Kunst Chelsea M, Pease Anthony P, Nelson Nathan C, Habing Greg, Ballegeer Elizabeth A
California Veterinary Specialists, Murrieta, CA, 92563.
Vet Radiol Ultrasound. 2014 Sep-Oct;55(5):511-20. doi: 10.1111/vru.12171. Epub 2014 May 16.
Elbow dysplasia is a heritable disease that is a common cause of lameness and progressive elbow osteoarthritis in young large breed dogs. The Orthopedic Foundation for Animals (OFA) screens elbow radiographs, and assigns grades 0-3 based on presence and severity of bony proliferation on the anconeal process. Grade 1 is assigned when less than 3 mm is present and considered positive for dysplasia. We investigated the incidence of elbow dysplasia and progression of osteoarthritis in elbows with grades 0 and 1 in 46 elbows screened at least 1 year previously, using CT as a gold standard and with the addition of CT absorptiometry. The incidence of dysplasia based on CT was 62% in grade 0, and 75% in grade 1 elbows, all of which had medial coronoid disease. Progressive osteoarthritis at recheck was consistent with elbow dysplasia. The sensitivity and specificity of the OFA grade for elbow dysplasia compared to CT findings was 75% and 38%, respectively. Increased bone mineral density of the medial coronoid process as characterized by osteoabsorptiometry warrants further investigation with respect to elbow dysplasia. Proliferation on the anconeal process without CT evidence of dysplasia or osteoarthritis was present in 20% of the elbows, and is theorized to be an anatomic variant or enthesopathy of the olecranon ligament/synovium. Results of our study suggest that the "anconeal bump" used for elbow screening by the OFA is a relatively insensitive characteristic, and support the use of CT for identifying additional characteristics of elbow dysplasia.
肘关节发育不良是一种遗传性疾病，是年轻大型犬跛行和进行性肘关节骨关节炎的常见原因。动物骨科基金会（OFA）对肘关节X光片进行筛查，并根据肘突上骨增生的存在情况和严重程度将其分为0-3级。当存在小于3毫米的骨增生时被判定为1级，并被认为发育不良呈阳性。我们对46个至少在1年前进行过筛查的肘关节进行了研究，这些肘关节的OFA分级为0级和1级，以CT作为金标准，并增加了CT骨密度测定，以调查肘关节发育不良的发生率和骨关节炎的进展情况。基于CT的发育不良发生率在0级肘关节中为62%，在1级肘关节中为75%，所有这些肘关节都有内侧冠状突疾病。复查时的进行性骨关节炎与肘关节发育不良一致。与CT检查结果相比，OFA分级对肘关节发育不良的敏感性和特异性分别为75%和38%。以骨密度测定为特征的内侧冠状突骨矿物质密度增加，对于肘关节发育不良值得进一步研究。在20%的肘关节中存在肘突上的增生，但没有CT证据表明存在发育不良或骨关节炎，理论上这是鹰嘴韧带/滑膜的一种解剖变异或附着点病。我们的研究结果表明，OFA用于肘关节筛查的“肘突肿块”是一个相对不敏感的特征，并支持使用CT来识别肘关节发育不良的其他特征。
