Chanoit Guillaume, Singhani Nikita N, Marcellin-Little Denis J, Osborne Jason A
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.
Am J Vet Res. 2010 Jul;71(7):780-3. doi: 10.2460/ajvr.71.7.780.
OBJECTIVE: To compare 5 radiographic views for the detection of osteochondritis dissecans (OCD) in dogs with signs of elbow joint pain. ANIMALS: 53 dogs (100 elbow joints) with forelimb lameness and signs of elbow joint pain. PROCEDURES: Mediolateral (ML), flexed ML, craniocaudal (CC), craniolateral-caudomedial oblique (Cr15L-CdMO), and distomedial-proximolateral oblique (Di35M-PrLO) radiographic views of the 100 elbow joints were obtained. Four examiners graded radiographs with regard to elbow joint OCD. Joints were assessed by use of arthroscopy. Receiver operating characteristic (ROC) curves, kappa measure of agreement, and Fisher exact tests for association between median diagnostic value and actual status were computed. RESULTS: 47 joints had an abnormal medial aspect of the humeral condyle (MAHC), and among them, 11 had OCD. The presence of fractures of the medial coronoid process was significantly and positively correlated with the presence of abnormalities of the MAHC (r = 0.40), but was negatively correlated with the presence of OCD (r = -0.32). At 95% specificity, median sensitivities to detect OCD were 57% for Cr15L-CdMO, 56% for CC, 10% for flexed ML, 7% for ML, and 4% for Di35M-PrLO views. The areas under the ROC curves were significantly larger for the Cr15L-CdMO and CC views than for the ML, flexed ML, and Di35M-PrLO views for the detection of OCD. Only the Cr15L-CdMO and CC views allowed accurate detection of OCD. CONCLUSIONS AND CLINICAL RELEVANCE: In dogs with signs of elbow joint pain, the Cr15L-CdMO view is excellent and the CC view was good for detection of OCD.
目的:比较5种X线投照视图对出现肘关节疼痛体征的犬剥脱性骨软骨炎(OCD)的检测效果。 动物:53只出现前肢跛行及肘关节疼痛体征的犬(100个肘关节)。 方法:对100个肘关节进行内外侧(ML)、屈曲位内外侧、前后位(CC)、颅外侧-尾内侧斜位(Cr15L-CdMO)以及远内侧-近外侧斜位(Di35M-PrLO)X线投照。4名检查者对肘关节OCD的X线片进行分级。通过关节镜检查对关节进行评估。计算受试者操作特征(ROC)曲线、一致性kappa测量值以及中位诊断值与实际状况之间关联的Fisher精确检验。 结果:47个关节肱骨髁内侧方面(MAHC)异常,其中11个有OCD。内侧冠状突骨折的存在与MAHC异常的存在呈显著正相关(r = 0.40),但与OCD的存在呈负相关(r = -0.32)。在95%的特异性水平下,检测OCD的中位敏感性在Cr15L-CdMO视图中为57%,CC视图中为56%,屈曲位ML视图中为10%,ML视图中为7%,Di35M-PrLO视图中为4%。对于检测OCD,Cr15L-CdMO和CC视图的ROC曲线下面积显著大于ML、屈曲位ML和Di35M-PrLO视图。只有Cr15L-CdMO和CC视图能够准确检测OCD。 结论及临床意义:在出现肘关节疼痛体征 的犬中,Cr15L-CdMO视图对OCD的检测效果极佳,CC视图效果良好。
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