患有前交叉韧带疾病的犬半月板疾病的临床发现的风险因素及诊断准确性

Risk factors and diagnostic accuracy of clinical findings for meniscal disease in dogs with cranial cruciate ligament disease.

作者信息

Dillon Dayle E, Gordon-Evans Wanda J, Griffon Dominique J, Knap Kim M, Bubb Carrie L, Evans Richard B

机构信息

Best Friends Vet Care North, Decatur, Illinois.

出版信息

Vet Surg. 2014 May;43(4):446-50. doi: 10.1111/j.1532-950X.2014.12103.x. Epub 2014 Apr 1.

Abstract

OBJECTIVE

To determine the risk factors for meniscal disease and diagnostic accuracy of physical examination in dogs with cranial cruciate ligament (CCL) deficiency.

STUDY DESIGN

Prospective cohort study.

ANIMALS

Stifles (n = 80) of dogs with CCL deficiency.

METHODS

Each dog was evaluated preoperatively for factors that may increase the risk of, or aid in the diagnosis of meniscal disease including presence of pain on extension and flexion of the affected stifle, range of motion during flexion and extension, thigh circumference, positive cranial-drawer test, positive tibial compression test, tibial plateau angle, complete tear of the CCL, presence of a meniscal click, and gait analysis. Odds ratios were calculated for each of the factors and a multivariate approach was used to create an ROC curve. Subsequent sensitivity, specificity, and area under the curve was used to determine the diagnostic value of clinical tests.

RESULTS

Dogs with pain upon flexion of the stifle were 4.3 times more likely to have medial meniscal disease than those without flexion pain and dogs with a complete CCL tear were 9.6 times more likely to have medial meniscal disease than those with partial tears. A meniscal click increased the likelihood of medial meniscal disease by a factor of 11.3. The diagnostic accuracy using a meniscal click and pain upon stifle flexion was 76%.

CONCLUSION

Combining the presence of a meniscal click and pain during flexion of the stifle provide a more accurate diagnosis of medial meniscal disease in dogs with CCL disease over individual examination variables.

摘要

目的

确定患有颅交叉韧带(CCL)缺陷的犬类半月板疾病的风险因素以及体格检查的诊断准确性。

研究设计

前瞻性队列研究。

动物

患有CCL缺陷的犬类的 stifles(n = 80)。

方法

对每只犬术前评估可能增加半月板疾病风险或有助于诊断半月板疾病的因素,包括患侧 stifle 屈伸时的疼痛情况、屈伸过程中的活动范围、大腿周长、阳性颅抽屉试验、阳性胫骨压缩试验、胫骨平台角、CCL 完全撕裂、半月板弹响的存在以及步态分析。计算每个因素的比值比,并采用多变量方法绘制ROC曲线。随后利用敏感性、特异性和曲线下面积来确定临床检查的诊断价值。

结果

患侧 stifle 屈曲时疼痛的犬发生内侧半月板疾病的可能性是无屈曲疼痛犬的4.3倍,CCL 完全撕裂的犬发生内侧半月板疾病的可能性是部分撕裂犬的9.6倍。半月板弹响使内侧半月板疾病的可能性增加了11.3倍。使用半月板弹响和 stifle 屈曲时疼痛进行诊断的准确性为76%。

结论

与单独的检查变量相比,结合半月板弹响的存在和 stifle 屈曲时的疼痛情况能更准确地诊断患有CCL疾病的犬类的内侧半月板疾病。

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