Occipital condyle defects assessed by radiography or CT can be a normal finding in foals.

Age of complete ossification of equine occipital condyles has not been published. Consequently, clinical significance of occipital condyle defects on radiographs or CT scans of young horses remains unknown. The goals of this single-center, retrospective, cross-sectional study were to characterize incidental occipital condyle defects and to define the age of complete ossification. The margin of occipital condyles was classified as regular or with defect(s). Analyses were made on 121 horses, including 106 radiographic and 19 CT studies showing the occipital condyles of horses less than 5 years of age obtained over 6 years in a referral hospital. Neurological signs and outcome were not associated with occipital defects. Horses with regular occipital condyles on radiographs had a median age of 974 days (median interquartile range = 707) compared with 47 days (interquartile range = 106) in the defect group. The odds of finding radiographically regular occipital condyles were 2.6% higher for each additional day of age (P = .011, 95% CI, 0.6-4.7%). In the CT group, univariate analyses demonstrated a significant effect of age on the aspect of occipital condyles (P = .016). Horses with regular occipital condyles were older (median age = 881 days; interquartile range = 1054) than horses with a defect (median age = 109 days, interquartile range = 318). All horses above 156 days (5.1 months) of age and 550 days (18.1 months) of age had regular occipital condyles on radiographic and CT images, respectively. This study describes occipital condyle defects as a potential normal finding in young horses and provides guidelines for interpretation of the occipital condyle ossification process.

Standing MRI for surgical planning of equine fracture repair.

OBJECTIVE: To report the feasibility of standing MRI (sMRI) and document the value of sMRI in surgical planning for surgical repair of limb fractures in the horse. STUDY DESIGN: Retrospective case series. ANIMALS: Thirty-one horses with preoperative sMRI. METHODS: Medical records were reviewed for fracture type, application of a polyester cast, sMRI sequences performed, technical variables, and image quality. Fracture geometry and concomitant lesions were compared between sMRI and radiography. The relative value of sMRI with regard to surgical planning was classified as minor (sMRI did not provide additional findings), intermediate (additional lesions found or slight modification to surgical plan), or major (sMRI led to significant alternations in surgical plan). RESULTS: Standing MRI provided good studies in all horses. Standing MRI was classified as having major relevance in 12 of 31 horses, intermediate relevance in 14 of 31 horses, and minor relevance in 5 of 31 horses. CONCLUSION: Preoperative sMRI produced good studies in all horses and influenced the surgical planning in the majority of fractures in this study. Application of a polyester cast seemed to improve comfort without appreciable loss of image quality. CLINICAL SIGNIFICANCE: Standing MRI can be considered as an adjunct to plan the repair of equine fractures, and a polyester cast does not impair image quality.

Metacarpophalangeal joint injury patterns on magnetic resonance imaging: A comparison in racing Standardbreds and Thoroughbreds.

The metacarpal condyle has received extensive attention as a predominant site of overload arthropathy in racehorses. However, detailed descriptions of MRI lesion patterns for the metacarpophalangeal joint and comparisons between types of racing horses are currently lacking. Aims of this retrospective, cross-sectional study were to describe and compare standing low-field magnetic resonance findings in the metacarpophalangeal joints for groups of Standardbreds and Thoroughbreds using systematic semiquantitative scores. Data archives at the Clinique Vétérinaire Equine de Chantilly and Imavet were searched during the period from June 2010 to February 2016. Images were retrieved and reviewed by one reader. A total of 30 Standardbreds and 77 Thoroughbreds were sampled. The Thoroughbreds developed a much higher rate of stress fractures (40.3% vs. 10%) and overall more severe scores of subchondral sclerosis and bone marrow lesions than Standardbreds. The Standardbreds had more sites of subchondral bone defect and resorption, as well as higher synovitis and joint capsule thickening scores. Both Standardbreds and Thoroughbreds frequently developed multifocal subchondral lesions not limited to the distal palmar condyle. The Standardbreds had a higher tendency to develop dorsomedial joint pole subchondral injuries. Both Standardbreds and Thoroughbreds developed a noticeably high rate of periarticular soft tissue injuries (36.7% in Standardbreds and 20.8% in Thoroughbreds), which were rarely considered as the main contributors to the lameness. Findings supported the use of low-field MRI as a whole-organ assessment tool for Standardbreds and Thoroughbreds with suspected metacarpophalangeal joint injuries.

Distal border synovial invaginations of the equine distal sesamoid bone communicate with the distal interphalangeal joint.

OBJECTIVES: Macroscopic studies have suggested a link between distal border synovial invaginations of the navicular bone and the distal interphalangeal joint. However, many practitioners consider that these invaginations are directly and solely related to navicular disease. The objective was to investigate the communication pattern of these synovial invaginations with the synovial compartments of the distal interphalangeal joint and the navicular bursa, using minimally invasive imaging techniques. METHODS: In a prospective observational study, 10 cadaveric limbs with radiographically evident distal border synovial invaginations were randomly assigned to computed tomography arthrography or bursography groups, using iopamidol. RESULTS: In 5/5 limbs, contrast medium filled the invaginations following distal interphalangeal arthrography. In the other five limbs, no contrast medium filled the invaginations following bursography. CLINICAL SIGNIFICANCE: Contrary to existing beliefs, these invaginations are more likely associated with distal interphalangeal joint synovitis and may not be directly linked to primary navicular bone pathology, but might reflect distal interphalangeal arthropathy. Therefore, the rationale for assessment of these invaginations in stallion selection or pre-purchase examinations as a predictive sign for navicular disease is questionable. Nonetheless, comorbidities are frequent in the equine distal limb. Enlarged synovial invaginations may also be seen in limbs with concomitant primary navicular disease. Further studies are needed to elucidate possible inter-related pathological processes.

COMPARISONS AMONG RADIOGRAPHY, ULTRASONOGRAPHY AND COMPUTED TOMOGRAPHY FOR EX VIVO CHARACTERIZATION OF STIFLE OSTEOARTHRITIS IN THE HORSE.

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.

Diffuse leptomeningeal histiocytic sarcoma in the cerebrospinal fluid of 2 dogs.

Two adult male castrated dogs were evaluated for progressive paraparesis and ataxia. Neurologic examination showed severe ataxia, delayed proprioceptive placement in the pelvic limbs, pain upon palpation of the lumbar spine as well as facial paresis in one dog, and decreased withdrawal reflex of the pelvic limbs in the other dog. Magnetic resonance imaging (MRI) in both dogs showed diffuse meningeal and intramedullary lesions. However, no evidence of a mass was found. Biopsies could not be performed safely due to the location of the lesions. Cerebrospinal fluid (CSF) examination revealed an inflammatory pleocytosis associated with increased protein concentration and numerous large atypical round cells, often multinucleated. Nuclear fragmentation, micronuclei, and rare atypical mitoses were observed. Immunocytochemistry revealed CD1(+) and CD11c(+) staining, which, in concert with the morphology confirmed the diagnosis of histiocytic sarcoma (HS). Euthanasia was elected due to poor prognosis. Histopathologic examination showed diffuse spinal and meningeal infiltration with CD18(+) neoplastic cells, without any evidence of mass formation, which completed the diagnosis of diffuse leptomeningeal HS involving the brain and the spinal cord. Canine central nervous system (CNS) HS has been seldom reported in the literature, with only isolated cases identified on CSF cytology. The cases reported here are remarkable in describing a diffuse CNS leptomeningeal HS associated with neoplastic cells in the CSF of dogs without a tumor mass. These cases emphasize the potential critical importance of CSF analysis in providing an antemortem diagnosis of neoplasia in neurologic patients.

Multiple tarsal luxations in 2 Holstein heifers.

Two Holstein heifers were referred for non-weight bearing lameness. The physical examination and radiographic findings were diagnostic of tarsal luxation. Treatment and outcome are reported. A closed reduction was successfully performed in 1 heifer. The second animal was euthanized after attempts to reduce and stabilize the joint.

Luxations multiples du tarse chez 2 taures Holstein. Deux taures Holstein ont été référées pour boiterie de non-appuie. L'examen physique et les radiographies étaient diagnostiques d'une luxation du tarse. Les traitements et pronostic sont décrits. Une réduction fermée a été possible sur une taure et l'autre a été euthanasiée après l'échec de la réduction.(Traduit par les auteurs).

RADIOGRAPHIC AND ANATOMIC CHARACTERISTICS OF DORSAL HOOF WALL LAYERS IN NONLAMINITIC HORSES.

Early radiographic diagnosis of acute laminitis is important for treatment planning and prognosis in horses. While four histopathologic layers make up the hoof wall, only two layers are distinguished on digital radiographs of horses' hooves. Objectives of this descriptive study were to determine which macroscopic layers correspond to the two radiographically visible layers, and to describe radiographic layer measurements in a group of clinically sound Warmblood horses. Twelve ex vivo equine hooves were examined at three different levels of the dorsal hoof wall. The four macroscopic layers were variably grouped and compared with radiographic layers. Stratum externum and stratum medium represented the superficial radiographic layer while stratum internum and dermis parietis represented the deep layer. In 27 clinically sound horses (54 thoracic feet), the superficial radiographic layer represented 64.3% ± 3.6% of the total dorsal hoof wall. Findings from this study provided baseline information for future studies of horses with acute laminitis.

Effect of cardiac and respiratory cycles on vertebral heart score measured on fluoroscopic images of healthy dogs.

OBJECTIVE: To assess the variability in vertebral heart score (VHS) measurement induced by cardiac and respiratory cycles in dogs. DESIGN: Prospective observational study. ANIMALS: 14 healthy Beagles. PROCEDURES: Dogs underwent fluoroscopic examination by 4 observers, and VHS was measured at end-tidal inspiration and end-tidal expiration during end systole and end diastole in left and right lateral recumbency. Mean VHS was compared within and among cardiac and respiratory phases and recumbency type, and correlation between VHS and heart rate was investigated. Interobserver variability was assessed. RESULTS: Mean VHS for each combination of respiratory and cardiac cycle was larger on images obtained in right lateral versus left lateral recumbency. The greatest differences were observed between VHS measured in the diastolic inspiratory phase (mean ± SD, 10.59 ± 0.49 vertebral units [VU] and 10.35 ± 0.50 VU for right and left lateral recumbency, respectively) and the systolic expiratory phase (10.11 ± 0.37 VU and 9.92 ± 0.50 VU for right and left lateral recumbency, respectively). The combination of respiratory and cardiac cycles induced a maximal difference in VHS of up to 0.97 VU and 1.11 VU in the inspiratory and expiratory phases, respectively. Heart rate was not correlated with the difference between VHS in systolic and diastolic phases. CONCLUSIONS AND CLINICAL RELEVANCE: Clinicians should be aware of the potential influence of these factors when assessing VHS in dogs; in addition to allowing optimal pulmonary assessment, consistently taking radiographs at end-inspiratory tidal volume may help to limit VHS variability attributable to the respiratory cycle. Further research is needed to assess the effects of cardiac and respiratory phases on VHS in dogs with cardiac or respiratory disease.

A pitfall on postoperative radiographs in dogs after tibial plateau leveling osteotomy.

OBJECTIVE: To identify the cause of an occasional radiolucent line in the tibia on postoperative radiographs after tibial plateau leveling osteotomy (TPLO) in dogs. STUDY DESIGN: Retrospective case series and ex vivo experiment. SAMPLE POPULATION: Dogs (n = 80; 87 stifles) with cranial cruciate ligament (CCL) rupture that had TPLO; and 4 canine tibia specimens. METHODS: Medical records (2007-2010) and radiographs of dogs that had TPLO were reviewed and examined for presence of a radiolucent line on postoperative radiographs. The TPLO procedure was reproduced ex vivo to determine the origin of this line by use of metallic wires to identify bone contours. RESULTS: A curvilinear radiolucent line was visible in 14 (16%) tibias and was 5.4 times more likely to be visible with lateral misalignment of the tibial diaphysis relative to the plateau and 2.6 times more likely visible on caudocranial radiographs with the stifle in outward rotation. Fracture complication rate was higher in dogs with this radiolucent line (P = .02) and with lateral misalignment of the tibial diaphysis relative to the plateau (risk ratio, 3.8). The line could be reproduced ex vivo and caused by superimposition of the craniomedial border of osteotomy with the tibial plateau. CONCLUSIONS: The radiolucent line was a spurious fracture line created by the medial margin of the tibial osteotomy and confounding factors such as tibial misalignment may explain the apparently associated higher complication rate.

Comparison between palpation and ultrasonography for evaluation of experimentally induced effusion in the distal interphalangeal joint of horses.

OBJECTIVE: To ultrasonographically quantify experimentally induced effusion of the distal interphalangeal (DIP) joint of horses and compare results with those obtained with palpation. SAMPLE: 8 forelimbs from equine cadavers and forelimbs of 5 mares. PROCEDURES: Preliminary ex vivo experiments were performed to validate the methods. Then, the DIP joints of the forelimbs of standing horses were serially distended with saline (0.9% NaCl) solution (1, 4, and 10 mL) by injection through an intra-articular catheter. Two ultrasonographers measured distension of the dorsal recess of the DIP joint, and 2 surgeons, who were not aware of the volume injected, graded joint effusion by palpation. RESULTS: Intraobserver and interobserver repeatability was excellent for ultrasonographic measurements. Interobserver agreement for use of palpation to detect joint distension was moderate (κ = 0.45). There was an overall increase in the palpation distension grade with an increase in injected volume. Sensitivity for detection with palpation of larger volumes (4 and 10 mL) was high (92% and 100%, respectively). However, sensitivity was lower (57%) for detection with palpation of minimal distension (1 mL). CONCLUSIONS AND CLINICAL RELEVANCE: Although palpation provided a reliable clinical assessment of DIP joint effusion for volumes of 4 to 10 mL, ultrasonographic measurements were easy to obtain, more accurate, and able to detect smaller amounts of distension. This may be clinically relevant for the assessment of effusion of the DIP joint that can arise in horses with early osteoarthritis or infectious arthritis with concomitant soft tissue swelling that precludes accurate assessment with palpation.

Foetal and postnatal equine articular cartilage development: magnetic resonance imaging and polarised light microscopy.

Adult articular cartilage (AC) has a well described multizonal collagen structure. Knowledge of foetal AC organisation and development may provide a prototype for cartilage repair strategies, and improve understanding of structural changes in developmental diseases such as osteochondrosis (OC). The objective of this study was to describe normal development of the spatial architecture of the collagen network of equine AC using 1.5 T magnetic resonance imaging (MRI) and polarised light microscopy (PLM), at sites employed for cartilage repair studies or susceptible to OC. T2-weighted fast-spin echo (FSE) sequences and PLM assessment were performed on distal femoral epiphyses of equine foetuses, foals and adults. Both MRI and PLM revealed an early progressive collagen network zonal organisation of the femoral epiphyses, beginning at 4 months of gestation. PLM revealed that the collagen network of equine foetal AC prior to birth was already organised into an evident anisotropic layered structure that included the appearance of a dense tangential zone in the superficial AC in the youngest specimens, with the progressive development of an underlying transitional zone. A third, increasingly birefringent, radial layer developed in the AC from 6 months of gestation. Four laminae were observed on the MR images in the last third of gestation. These included not only the AC but also the superficial growth plate of the epiphysis. These findings provide novel data on normal equine foetal cartilage collagen development, and may serve as a template for cartilage repair studies in this species or a model for developmental studies of OC.

Comparison of inversion recovery gradient echo with inversion recovery fast spin echo techniques for magnetic resonance imaging detection of navicular bone marrow lesions in horses.

OBJECTIVE: To compare navicular bone marrow lesion (BML) conspicuity in the feet of horses as determined via 2 fat-suppressed MRI techniques, including standard short tau inversion recovery (STIR) and inversion recovery gradient echo (IRGE). SAMPLE: Feet (n = 150) of horses with lameness referable to the distal portion of the digit. PROCEDURES: STIR and IRGE sequences were obtained prospectively in all feet with a standing low-field equine MRI system. Presence of a BML was ascertained by identification of a characteristic combination of marrow alterations in T1-weighted, T2*-weighted, T2-weighted, and STIR images. Signal-to-noise and contrast-to-noise ratios were calculated on STIR and IRGE sequences in 56 feet with a navicular BML. RESULTS: Signal-to-noise and contrast-to-noise ratios of both sequences correlated linearly (r = 0.87 and r = 0.92, respectively) but were significantly higher for STIR images (mean ± SD, 22.6 ± 12.7 and 12.4 ± 11.4, respectively), compared with IRGE images (13.7 ± 8.0 and 5.9 ± 7.2, respectively). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that the IRGE sequence revealed BMLs significantly less conspicuously, compared with the standard STIR sequence. The 2 techniques cannot be used interchangeably, and IRGE is therefore not recommended as the sole fat-suppressed sequence for routine equine standing MRI protocols.

Clinical significance and prognosis of deep digital flexor tendinopathy assessed over time using MRI.

Deep digital flexor (DDF) tendinopathy is one of the most frequent causes of foot lameness and the prognosis is guarded. The progress of lesion healing may be followed by magnetic resonance (MR) imaging to formulate a prognosis and to adapt the rehabilitation program. We assessed the correlation of outcome with total tendon damage and temporal resolution of MR abnormalities. Images from 34 horses with DDF tendinopathy that had undergone at least two low-field standing MR examinations of the foot (mean 2.5 ± 1.3 times) were reviewed. No horse having a T1-GRE hyperintense lesion over 30 mm in length or over 10% tendon cross-sectional area returned to its previous activity level. Horses with concomitant lesions had worse outcome than horses with DDF tendinopathy only (P = 0.005). In all horses including those with excellent outcome, the lesion persisted, even mildly, in T1-GRE and PD images. Horses with tendon lesion resolution on STIR-FSE and T2-FSE images on recheck examination had a better outcome (P = 0.0004 and P = 0.002, respectively), and all horses that returned to their previous level of performance had complete resolution of signal hyperintensity on the STIR-FSE sequence. Although rehabilitation remains multifactorial, characteristics of DDF tendinopathy and concomitant lesions on first and recheck MR examinations allow refining the prognosis.

Anatomic variations of feline internal and external jugular veins.

We evaluated 50 feline head and neck computed tomography examinations to determine the prevalence of vascular variation in the internal and external jugular veins. We identified three distinct anatomic conformations of the internal jugular vein. No variation of external jugular vein morphology was detected. Feline patients can have different internal jugular vein morphology that should be recognized for surgical planning.

A comparison of computed tomography, computed radiography, and film-screen radiography for the detection of canine pulmonary nodules.

Computed tomography (CT) has become more widely available and computed radiography (CR) has replaced film-screen radiography for canine thoracic imaging in many veterinary practices. There are limited data comparing these modalities in a veterinary clinical setting to detect pulmonary nodules. We compared CT, CR, and film-screen radiography for detecting the presence, number, and characteristics of pulmonary nodules in dogs. Observer performance for a variety of experience levels was also evaluated. Twenty-one client-owned dogs with a primary neoplastic process underwent CT and CR; nine also received film-screen radiographs. Positive/negative classification by consensus agreed between the three modalities in 8/9 dogs and between CR and CT in the remaining 12. CT detected the greatest (P = 0.002) total number of nodules and no difference was seen between CR and films. The greatest number of nodules was seen in the right middle and both caudal regions, but only using CT (P < 0.0001). Significantly smaller nodules were detected with CT (P = 0.0007) and no difference in minimum size was detected between CR and films. Observer accuracy was high for all modalities; particularly for CT (90.5-100%) and for the senior radiologist (90.5-100%). CT was also characterized by the least interobserver variability. Although CT, CR, and film-screen performed similarly in determining the presence or absence of pulmonary nodules, a greater number of smaller nodules was detected with CT, and CT was associated with greater diagnostic confidence and observer accuracy and agreement.

Comparison of magnetic resonance imaging, computed tomography, and radiography for assessment of noncartilaginous changes in equine metacarpophalangeal osteoarthritis.

We compared the ability of 1.5 T magnetic resonance imaging (MRI), computed tomography (CT), and computed radiography (CR) to evaluate noncartilaginous structures of the equine metacarpophalangeal joint (MCP), and the association of imaging changes with gross cartilage damage in the context of osteoarthritis. Four CR projections, helical single-slice CT, and MRI (Ti-weighted gradient recalled echo [GRE], T2*-weighted GRE with fast imaging employing steady-state acquisition [FIESTA], T2-weighted fast spin echo with fat saturation, and spoiled gradient recalled echo with fat saturation ISPGR-FS]) were performed on 20 racehorse cadaver forelimbs. Osteophytosis, synovial effusion, subchondral bone lysis and sclerosis, supracondylar lysis, joint fragments, bone marrow lesions, and collateral desmopathy were assessed with each modality. Interexaminer agreement was inferior to intraexaminer agreement and was generally moderate (i.e., 0.4 < kappa < 0.6). Subchondral bone sclerosis scores using CT or MRI were correlated significantly with the reference quantitative CT technique used to assess bone mineral density (P < 0.0001). Scores for subchondral lysis and osteophytosis were higher with MRI or CT vs. CR (P < 0.0001). Although differences between modalities were noted, osteophytosis, subchondral sclerosis, and lysis as well as synovial effusion were all associated with the degree of cartilage damage and should be further evaluated as potential criteria to be included in a whole-organ scoring system. This study highlights the capacity of MRI to evaluate noncartilaginous changes in the osteoarthritic equine MCP joint.

Distal interphalangeal articular cartilage assessment using low-field magnetic resonance imaging.

The suitability of low-field magnetic resonance (MR) imaging for assessment of articular cartilage has been questioned, based on insufficient image quality. The purposes of this study were to describe the MR anatomy of the normal distal interphalangeal (DIP) cartilage, and to evaluate the sensitivity and accuracy of low-field MR imaging for identification of cartilage erosions that were created ex vivo. Imaging sequences included sagittal and dorsal multiple-oblique T1-weighted gradient-recalled echo (GRE) and sagittal dual echo sequences. In the thickest regions, normal cartilage appeared as a trilaminar structure on high-resolution T1-weighted GRE sequences. All 8 mm large full-thickness erosions were correctly identified (100% sensitivity and accuracy) using T1-weighted GRE sequences. Sensitivity and accuracy ranged from 80% to 100% and 10% to 80%, respectively, for detecting focal full-thickness erosions and from 35% to 80% and 35% to 60%, respectively, for detecting partial thickness erosions, using T1-weighted GRE sequences. Superficial irregularities were not diagnosed using any sequence. Overall, fewer cartilage alterations were detected with sagittal dual echo sequences than with sagittal T1-weighted GRE sequences. The dorsal multiple-oblique plane was useful to detect linear dorsopalmar erosions. A combination of T1-weighted GRE sequences in two planes has potential for identification of severe DIP cartilage erosion in anesthetized horses using low-field MR imaging.