Brink Palle, Skydsgaard Mikala, Teige Jon, Tverdal Aage, Dolvik Nils I
Jagersro Equine ATG Clinic, Jagersro, 212 37 Malmo, Sweden.
Am J Vet Res. 2010 Jan;71(1):47-54. doi: 10.2460/ajvr.71.1.47.
To develop a scoring system for histopathologic changes in the synovium of tarsocrural joints (TCJs) of horses with osteochondritis dissecans (OCD) and to test for association between histopathologic changes and joint effusion or lameness.
93 horses with OCD of the intermediate ridge of the tibia of 1 or both TCJs (134 joints) and 38 control horses without disease of TCJs (38 joints).
For OCD-affected horses, pretreatment lameness, TCJ effusion, and results of pelvic limb flexion test were scored. Synovial biopsy specimens were obtained from TCJs of OCD-affected horses during arthroscopy, and similar postmortem tissue specimens were obtained from control horses through a small arthrotomy. Histologic signs of synovitis in 172 biopsy specimens were scored by 2 pathologists (A and B) by use of 2 criteria: synoviocyte proliferation and cellular infiltration.
Analysis of scoring revealed good to very good intraobserver agreement within pathologist A (weighted kappa [WK], 0.76 to 0.81), and moderate to good agreement within pathologist B (WK, 0.56 to 0.63). Interobserver agreement for synoviocyte proliferation (WK, 0.34 to 0.52) and cellular infiltration (WK, 0.38 to 0.48) scores was fair to moderate. Joint effusion and synoviocyte proliferation were significantly associated, as were joint effusion and cellular infiltration. There was no association between histopathologic changes and the other clinical signs evaluated.
The scoring system was helpful for evaluating synovial inflammation caused by OCD of the intermediate ridge of the tibia in horses. Histopathologic signs of synovial inflammation were associated with effusion but not with lameness.
建立一种针对患有剥脱性骨软骨炎(OCD)马匹跗关节(TCJ)滑膜组织病理学变化的评分系统,并检测组织病理学变化与关节积液或跛行之间的关联。
93匹患有一侧或双侧TCJ胫骨中间嵴OCD的马匹(134个关节)以及38匹无TCJ疾病的对照马匹(38个关节)。
对于受OCD影响的马匹,对其预处理时的跛行、TCJ积液以及骨盆肢屈曲试验结果进行评分。在关节镜检查期间从受OCD影响马匹的TCJ获取滑膜活检标本,通过小切口手术从对照马匹获取类似的死后组织标本。2名病理学家(A和B)使用2项标准对172份活检标本中的滑膜炎组织学征象进行评分:滑膜细胞增殖和细胞浸润。
评分分析显示,病理学家A内部的观察者间一致性良好至极优(加权kappa [WK],0.76至0.81);病理学家B内部的一致性为中等至良好(WK,0.56至0.63)。滑膜细胞增殖(WK,0.34至0.52)和细胞浸润(WK,0.38至0.48)评分的观察者间一致性为中等至一般。关节积液与滑膜细胞增殖显著相关,关节积液与细胞浸润也显著相关。组织病理学变化与所评估的其他临床体征之间无关联。
该评分系统有助于评估马匹胫骨中间嵴OCD引起的滑膜炎症。滑膜炎症的组织病理学征象与积液相关,但与跛行无关。