Ley C J, Björnsdóttir S, Ekman S, Boyde A, Hansson K
Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Icelandic Food and Veterinary Authority, Selfoss, Iceland.
Equine Vet J. 2016 Jan;48(1):57-64. doi: 10.1111/evj.12370. Epub 2015 Jan 30.
Validated noninvasive detection methods for early osteoarthritis (OA) are required for OA prevention and early intervention treatment strategies.
To evaluate radiography and low-field magnetic resonance imaging (MRI) for the detection of early stage OA osteochondral lesions in equine centrodistal joints using microscopy as the reference standard.
Prospective imaging of live horses and imaging and microscopy of cadaver tarsal joints.
Centrodistal (distal intertarsal) joints of 38 Icelandic research horses aged 27-29 months were radiographed. Horses were subjected to euthanasia approximately 2 months later and cadaver joints examined with low-field MRI. Osteochondral joint specimens were classified as negative or positive for OA using light microscopy histology or scanning electron microscopy. Radiographs and MRIs were evaluated for osteochondral lesions and results compared with microscopy.
Forty-two joints were classified OA positive with microscopy. Associations were detected between microscopic OA and the radiography lesion categories; mineralisation front defect (P<0.0001), joint margin lesion (P<0.0001), central osteophyte (P = 0.03) and the low-field MRI lesion categories; mineralisation front defect (P = 0.01), joint margin lesion (P = 0.02) and articular cartilage lesion (P = 0.0003). The most frequent lesion category detected in microscopic OA positive joints was the mineralisation front defect in radiographs (28/42 OA positive joints, specificity 97%, sensitivity 67%). No significant differences were detected between the sensitivity and specificity of radiography and low-field MRI pooled lesion categories, but radiography was often superior when individual lesion categories were compared.
Early stage centrodistal joint OA changes may be detected with radiography and low-field MRI. Detection of mineralisation front defects in radiographs may be a useful screening method for detection of early OA in centrodistal joints of young Icelandic horses.
早期骨关节炎(OA)的有效非侵入性检测方法对于OA的预防和早期干预治疗策略至关重要。
以显微镜检查作为参考标准,评估X线摄影和低场磁共振成像(MRI)在检测马远中跗关节早期OA骨软骨损伤方面的效果。
对活马进行前瞻性成像,并对尸体跗关节进行成像和显微镜检查。
对38匹年龄在27至29个月的冰岛研究用马的远中跗(跗间远端)关节进行X线摄影。大约2个月后对马匹实施安乐死,并对尸体关节进行低场MRI检查。使用光学显微镜组织学或扫描电子显微镜将骨软骨关节标本分类为OA阴性或阳性。对X线片和MRI进行骨软骨损伤评估,并将结果与显微镜检查结果进行比较。
显微镜检查将42个关节分类为OA阳性。在显微镜下OA与X线摄影损伤类别之间检测到相关性;矿化前沿缺损(P<0.0001)、关节边缘损伤(P<0.0001)、中央骨赘(P = 0.03)以及与低场MRI损伤类别之间;矿化前沿缺损(P = 0.01)、关节边缘损伤(P = 0.02)和关节软骨损伤(P = 0.0003)。在显微镜下OA阳性关节中检测到的最常见损伤类别是X线片中的矿化前沿缺损(42个OA阳性关节中的28个,特异性97%,敏感性67%)。在X线摄影和低场MRI合并损伤类别之间未检测到敏感性和特异性的显著差异,但在比较单个损伤类别时,X线摄影通常更具优势。
X线摄影和低场MRI可检测到早期远中跗关节OA变化。X线片中矿化前沿缺损的检测可能是检测年轻冰岛马远中跗关节早期OA的一种有用筛查方法。