Wagner Kahrma, Griffon Dominique J, Thomas Micheal W, Schaeffer David J, Schulz Kurt, Samii Valerie F, Necas Alois
University of Illinois College of Veterinary Medicine, Urbana, IL 61802, USA.
Vet Surg. 2007 Oct;36(7):691-8. doi: 10.1111/j.1532-950X.2007.00322.x.
To compare the diagnostic value of arthroscopy, computed tomography (CT), and radiography for evaluation of radio-ulnar incongruence (RUI).
Experimental evaluation of induced progressive RUI.
Cadaveric Labrador forelimbs (n=11).
The radius was shortened by 1, 2, and 3 mm with a surgical model of RUI. RUI was scored on radiographs, CT (2 radiologists), and arthroscopy (2 surgeons) before and after each modification. The sensitivity and specificity of each modality were compared. The effects of arthroscope and elbow position on arthroscopy observations were evaluated. Agreement between surgeons, radiologists, and each imaging technique and the known status of the elbow was calculated.
Complete arthroscopic sessions had an averaged sensitivity of 94% and specificity of 81.9%. The ability to detect mild incongruity (1 mm step) was greater at the incisure than other locations (P<.001). The average sensitivity and specificity of radiography were 99.3% and 42.4%, and for CT were 85.05% and 45.8%, respectively. The average agreement between imaging techniques and the known status of the elbows was greater with complete arthroscopic sessions (89.75%) than radiography (70.1%) and CT (76.85%). Inter-investigator agreement was greater between surgeons scoring arthroscopic examinations (88.6%) than radiologists scoring CT studies (43.9%).
Evaluation of arthroscopic images allows sensitive and reproducible detection of experimental RUI, especially at the incisure. Arthroscopic evaluation of experimental RUI reached a higher diagnostic value than radiographs and CT images, because of its specificity and reproducibility.
The diagnostic value and reproducibility of arthroscopy may compare favorably with those of CT when evaluating RUI in dogs with elbow disease.
比较关节镜检查、计算机断层扫描（CT）和X线摄影对评估桡尺骨不匹配（RUI）的诊断价值。
对诱导性进行性RUI的实验评估。
拉布拉多犬尸体前肢（n = 11）。
使用RUI手术模型将桡骨分别缩短1、2和3毫米。在每次调整前后，通过X线摄影、CT（两名放射科医生）和关节镜检查（两名外科医生）对RUI进行评分。比较每种检查方式的敏感性和特异性。评估关节镜和肘部位置对关节镜观察结果的影响。计算外科医生、放射科医生以及每种成像技术与肘部已知状况之间的一致性。
完整的关节镜检查平均敏感性为94%，特异性为81.9%。在切迹处检测轻度不匹配（1毫米台阶）的能力高于其他部位（P<0.001）。X线摄影的平均敏感性和特异性分别为99.3%和42.4%，CT的平均敏感性和特异性分别为85.05%和45.8%。完整的关节镜检查（89.75%）与肘部已知状况之间的平均一致性高于X线摄影（70.1%）和CT（76.85%）。关节镜检查评分的外科医生之间的调查者间一致性（88.6%）高于CT研究评分的放射科医生之间的一致性（43.9%）。
对关节镜图像的评估能够灵敏且可重复地检测实验性RUI，尤其是在切迹处。由于其特异性和可重复性，对实验性RUI的关节镜评估比X线片和CT图像具有更高的诊断价值。
在评估患有肘部疾病的犬的RUI时，关节镜检查的诊断价值和可重复性可能优于CT。
