De Lasalle Julie, Alexander Kate, Olive Julien, Laverty Sheila
Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, 3200 Sicotte, PO Box 5000, Saint-Hyacinthe, QC, Canada.
Comparative Orthopedic Research Laboratory, Faculty of Veterinary Medicine, University of Montreal, 3200 Sicotte, PO Box 5000, Saint-Hyacinthe, J2S 7C6, QC, Canada.
Vet Radiol Ultrasound. 2016 Sep;57(5):489-501. doi: 10.1111/vru.12370. Epub 2016 May 30.
A better understanding of imaging characteristics of equine stifle osteoarthritis (OA) may allow earlier detection and improve prognosis. Objectives of this ex vivo, prospective, methods comparison study were to (1) describe the location and severity of naturally acquired OA lesions in the equine stifle using ultrasound (US), radiography (XR), computed tomography (CT), and macroscopic evaluation (ME); (2) compare the diagnostic performance of each imaging modality with ME; and (3) describe subchondral bone mineral density (BMD) in equine stifle joints with OA using CT. Radiographic, CT, and US evaluations were performed on 23 equine cadaver stifles and compared with ME. Significant associations were found between osteophyte global scores for all imaging modalities (CT, P ˂ 0.0001; XR, P = 0.005; US, P = 0.04) vs. ME osteophyte global scores. Osteophytes were detected most frequently in the medial femorotibial (MFT) joint. A specific pattern of osteophytes was observed, with a long ridge of new bone at the insertion of the MFT joint capsule cranially on the medial femoral condyle. A novel caudo-10°proximo-5°lateral-cranio-disto-medial oblique radiographic projection was helpful for detection of intercondylar osteophytes. Multiplanar CT reformatted images were helpful for characterizing all osteophytes. Osteophyte grades at most sites did not differ among modalities. Low sensitivity/specificity for subchondral bone sclerosis and flattening of femoral condyles suggested that these signs may not be reliable radiographic and CT indicators of equine stifle OA. Equine stifle OA was associated with a decrease in BMD and specific sites of focal subchondral bone resorption/cyst formation were found in some specimens.
更好地了解马 stifle 骨关节炎（OA）的影像学特征可能有助于早期检测并改善预后。本体外前瞻性方法比较研究的目的是：（1）使用超声（US）、X 线摄影（XR）、计算机断层扫描（CT）和宏观评估（ME）描述马 stifle 自然获得性 OA 病变的位置和严重程度；（2）将每种成像方式的诊断性能与 ME 进行比较；（3）使用 CT 描述患有 OA 的马 stifle 关节的软骨下骨矿物质密度（BMD）。对 23 个马尸体 stifle 进行了 X 线摄影、CT 和 US 评估，并与 ME 进行比较。发现所有成像方式（CT，P ˂ 0.0001；XR，P = 0.005；US，P = 0.04）的骨赘总体评分与 ME 骨赘总体评分之间存在显著关联。骨赘最常在内侧股胫（MFT）关节中被检测到。观察到一种特定的骨赘模式，在内侧股骨髁上，MFT 关节囊插入处的颅骨侧有一条新骨长嵴。一种新的尾侧 10°、近端 5°、外侧 - 颅骨 - 远端 - 内侧斜位 X 线摄影投影有助于髁间骨赘的检测。多平面 CT 重组图像有助于所有骨赘的特征描述。大多数部位的骨赘分级在不同成像方式之间没有差异。软骨下骨硬化和股骨髁扁平化的低敏感性/特异性表明，这些征象可能不是马 stifle OA 的可靠 X 线摄影和 CT 指标。马 stifle OA 与 BMD 降低有关，并且在一些标本中发现了局灶性软骨下骨吸收/囊肿形成的特定部位。
