vru.12523] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 04/11/2017] [Accepted: 05/16/2017] [Indexed: 11/29/2022] Open
Abstract
Lesions of the distal deep digital flexor tendon (DDFT) are frequently diagnosed using MRI in horses with foot pain. Intralesional injection of biologic therapeutics shows promise in tendon healing; however, accurate injection of distal deep digital flexor tendon lesions within the hoof is difficult. The aim of this experimental study was to evaluate accuracy of a technique for injection of the deep digital flexor tendon within the hoof using MRI-guidance, which could be performed in standing patients. We hypothesized that injection of the distal deep digital flexor tendon within the hoof could be accurately guided using open low-field MRI to target either the lateral or medial lobe at a specific location. Ten cadaver limbs were positioned in an open, low-field MRI unit. Each distal deep digital flexor tendon lobe was assigned to have a proximal (adjacent to the proximal aspect of the navicular bursa) or distal (adjacent to the navicular bone) injection. A titanium needle was inserted into each tendon lobe, guided by T1-weighted transverse images acquired simultaneously during injection. Colored dye was injected as a marker and postinjection MRI and gross sections were assessed. The success of injection as evaluated on gross section was 85% (70% proximal, 100% distal). The success of injection as evaluated by MRI was 65% (60% proximal, 70% distal). There was no significant difference between the success of injecting the medial versus lateral lobe. The major limitation of this study was the use of cadaver limbs with normal tendons. The authors conclude that injection of the distal deep digital flexor tendon within the hoof is possible using MRI guidance.
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Affiliation(s)
- Lauren M Groom
- Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, VA, 24060
| | - Nathaniel A White
- Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, VA, 24060
| | - M Norris Adams
- Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, VA, 24060
| | - Jennifer G Barrett
- Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, VA, 24060
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