Assessment of wear and periacetabular osteolysis using dual energy computed tomography on a pig cadaver to identify the lowest acceptable radiation dose.

OBJECTIVES: Computed tomography (CT) plays an important role in evaluating wear and periacetabular osteolysis (PAO) in total hip replacements. One concern with CT is the high radiation exposure since standard pelvic CT provides approximately 3.5 millisieverts (mSv) of radiation exposure, whereas a planar radiographic examination with three projections totals approximately 0.5 mSv. The objective of this study was to evaluate the lowest acceptable radiation dose for dual-energy CT (DECT) images when measuring wear and periacetabular osteolysis in uncemented metal components. MATERIALS AND METHODS: A porcine pelvis with bilateral uncemented hip prostheses and with known linear wear and acetabular bone defects was examined in a third-generation multidetector DECT scanner. The examinations were performed with four different radiation levels both with and without iterative reconstruction techniques. From the high and low peak kilo voltage acquisitions, polychrmoatic images were created together with virtual monochromatic images of energies 100 kiloelectron volts (keV) and 150 keV. RESULTS: We could assess wear and PAO while substantially lowering the effective radiation dose to 0.7 mSv for a total pelvic view with an accuracy of around 0.5 mm for linear wear and 2 mm to 3 mm for PAO. CONCLUSION: CT for detection of prosthetic wear and PAO could be used with clinically acceptable accuracy at a radiation exposure level equal to plain radiographic exposures.Cite this article: B. Sandgren, M. Skorpil, P. Nowik, H. Olivecrona, J. Crafoord, L. Weidenhielm, A. Persson. Assessment of wear and periacetabular osteolysis using dual energy computed tomography on a pig cadaver to identify the lowest acceptable radiation dose. Bone Joint Res 2016;5:307-313. DOI: 10.1302/2046-3758.57.2000566.

Enhanced concentration of COMP (cartilage oligomeric matrix protein) in osteochondral fractures from racing Thoroughbreds.

The aim of the present study was to correlate the levels of COMP and aggrecan as indicators of tissue damage, in synovial fluid (sf) from carpal joints of acutely lame racehorses, with macroscopical lesions of articular cartilage (OA), osteochondral fractures and ligament tears found at arthroscopy. Sixty-three lame horses [49 Standardbred trotters (STB) and 14 Thoroughbreds (TB)] in conventional training and racing that underwent arthroscopy of their middle carpal or radiocarpal joints were included in the study. Intact as well as fragmented COMP and aggrecan released into the synovial fluid were quantified by western blot analyses and ELISA. The expression of COMP in tissues was estimated by mRNA in situ hybridisation and protein immunolocalisation in cartilage and osteochondral fractures. The concentration of sf-COMP was higher in TB with an osteochondral fracture than in STB with osteochondral fractures and TB and STB with OA. The chondrocytes in middle and deep zones of the articular cartilage of the osteochondral fragments (from a TB) expressed COMP mRNA, in contrast to the cartilage on the opposite side of the fracture where no expression was detected. In the synovial fluid from a joint (TB) with osteochondral fractures only intact COMP was present, whereas, fragmented COMP was more prominent in synovial fluid from a joint with OA. The concentration of sf-aggrecan did not differ between the two breeds, or between different lesions. The increased concentration of sf-COMP in TB with osteochondral fractures, but not in synovial fluid from equine joints with OA, is a novel finding. The results from this study indicate that elevated sf-COMP concentration in the joints of Thoroughbreds may be a useful marker for carpal joint osteochondral fragments.

Concentration of collagen, aggrecan and cartilage oligomeric matrix protein (COMP) in synovial fluid from equine middle carpal joints.

The aim of the present investigation was to study the metabolic activity of the third carpal bone and the release of COMP, aggrecan and collagen type II molecules in the synovial fluid as a result of injury. Cartilage oligomeric matrix protein (COMP), aggrecan and collagen type II or fragments of these molecules released to the synovial fluid and serum (COMP) were quantified in samples from 73 left equine middle carpal joints from 2 breeds with different activity profiles (52 Standardbred trotters [STB] and 21 Swedish Warmblood riding horses [SWH]) and different articular cartilage lesions. Synovial and serum samples were analysed using inhibition ELISA for COMP and aggrecan. An ELISA that combines features of both the competitive and capture ELISAs was used for collagen type II. COMP and aggrecan concentrations decreased in synovial fluid from the joints with moderate lesions of STB compared with the normal joints; COMP from 16.6 to 12.0 microg/ml and aggrecan from 93.0 to 68.1 microg/ml. In serum, COMP concentrations were also lowered in the STB with moderate lesions compared with the normal joints, while in the SWH, the COMP concentration in synovial fluids from joints with moderate lesions was somewhat increased at 19.6 microg/ml compared with the normal joints (17.6 microg/ml). The ratio between aggrecan/COMP in the synovial fluid from joints with moderate lesions was higher in the STB (6.2) than in the SWH (3.4). The level of collagen type II in synovial fluid was higher in the SWH (8.8 microg/ml) than the STB (1.6 microg/ml), but there was no correlation between joint damage and collagen concentrations in synovial fluids (10.0 and 1.8 microg/ml in joints with moderate lesions from SWH and STB, respectively). A marked difference in COMP synthesised upon metabolic labelling between the normal and osteoarthritic cartilage was seen and the synthesis of COMP in the articular cartilage of the third carpal bone with moderate articular lesions (from an STB) was lower than in the joint with mild lesions. This difference between breeds may reflect different load characters, in release of macromolecules in osteoarthritic and normal joints. This a novel finding that should be considered in studies of equine traumatic arthritis.

Sclerosis of the third carpal bone. A prospective study of its significance in a group of young standardbred trotters.

To assess the significance of radiographic signs of sclerosis of the third carpal bone (C3) in young Standardbred trotters in relation to performance, lameness and bone turnover both carpi in 14 Standardbred trotters were radiographically and scintigraphically examined 6 times, from the beginning of speed training until the beginning of racing, between the mean ages of 20 and 42 months. At the end of the study 8 horses had raced in official qualifying races and 14 limbs in 11 horses had been diagnosed with carpal lameness. All horses but 2 developed sclerosis and all but one had increased bone turnover in the C3 area by scintigraphy. C3 sclerosis increased continuously over time and with increased performance. Carpal lameness was significantly associated with progression of sclerosis but in most cases sclerosis developed without concomitant signs of carpal lameness. No association between carpal lameness and increased scintigraphic uptake was found, but horses that had qualified for racing had significantly higher C3 to carpus ratio of radiopharmaceutical uptake. We conclude that there is a continuous increase in C3 radiographic sclerosis with time in young Standardbred trotters in professional training, but radiographic sclerosis appears to be of limited value as an indicator of clinical carpal disease or level of performance in Standardbred trotters.

The acute phase protein serum amyloid A (SAA) as an inflammatory marker in equine influenza virus infection.

The acute phase protein serum amyloid A (SAA) has proven potentially useful as an inflammatory marker in the horse, but the knowledge of SAA responses in viral diseases is limited. The aim of this study was to evaluate SAA as a marker for acute equine influenza A2 (H3N8) virus infection. This is a highly contagious, serious condition that inflicts suffering on affected horses and predisposes them to secondary bacterial infections and impaired performance. Seventy horses, suffering from equine influenza, as verified by clinical signs and seroconversion, were sampled in the acute (the first 48 h) and convalescent (days 11-22) stages of the disease, and SAA concentrations were determined. Clinical signs and rectal temperature were recorded. Secondary infections, that could have influenced SAA concentrations, were clinically suspected in 4 horses. SAA concentrations were higher in the acute stage than in the convalescent stage, and there was a statistically positive relationship between acute stage SAA concentrations and clinical signs and between acute stage SAA concentrations and maximal rectal temperature. Horses sampled early in the acute stage had lower SAA concentrations than those sampled later, indicating increasing concentrations during the first 48 h. There was a statistically positive relationship between convalescent SAA concentrations and degree of clinical signs during the disease process. The results of this investigation indicate that equine SAA responds to equine influenza infection by increasing in concentration during the first 48 h of clinical signs and returning to baseline within 11-22 days in uncomplicated cases.

A primary male autosomal linkage map of the horse genome.

A primary male autosomal linkage map of the domestic horse (Equus caballus) has been developed by segregation analysis of 140 genetic markers within eight half-sib families. The family material comprised four Standardbred trotters and four Icelandic horses, with a total of 263 offspring. The marker set included 121 microsatellite markers, eight protein polymorphisms, five RFLPs, three blood group polymorphisms, two PCR-RFLPs, and one single strand conformation polymorphism (SSCP). One hundred markers were arranged into 25 linkage groups, 22 of which could be assigned physically to 18 different chromosomes (ECA1, ECA2, ECA3, ECA4, ECA5, ECA6, ECA7, ECA9, ECA10, ECA11, ECA13, ECA15, ECA16, ECA18, ECA19, ECA21, ECA22, and ECA30). The average distance between linked markers was 12.6 cM and the longest linkage group measured 103 cM. The total map distance contained within linkage groups was 679 cM. If the distances covered outside the ends of linkage groups and by unlinked markers were included, it was estimated that the marker set covered at least 1500 cM, that is, at least 50% of the genome. A comparison of the relationship between genetic and physical distances in anchored linkage groups gave ratios of 0.5-0.8 cM per Mb of DNA. This would suggest that the total male recombinational distance in the horse is 2000 cM; this value is lower than that suggested by chiasma counts. The present map should provide an important framework for future genome mapping in the horse.

Bony fragments in the tarsocrural and metacarpo- or metatarsophalangeal joints in the standardbred horse--a radiographic survey.

Radiographic examination of the tarsocrural, metacarpo- or metatarsophalangeal joints was made in 139 Standardbred horses. Most were under three years old with no history of orthopaedic problems. In the tarsocrural joint, osteochondrosis was observed in 25 (18.1 percent) of the horses (n = 138) and 14 (56 percent) of these were affected bilaterally. In the metatarsophalangeal joint, the most frequent radiographic abnormality was single or multiple bony fragments or defects at the plantar proximal end of the proximal phalanx, which was noticed in 40 (28.8 percent) of the horses (n = 139). The lesion was much more frequent in the hind than in the forelimbs. Ten percent of horses affected in the hindlimbs had the lesions bilaterally. Palmar or plantar fragments wee also more common in the medial, than the lateral, part of the joint. With regard to osteochondrosis in the tarsocrural joint and palmar or plantar bony fragments in the metacarpo- or metatarsophalangeal joints, no significant differences in incidence were found between sexes or between left and right sides. There was no correlation between findings of osteochondrosis in the tarsocrural joints and the occurrence of bony fragments in the plantar part of the metatarsophalangeal joints. In the forelimbs, bony fragments in the dorsal parts of the metacarpophalangeal joint were noticed in three (2.9 percent) of the horse (n = 103) and the corresponding figure for the metatarsophalangeal joint was three (2.2 percent) (n = 139). In 102 horses, the tarsocrural, the metacarpo- and the metatarsophalangeal joints were radiographed at the same time. One or several joints were affected with osteochondrosis, bony fragments, or defects in underlying bones in 45 (44.1 percent) of these horses.

Determination of phenobarbital in human saliva by gas chromatography with electron-capture detection.

A gas chromatographic method for the determination of phenobarbital in saliva has been developed. Phenobarbital is converted into its bispentafluorobenzyl derivative by extractive alkylation at pH 9 with 0.1 M tetrabutylammonium ion as extracting agent and 0.1 M pentafluorobenzyl bromide as alkylating reagent in methylene chloride. A reaction time of 20 min is required. Quantitation is effected by electorn-capture detection in a gas chromatograph equipped with a pre-column venting system for removal of methylene chloride and pentafluorobenzyl bromide. This procedure allows the direct introduction of the reaction mixture into the gas chromatograph. A 60-ng amount of phenobarbital in 100 mul of human saliva can be determined with a precision of 1.9% (S.D.) and a recovery of 93%.