Case-Control Comparison of Cervical Spine Radiographs From Horses With a Clinical Diagnosis of Cervical Facet Disease With Normal Horses.
Abstract: The accuracy of using radiographs to diagnose cervical facet osteoarthritis (CFA) in horses is undetermined. Further investigation is required to determine the clinical significance of radiographic evidence of CFA, the prevalence of radiographic changes in horses without clinical signs, and the long-term efficacy of intra-articular CFA treatment. The objectives of this study is to compare degenerative changes of the cervical facet joints of the cervical vertebrae on radiographs of horses with clinical signs of CFA with healthy cohort-matched horses, to compare clinical findings between groups, and to obtain follow-up information on the long-term outcome in treated horses. This is a retrospective case-control cohort-matched comparison study of horses treated for cervical facet disease versus horses with no clinical signs of cervical facet disease. Horses diagnosed with CFA and treated with intra-articular injection of corticosteroids were included. Follow-up information on recovery from treatment was obtained via telephone survey of owners/trainers. Healthy horses with no clinical signs of CFA were matched to treated horses by breed, sex, age, and sport as the control group. Two blinded radiologists reviewed cervical spine radiographs for each horse and recorded CFA score and intravertebral/intervertebral measurements. Clinical and radiographic parameters were compared between treatment and control groups. There was a significant difference in CFA grades for C5-6 and C6-7 between horses with presence of clinical signs and healthy horses. However, interobserver agreement between radiologists for grading CFA was moderate and only 56% of values were identical for both observers. Atrophy of the neck was present on clinical examination in most cases in the treatment group. Dressage horses were overrepresented. Overall, 64% of horses returned to their previous level of performance after treatment. Clinical examination data collected for the treatment group were retrospective and were obtained by different clinicians. Eight owners/trainers were not able to be reached for the survey. There was a significant difference in CFA grades for C5-6 and C6-7 between horses with presence of clinical signs and healthy horses. Despite these statistical differences, the clinical diagnosis of CFA based on radiographic grading alone is questionable because of the lack of agreement between the radiologists. To strengthen the diagnosis, clinical signs of facet disease, in particular atrophy of the neck muscles, need to be present to make this diagnosis. Intra-articular corticosteroid injection was effective at allowing most treated horses to return to athletic use..
Copyright © 2020 Elsevier Inc. All rights reserved.
Publication Date: 2020-06-20 PubMed ID: 32797798DOI: 10.1016/j.jevs.2020.103176Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The study explores the accuracy of radiographs for diagnosing cervical facet osteoarthritis (CFA) in horses. The researchers compare the radiographic changes and clinical findings in horses with CFA symptoms against healthy horses, and assess the long-term outcomes in horses treated for CFA.
Research Methodology
- This research is a retrospective case-control study of horses treated for cervical facet disease against horses with no clinical signs of the disease.
- Horses diagnosed with CFA and treated with an intra-articular injection of corticosteroids are assessed.
- A telephone survey is conducted to gather follow-up information about recovery from treatment from the owners or trainers.
- Healthy control horses, matched by breed, sex, age, and sport, are compared to the treated horses.
- All cervical spine radiographs are reviewed by two independent radiologists, who record CFA score and inter/intravertebral measurements. The observations are compared between the control and treated groups.
Findings & Observations
- There was a significant difference in CFA grades for C5-6 and C6-7 between horses showing clinical symptoms and healthy horses.
- Interobserver agreement between independent radiologists was moderate, with identical observations only in 56% of cases.
- Most treated horses demonstrated neck atrophy during clinical examination, especially those involved in dressage.
- Approximately 64% of treated horses returned to their previous performance level after treatment.
- The diagnosis of CFA based solely on radiographic grading is questioned because of varying observer agreements.
Research Limitations
- The clinical data for the treated group were collected retrospectively and by different clinicians, possibly impacting consistency of data.
- Eight owners/trainers could not be reached for the survey, slightly limiting the pool of follow-up information.
Conclusion
- Despite the statistical differences in CFA grades, radiographic grading alone may not be a sufficient diagnostic tool due to inconsistent agreement among radiologists.
- Visible clinical signs of the disease, such as neck muscle atrophy, need to be present to confirm the diagnosis.
- Intra-articular corticosteroid injection treatment proved effective in enabling majority of treated horses to return to regular athletic performance.
Cite This Article
APA
Koenig JB, Westlund A, Nykamp S, Kenney DG, Melville L, Cribb N, Oberbichler D.
(2020).
Case-Control Comparison of Cervical Spine Radiographs From Horses With a Clinical Diagnosis of Cervical Facet Disease With Normal Horses.
J Equine Vet Sci, 92, 103176.
https://doi.org/10.1016/j.jevs.2020.103176 Publication
Researcher Affiliations
- Dept of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada. Electronic address: jkoenig@uoguelph.ca.
- Dept of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
- Health Sciences Center, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
- Health Sciences Center, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
- Dept of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
- Dept of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
- Oberbichler Equine Services, Wellesley, ON, Canada.
MeSH Terms
- Animals
- Case-Control Studies
- Cervical Vertebrae / diagnostic imaging
- Horse Diseases / diagnosis
- Horses
- Radiography
- Retrospective Studies
Citations
This article has been cited 1 times.- Story MR, Haussler KK, Nout-Lomas YS, Aboellail TA, Kawcak CE, Barrett MF, Frisbie DD, McIlwraith CW. Equine Cervical Pain and Dysfunction: Pathology, Diagnosis and Treatment.. Animals (Basel) 2021 Feb 6;11(2).
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