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磁共振成像在识别马软骨下骨损伤中的应用:11例病例(1999 - 2003年)

Use of magnetic resonance imaging for identifying subchondral bone damage in horses: 11 cases (1999-2003).

作者信息

Zubrod Chad J, Schneider Robert K, Tucker Russell L, Gavin Patrick R, Ragle Claude A, Farnsworth Kelly D

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA.

出版信息

J Am Vet Med Assoc. 2004 Feb 1;224(3):411-8. doi: 10.2460/javma.2004.224.411.

Abstract

OBJECTIVE

To assess the use of magnetic resonance (MR) imaging for identifying subchondral bone damage in the distal limbs of horses.

DESIGN

Retrospective study.

ANIMALS

11 horses.

PROCEDURE

Medical records of horses with lameness and subsequent evidence of subchondral bone damage as determined by MR imaging were reviewed. Severity and duration of lameness, results of diagnostic local anesthesia and diagnostic testing, surgical and necropsy findings, and treatment were recorded. Outcome was determined by follow-up information obtained from the owner or referring veterinarian.

RESULTS

Lameness was localized by physical examination and diagnostic local anesthesia. Lameness was localized to the metacarpophalangeal or metatarsophalangeal joint in 4 horses, distal interphalangeal joint in 5 horses, and tarsocrural joint in 2 horses. The duration of lameness ranged from 2 weeks to 20 months. Magnetic resonance imaging of the affected joints revealed abnormal fluid accumulation within the subchondral bone. None of the abnormalities observed by MR imaging were detected by radiography. Subchondral bone damage was diagnosed in all horses. Arthroscopy of the affected joint was performed in 4 horses. Communication with the articular surface of the affected bone was suspected on the basis of results of MR imaging in 4 horses and was confirmed by arthroscopy in 1 horse and by necropsy in 1 horse.

CONCLUSIONS AND CLINICAL RELEVANCE

Magnetic resonance imaging was useful for providing a diagnosis when other imaging techniques did not definitively identify the cause of lameness. Subchondral bone damage was clearly identified by MR imaging and should be considered as a cause of lameness in horses in which radiographic findings are unremarkable.

摘要

目的

评估磁共振成像(MR)用于识别马四肢远端软骨下骨损伤的情况。

设计

回顾性研究。

动物

11匹马。

步骤

回顾了跛行马的病历,这些马随后经MR成像确定存在软骨下骨损伤。记录跛行的严重程度和持续时间、诊断性局部麻醉和诊断性检查结果、手术及尸检结果以及治疗情况。通过从马主或转诊兽医处获得的随访信息确定结果。

结果

通过体格检查和诊断性局部麻醉对跛行进行定位。4匹马的跛行定位于掌指关节或跖趾关节,5匹马定位于远侧指间关节,2匹马定位于跗关节。跛行持续时间从2周至20个月不等。对患关节进行的磁共振成像显示软骨下骨内有异常积液。X线摄影未检测到MR成像所观察到的任何异常。所有马匹均诊断为软骨下骨损伤。对4匹马的患关节进行了关节镜检查。根据MR成像结果,4匹马怀疑存在与患骨关节面的连通,其中1匹马经关节镜检查证实,1匹马经尸检证实。

结论及临床意义

当其他成像技术不能明确跛行原因时,磁共振成像有助于做出诊断。MR成像能清晰识别软骨下骨损伤,对于X线检查结果不明显的跛行马,应考虑软骨下骨损伤为跛行原因之一。

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