Jones Laura E, Dyson Sue J
J Am Vet Med Assoc. 2015 Oct 1;247(7):801-11. doi: 10.2460/javma.247.7.801.
To describe in detail the radiographic appearance of ossified ungular cartilages in horses and to evaluate the usefulness of a flexed dorsolateral-palmaromedial oblique (flexed oblique) radiographic view in evaluating the ungular cartilages.
Retrospective case series. Sample-Radiographs of 1,255 front feet of horses.
Ossification of the ungular cartilages was graded during evaluation of radiographs on a scale from 0 to 5; feet with cartilages with an ossification grade ≥ 2 were included (386 feet [271 horses]). The shape (straight, curved outward or inward, and dorsopalmar extension of ossification) was determined. The view on which abnormalities were best identified was documented. Abnormalities of the compact bone, radiopacity, trabecular architecture, compactospongious demarcation, and presence of radiolucent lines were recorded; grouped as modeling, adaptive changes, or both; compared with ossification grade, separate centers of ossification, mediolateral symmetry of ossification, shape, cartilage (medial or lateral), and foot (left or right); and tested for significant associations.
Fractures (n = 35) were most common in feet with cartilages with an ossification grade of 4 (18) or 5 (17) and were best identified in flexed oblique images, compared with more commonly recommended images. Multivariable logistic regression showed a significant positive association of ossification grade with modeling or adaptive changes; feet with cartilages with an ossification grade of 4 (OR, 11.59; 95% CI, 6.52 to 20.60) or 5 (OR, 72.90; 95% CI, 25.32 to 209.90) were more likely than those with an ossification grade of 2 or 3 to have modeling or adaptive changes. Abnormally shaped cartilages were more likely to have modeling or adaptive changes, compared with normally shaped cartilages (OR, 4.90; 95% CI, 1.94 to 12.42).
Extensive ossification and the presence of inward or outward curvature as well as palmar curvature or a bulbous shape were significant risk factors for modelling and adaptive changes. Flexed oblique images provided clinically useful information, including detection of abnormal shape and fractures, that may not be evident on other currently recommended images. Such images are recommended for complete radiographic appraisal of ossified ungular cartilages of the foot in horses.
详细描述马的角状软骨骨化的X线表现,并评估背外侧-掌内侧斜位(屈曲斜位)X线视图在评估角状软骨中的作用。
回顾性病例系列研究。样本——1255匹马前足的X线片。
在评估X线片时,对角状软骨的骨化程度按0至5级进行分级;纳入骨化程度≥2级的软骨的蹄(386个蹄[271匹马])。确定其形状(直的、向外或向内弯曲以及骨化的背掌延伸)。记录最能识别异常的视图。记录密质骨、不透X线性、小梁结构、密质骨与松质骨分界以及透亮线的异常情况;分为塑形、适应性改变或两者皆有;与骨化程度、单独的骨化中心、骨化的内外侧对称性、形状、软骨(内侧或外侧)以及蹄(左或右)进行比较,并检验是否存在显著关联。
骨折(n = 35)在骨化程度为4级(18例)或5级(17例)的软骨的蹄中最为常见,与更常推荐的图像相比,在屈曲斜位图像中最易识别。多变量逻辑回归显示骨化程度与塑形或适应性改变之间存在显著正相关;骨化程度为4级(OR,11.59;95% CI,6.52至20.60)或5级(OR,72.90;95% CI,25.32至209.90)的软骨的蹄比骨化程度为2级或3级的蹄更有可能出现塑形或适应性改变。与形状正常的软骨相比,形状异常的软骨更有可能出现塑形或适应性改变(OR,4.90;95% CI,1.94至12.42)。
广泛的骨化以及存在向内或向外的弯曲以及掌侧弯曲或球根状形状是塑形和适应性改变的重要危险因素。屈曲斜位图像提供了临床上有用的信息,包括检测异常形状和骨折,而这些在目前其他推荐的图像上可能不明显。建议使用此类图像对马的蹄角状软骨骨化进行完整的X线评估。