Vanderperren K, Bergman H J, Spoormakers T J P, Pille F, Duchateau L, Puchalski S M, Saunders J H
Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Belgium.
Equine Vet J. 2014 Jul;46(4):463-7. doi: 10.1111/evj.12141. Epub 2013 Dec 5.
Lysis of the axial aspect of equine proximal sesamoid bones (PSBs) is a rare condition reported to have septic or traumatic origins. Limited information exists regarding imaging of nonseptic axial osteitis of a PSB.
To report the clinical, radiographic, ultrasonographic, computed tomographic and intra-arterial contrast-enhanced computed tomographic abnormalities in horses with axial nonseptic osteitis of a PSB.
Retrospective clinical study.
Eighteen horses diagnosed with nonseptic osteitis of the axial border of a PSB between 2007 and 2012 were reviewed retrospectively. Case details, clinical examination, radiographic, ultrasonographic, computed tomographic and intra-arterial/intra-articular contrast-enhanced computed tomographic features were recorded, when available. Radiographic, ultrasonographic and computed tomographic evaluations of the fetlock region had been performed on 18, 15 and 9 horses, respectively. The effect of the degree of lysis on the grade and duration of lameness was determined.
All horses had chronic unilateral lameness, 4 with forelimb and 14 with hindlimb signs. On radiographs, lysis was identified in both PSBs in 14 horses, one PSB in 3 horses and in one horse no lysis was identified. The degree of osteolysis was variable. Ultrasonography identified variably sized irregularities of the bone surface and alteration in echogenicity of the palmar/plantar ligament (PL). All horses undergoing computed tomographic examination (n = 9) had biaxial lysis. The lesions were significantly longer and deeper on computed tomographic images compared with radiographic images. Intra-arterial contrast-enhanced computed tomography may reveal moderate to marked contrast enhancement of the PL. There was no significant effect of the degree of lysis on the grade and duration of lameness.
Lesions of nonseptic axial osteitis of a PSB can be identified using a combination of radiography and ultrasonography. Computed tomography provides additional information regarding the extent of the pathology.
马近节籽骨（PSB）轴面溶解是一种罕见病症，据报道其病因有感染性或创伤性。关于非感染性PSB轴面骨炎的影像学资料有限。
报告患有PSB轴面非感染性骨炎马匹的临床、X线、超声、计算机断层扫描及动脉内对比增强计算机断层扫描异常情况。
回顾性临床研究。
回顾性分析2007年至2012年间诊断为PSB轴缘非感染性骨炎的18匹马。记录病例详情、临床检查、X线、超声、计算机断层扫描及动脉内/关节内对比增强计算机断层扫描特征（如有）。分别对18匹、15匹和9匹马的跗关节区域进行了X线、超声和计算机断层扫描评估。确定溶解程度对跛行等级和持续时间的影响。
所有马匹均有慢性单侧跛行，4匹有前肢症状，14匹有后肢症状。X线片显示，14匹马的双侧PSB均有溶解，3匹马的一侧PSB有溶解，1匹马未发现溶解。骨溶解程度各异。超声检查发现骨表面大小不一的不规则区域以及掌侧/跖侧韧带（PL）回声改变。所有接受计算机断层扫描检查的马匹（n = 9）均有双轴溶解。与X线图像相比，计算机断层扫描图像上的病变明显更长、更深。动脉内对比增强计算机断层扫描可能显示PL有中度至明显的对比增强。溶解程度对跛行等级和持续时间无显著影响。
结合X线和超声检查可识别PSB轴面非感染性骨炎病变。计算机断层扫描可提供有关病变范围的更多信息。
