Atkinson L, Schiborra F, O'Connell E, Barton J, Humphreys W
Small Animal Teaching Hospital, University of Liverpool, Neston, UK.
J Small Anim Pract. 2025 Apr;66(4):272-279. doi: 10.1111/jsap.13818. Epub 2024 Dec 26.
To describe thoracic and abdominal imaging findings in dogs with immune-mediated polyarthritis and to evaluate their impact on the decision to commence immunosuppressive therapy.
Retrospective case series describing imaging findings in dogs with immune-mediated polyarthritis across modalities, including thoracic radiographs, abdominal ultrasound, computed tomography, and where available, echocardiography. Additionally, two internal medicine clinicians reviewed the signalment, clinical signs, clinicopathological findings and diagnostic imaging results on two separate occasions, reaching a consensus for each dog on whether immunosuppression would be their treatment of choice or whether their recommendations would be altered by the results of diagnostic imaging.
Seventy-one dogs met the inclusion criteria. Abnormal diagnostic imaging findings were identified in 25.4% (18/71) of dogs. Thoracic radiography did not identify significant imaging findings in any of the dogs. Lymphadenomegaly was the most commonly reported finding on computed tomography (32/40) and abdominal ultrasound (13/34). Neoplasia was identified in three dogs (3/71). Four (4/13) dogs had echocardiography findings consistent with endocarditis. Immunosuppression without performing diagnostic imaging would have been considered in 41 of 71 (57.7%) dogs, based on the signalment, presenting signs, results of physical examination and clinicopathological testing. Of these, 10 dogs (24.3%) had diagnostic imaging findings suggestive of an underlying trigger, therefore changing the clinician's decision to proceed with immunosuppression.
Abdominal imaging and echocardiography should be prioritised over thoracic radiography, in dogs with immune-mediated polyarthritis. Signalment, presenting complaint, physical examination findings and clinicopathological results are not reliable predictors of abnormal diagnostic imaging findings in dogs with immune-mediated polyarthritis.
描述免疫介导性多关节炎犬的胸腹部影像学表现,并评估其对开始免疫抑制治疗决策的影响。
回顾性病例系列,描述免疫介导性多关节炎犬在多种检查方式下的影像学表现,包括胸部X光片、腹部超声、计算机断层扫描,以及(如有)超声心动图。此外,两名内科临床医生在两个不同时间审查了病畜信息、临床症状、临床病理检查结果和诊断性影像学结果,就每只犬是否选择免疫抑制治疗或其建议是否会因诊断性影像学结果而改变达成共识。
71只犬符合纳入标准。25.4%(18/71)的犬有异常诊断性影像学表现。胸部X光片在所有犬中均未发现明显影像学表现。淋巴结肿大是计算机断层扫描(32/40)和腹部超声(13/34)中最常报告的表现。三只犬(3/71)发现肿瘤。四只犬(4/13)的超声心动图表现符合心内膜炎。根据病畜信息、临床表现、体格检查结果和临床病理检查,71只犬中有41只(57.7%)在未进行诊断性影像学检查时就会考虑免疫抑制治疗。其中,10只犬(24.3%)的诊断性影像学表现提示存在潜在诱因,从而改变了临床医生进行免疫抑制治疗的决定。
对于免疫介导性多关节炎犬,腹部影像学检查和超声心动图应优先于胸部X光片。病畜信息、主诉、体格检查结果和临床病理结果并非免疫介导性多关节炎犬诊断性影像学异常表现的可靠预测指标。