Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
N Z Vet J. 2020 Sep;68(5):283-288. doi: 10.1080/00480169.2020.1750499. Epub 2020 May 25.
To compare the outcome, in terms of lameness score or return to athletic function, of horses with acute chronic digital lameness that underwent magnetic resonance imaging (MRI) of the distal limb and to compare the proportion of horses that received intra-articular therapy of the distal interphalangeal (DIP) joint and pattern of diagnostic analgesia in these groups. This is a retrospective study of horses (n = 95) with acute (≤12 weeks; n = 46) or chronic (>12 weeks; n = 49) digital lameness that underwent MRI of the distal limb from 2009-2016, at two equine referral centres in the USA. Criteria for inclusion in the study were that a majority of lameness localised distal to the fetlock, and that lameness assessments for ≥12 months following MRI could be obtained from the medical record or the owner could be interviewed regarding their horse's athletic function. Outcome was characterised by an improvement score where 2 = return to work at a previous or higher level or lameness improved by one grade or more, 1 = return to work at a lower level or lameness improved by less than one grade, and 0 = did not return to work or lameness grade worsened. Whether horses had received intra-articular therapy of the DIP joint and the pattern of diagnostic analgesia prior to MRI was also obtained from medical records or by interviewing the owner. There was a difference (p = 0.004) in the proportion of horses assigned to improvement scores of 0, 1 and 2 between horses with acute or chronic lameness. There was no evidence of a difference in the likelihood of having received intra-articular therapy of the DIP joint prior to MRI between horses with chronic or acute lameness (p = 0.085). Similarly, there was no evidence of a difference in the pattern of diagnostic analgesia prior to MRI between the two groups (p = 0.94). Eighty-two percent of owners of horses with acute and 62% of those with horses with chronic lameness had a positive opinion of the utility of MRI as a diagnostic modality. In a population of horses with digital lameness undergoing MRI, a difference in the outcome, in terms of lameness score or return to athletic function was identified between horses with acute lameness compared to those with chronic lameness. Horses with digital lameness that undergo MRI when the lameness is acute may have an improved prognosis due to accurate diagnosis and earlier application of appropriate therapy.
比较急性和慢性数字跛行马接受磁共振成像（MRI）检查的结局（跛行评分或运动功能恢复），并比较接受关节内治疗和诊断性镇痛模式的马的比例在这些组中。这是一项回顾性研究，研究对象为 2009 年至 2016 年在美国两家马科转诊中心接受 MRI 检查的急性（≤12 周；n=46）或慢性（>12 周；n=49）数字跛行的马。纳入研究的标准是大多数跛行局限于球节以下，并且可以从病历或马主处获得 MRI 检查后至少 12 个月的跛行评估，以了解其马匹的运动功能。结果以改善评分来描述，其中 2=恢复到以前或更高的工作水平或跛行改善一级或以上，1=恢复到较低水平或跛行改善不到一级，0=未恢复工作或跛行恶化。还从病历或询问马主处获得了马匹在 MRI 检查前是否接受关节内治疗和诊断性镇痛模式的信息。急性或慢性跛行马的改善评分 0、1 和 2 的分配比例存在差异（p=0.004）。慢性或急性跛行马在 MRI 检查前接受关节内治疗的可能性无差异（p=0.085）。同样，在 MRI 检查前的诊断性镇痛模式之间也没有证据表明存在差异（p=0.94）。82%的急性跛行马和 62%的慢性跛行马的主人对 MRI 作为诊断方式的实用性持肯定态度。在接受 MRI 检查的数字跛行马中，与慢性跛行马相比，急性跛行马的跛行评分或运动功能恢复的结局存在差异。急性跛行的数字跛行马接受 MRI 检查后，由于准确的诊断和更早地应用适当的治疗，预后可能会得到改善。
