Wavreille Vincent, Fitzpatrick Noel, Drost Wm Tod, Russell Duncan, Allen Matthew J
Department of Veterinary Clinical Sciences, Ohio State University, Columbus, Ohio.
Vet Surg. 2015 May;44(4):501-10. doi: 10.1111/j.1532-950X.2014.12233.x. Epub 2014 Sep 16.
To describe the magnetic resonance imaging (MRI), arthroscopic, and histopathologic changes in dogs with medial coronoid disease and to identify potential relationships between these findings.
Retrospective case series.
Twenty-five diseased medial coronoid processes (MCP) were collected from 19 dogs with a confirmed diagnosis of medial coronoid disease that were surgically treated by subtotal coronoid ostectomy. A reference group of normal MCP was collected from 9 dogs euthanatized for reasons unrelated to elbow disease.
MCP specimens were evaluated by MRI using a novel grading scheme (all dogs), arthroscopy using a modified Outerbridge scheme (affected dogs only) and histopathology (all dogs).
The common histopathologic findings were subchondral microfractures, subchondral microfractures continuous with cartilaginous fissures, moderate to severe hypercellularity of the marrow space, trabecular bone necrosis, and articular cartilage degeneration. The severity of cartilage disease in the MCP was moderate to severe in most specimens, even in cases with minimal arthroscopic pathology. Three distinct patterns of bone marrow lesion (BML) were identified adjacent to the MCP, but there was no correlation between BML pattern and either histopathologic or arthroscopic findings. There was moderate correlation between modified Outerbridge scores and MRI scores. No correlation was identified between the histopathologic changes and either MRI or arthroscopic scores.
There was no significant correlation between the clinical scores and histopathologic changes. Ongoing improvements in the resolution of noninvasive imaging techniques will likely improve description and understanding of the MCP disease in dogs.
描述患有内侧冠状突疾病犬的磁共振成像(MRI)、关节镜检查及组织病理学变化,并确定这些检查结果之间的潜在关系。
回顾性病例系列研究。
从19只确诊为内侧冠状突疾病且接受了冠状突次全切除术的犬收集了25个患病的内侧冠状突(MCP)。从9只因与肘部疾病无关的原因实施安乐死的犬收集了正常MCP作为参照组。
使用一种新的分级方案通过MRI评估MCP标本(所有犬),使用改良的Outerbridge方案通过关节镜检查评估(仅患病犬),并进行组织病理学检查(所有犬)。
常见的组织病理学发现包括软骨下微骨折、与软骨裂隙相连的软骨下微骨折、骨髓腔中度至重度细胞增多、小梁骨坏死及关节软骨退变。大多数标本中MCP的软骨疾病严重程度为中度至重度,即使在关节镜病理表现轻微的病例中也是如此。在MCP附近发现了三种不同类型的骨髓病变(BML)模式,但BML模式与组织病理学或关节镜检查结果之间均无相关性。改良的Outerbridge评分与MRI评分之间存在中度相关性。未发现组织病理学变化与MRI或关节镜检查评分之间存在相关性。
临床评分与组织病理学变化之间无显著相关性。无创成像技术分辨率的不断提高可能会改善对犬MCP疾病的描述和理解。