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超声检查对驹(28 - 166日龄)股骨滑车亚临床骨软骨病的筛查:一项前瞻性农场研究

Ultrasonographic screening for subclinical osteochondrosis of the femoral trochlea in foals (28-166 days old): a prospective farm study.

作者信息

Martel G, Crowley D, Olive J, Halley J, Laverty S

机构信息

Comparative Orthopedic Research Laboratory, Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada.

Fethard Equine Hospital, Fethard, Ireland.

出版信息

Equine Vet J. 2018 May;50(3):312-320. doi: 10.1111/evj.12772. Epub 2017 Nov 9.

Abstract

BACKGROUND

Extensive osteochondritis dissecans (OCD) lesions of the lateral ridge of the trochlea of the femur (LRTF), the most common OCD-affected site in the stifle, have a poor outcome with surgical debridement and can be career ending. The early detection of osteochondrosis lesions and their conservative management holds the promise to enhance outcome. We hypothesise that ultrasonography is a valuable field screening tool to detect and monitor early subclinical LRTF osteochondrosis.

OBJECTIVES

The goals were to 1) describe the normal ultrasonographic features of the LRTF in foals of different ages and 2) screen a foal cohort at the farm for early subclinical osteochondrosis lesions.

STUDY DESIGN

Prospective cohort study.

METHODS

The LRTF of both hindlimbs of Thoroughbred foals (n = 46, 27-166 days old) were imaged once with ultrasonography and radiography (lateromedial and caudolateral-craniomedial oblique views). Cartilage thickness, ossification front indentation of the chondro-osseous junction and epiphyseal vascularisation were assessed on ultrasonography. Follow-up radiographs were taken as yearlings.

RESULTS

The cartilage thickness, ossification front indentation and epiphyseal vascularisation significantly decreased with advancing maturity. Subclinical osteochondrosis lesions, characterised by semicircular indentations in the ossification front (indirect evidence of focal failure of ossification and retained cartilage) were detected in six foals (28-145 days old), both with radiography and ultrasonography. Ultrasonography provided a better overall subjective assessment of the osteochondrosis lesion topography (length, depth and the width) compared with radiography.

MAIN LIMITATIONS

Post-mortem validation of lesions was not possible.

CONCLUSION

Ultrasonography of the LRTF is a practical, inexpensive and reliable technique to discriminate physiological from pathological events at the LRTF in young foals. It revealed the complex topography of the chondro-osseous junction permitting a rapid, comprehensive assessment of the subclinical osteochondrosis lesions in very young foals.

摘要

背景

股骨滑车外侧嵴广泛剥脱性骨软骨炎(OCD)病变是膝关节中最常见的受OCD影响的部位,手术清创效果不佳,甚至可能导致职业生涯终结。早期发现骨软骨病病变并进行保守治疗有望改善预后。我们假设超声检查是检测和监测早期亚临床股骨滑车外侧嵴骨软骨病的一种有价值的现场筛查工具。

目的

目标是1)描述不同年龄马驹股骨滑车外侧嵴的正常超声特征,以及2)在农场对一群马驹进行早期亚临床骨软骨病病变筛查。

研究设计

前瞻性队列研究。

方法

对纯种马驹(n = 46,27 - 166日龄)的双后肢股骨滑车外侧嵴进行一次超声和放射成像检查(内外侧和后外侧 - 前内侧斜位)。通过超声评估软骨厚度、软骨 - 骨交界处的骨化前沿凹陷和骨骺血管化情况。一岁时拍摄随访X光片。

结果

随着成熟度增加,软骨厚度、骨化前沿凹陷和骨骺血管化显著降低。在6匹日龄为28 - 145天的马驹中,通过放射成像和超声检查均检测到亚临床骨软骨病病变,其特征为骨化前沿出现半圆形凹陷(骨化局部失败和软骨残留的间接证据)。与放射成像相比,超声检查对骨软骨病病变的形态(长度、深度和宽度)提供了更好的总体主观评估。

主要局限性

无法进行病变的尸检验证。

结论

股骨滑车外侧嵴的超声检查是一种实用、廉价且可靠的技术,可区分幼驹股骨滑车外侧嵴的生理和病理情况。它揭示了软骨 - 骨交界处的复杂形态,能够快速、全面地评估非常年幼马驹的亚临床骨软骨病病变。

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