Ruohoniemi M, Mäkelä O, Eskonen T
Department of Clinical Veterinary Sciences, Faculty of Veterinary Medicine, PO Box 57, FIN-00014 University of Helsinki, Finland.
Equine Vet J. 2004 Mar;36(2):143-8. doi: 10.2746/0425164044868729.
Research on the clinical significance of ossification of the cartilages of the foot has been limited, despite the common nature of the condition and conflicting reports in previous literature.
Some radiographic features in the ossification of the cartilages, such as incomplete fusion lines between separate centres of ossification and the ossified base, are of clinical significance.
The relationships between radiopharmaceutical uptake in bone phase nuclear scintigraphy at the heels (palmar processes of the distal phalanx, including ossification of the cartilages of the foot), radiographic extent and type of ossification of the cartilages and clinical lameness were evaluated retrospectively in 21 Finnhorses (age > or = 4 years) in a total of 36 front feet.
No significant relationship between height of the ossifications and radiopharmaceutical uptake at the ipsilateral heels existed. Clearly separate centres of ossification were not associated with increased uptake. Moderately increased uptake was suspected to be associated with ossification of the adjacent cartilage in only one foot. Intense uptake was present unilaterally in 4 horses, at one medial and 3 lateral heels. In 2 of these horses, a unilateral palmar digital nerve block relieved the mild lameness; 2 horses had no obvious lameness but had a history of being stiff or having locomotion problems during high speed trot. At 2 of the lateral heels, an incomplete fusion line was present between a large separate centre of ossification and the base, and the third horse had a high sidebone with bony protrusions, suggestive of chronic entheseopathy in a narrow foot. At the medial heel, an oblique radiograph revealed a faint radiolucent line at the base of the ossification. In all cartilages with intense radiopharmaceutical uptake at the heel and/or lameness, the ossified part of the cartilage was wider and more irregular compared to other ossifications of the front feet of the individual.
Increased radiopharmaceutical uptake, associated with a different radiographic appearance from that of other ossifications of the front feet, was a conclusive sign of clinical significance. Obscure locomotion problems were more commonly associated with ossification of the cartilages than true lameness.
This information is useful in lameness and prepurchase examinations and is likely also to be applicable to other coldblooded breeds used for athletic purposes.
尽管足部软骨骨化情况较为常见且既往文献报道存在矛盾,但关于足部软骨骨化临床意义的研究仍较为有限。
软骨骨化的某些影像学特征,如不同骨化中心与骨化基底之间的融合线不完全,具有临床意义。
对21匹芬兰马(年龄≥4岁)共36只前蹄进行回顾性评估,分析足跟部骨相核素骨扫描(远端指骨掌突,包括足部软骨骨化)中放射性药物摄取情况、软骨骨化的影像学范围和类型与临床跛行之间的关系。
骨化高度与同侧足跟部放射性药物摄取之间无显著相关性。明显分离的骨化中心与摄取增加无关。仅在一只蹄中怀疑摄取中度增加与相邻软骨骨化有关。4匹马单侧出现强烈摄取,分别位于内侧足跟1例、外侧足跟3例。其中2匹马,单侧掌侧指神经阻滞可缓解轻度跛行;2匹马无明显跛行,但有高速小跑时僵硬或运动问题的病史。在外侧足跟的2例中,一个大的独立骨化中心与基底之间存在不完全融合线,第三匹马有一个高侧副骨并伴有骨质增生,提示窄蹄慢性附着点病。在内侧足跟,一张斜位X线片显示骨化基底处有一条模糊的透亮线。在所有足跟部放射性药物摄取强烈和/或跛行的软骨中,与个体前蹄的其他骨化相比,软骨的骨化部分更宽且更不规则。
放射性药物摄取增加,且与前蹄其他骨化的影像学表现不同,是具有临床意义的决定性标志。隐匿的运动问题比真正的跛行更常与软骨骨化有关。
该信息对跛行和购马前检查有用,可能也适用于其他用于运动目的的冷血品种。