Diagnostic accuracy of plain radiography to identify synovial penetration in horses with traumatic limb wounds.
Abstract: The diagnostic value of plain radiography for diagnosing synovial penetration in limb wounds near synovial structures has not been determined. Objective: To assess diagnostic accuracy of plain radiography to identify synovial penetration in horses with traumatic limb wounds. Methods: Retrospective case study. Methods: Case records of horses presented to the Faculty of Veterinary Medicine of Ghent University (2011-2021) with limb wounds near synovial structures were categorised in groups with and without synovial penetration using results of synovial fluid analysis and surgical findings. Plain radiographic images were evaluated retrospectively. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for the total study sample and for the cases with and without use of a metallic probe in the wound during radiographic evaluation. Results: Based on the total sample of 141 horses with synovial penetration and 75 cases without synovial involvement, plain radiography presented a sensitivity of 61% (95% CI: 52%-69%), a specificity of 81% (95% CI: 70%-89%), a PPV of 86% (95% CI: 79%-90%) and a NPV of 53% (95% CI: 46%-58%). With the use of a metallic probe, a sensitivity of 54% (95% Cl: 39%-69%), a specificity of 88% (95% Cl: 64%-99%), a PPV of 93% (95% Cl: 78%-98%) and a NPV of 41% (95% Cl: 32%-49%) were obtained. Conclusions: Sample size did not allow comparing different synovial structures. Results can be influenced by individual case characteristics. Conclusions: If findings of a series of plain radiographs suggest synovial penetration in horses with a wound near a synovial cavity, then synovial penetration is likely, but the absence of plain radiographic findings does not rule out synovial penetration. The use of a metallic probe during radiography may be helpful. However, plain radiography should be interpreted cautiously, and clinical decision making should also include other techniques. Unassigned: O valor diagnóstico de radiografias planas para diagnosticar penetração sinovial em feridas nos membros próximas a estruturas sinoviais não é determinado. Objective: Investigar a acurácia diagnóstica de radiografias planas para identificar penetração sinovial em cavalos com feridas traumáticas nos membros. Unassigned: Estudo de casos retrospectivos. MÉTODOS: Prontuários médicos de equinos hospitalizados na Faculdade de Medicina Veterinária da Universidade de Guent (2011–2021) com feridas nos membros próximas a estruturas sinoviais foram categorizados em grupos com e sem penetração sinovial utilizando resultados de citologia e achados cirúrgicos. Radiografias planas foram analisadas retrospectivamente. Sensibilidade, especificidade, valor preditivo negativo (VPN) e positivo (VPP) foram calculados para todos os animais incluídos, e para os casos com e sem o uso de uma probe metálica na radiografia. Results: Baseado no número total de 141 cavalos com penetração sinovial e 75 cavalos sem envolvimento sinovial, radiografia plana apresentou uma sensibilidade de 61% (95% IC: 52%–69%), especificidade de 81% (95% IC: 70%–89%), VPP de 86% (95% IC: 79%–90%) e VPN de 53% (95% IC: 46%–58%). Com o uso da probe metálica, a sensibilidade foi de 54% (95% IC: 39%–69%), especificidade de 88% (95% IC: 64%–99%), VPP de 93% (95% IC: 78%–98%) e VPN de 41% (95% IC: 32%–49%). PRINCIPAIS LIMITAÇÕES: O pequeno número de animais não possibilitou a comparação entre diferentes tipos de estruturas sinoviais. Os resultados podem ter sido influenciados por características individuais. CONCLUSÕES: Se os achados de radiografia plana sugerem penetração sinovial em equinos com feridas no membro próximas a estruturas sinoviais, penetração sinovial é provável, mas a ausência de achados radiográficos indicativos não excluem a presença de penetração sinovial. O uso de uma probe metálica pode ser útil. Contudo, radiografias planas devem ser interpretadas cautelosamente, e a decisão clínica deve ser baseada em uma combinação com outras modalidades.
© 2024 EVJ Ltd.
Publication Date: 2024-01-10 PubMed ID: 38199977DOI: 10.1111/evj.14050Google Scholar: Lookup
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Summary
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The research article focuses on studying the changes in protein expression within the marginal transitional zone (MTZ) of joint areas in foals, specifically comparing newborns and weanlings.
Overview of the Research Study
- The study targets the marginal transitional zone (MTZ), an area within the diarthrodial joint that forms a junction of various structures including the synovium, fibrous joint capsule, cartilage, periosteum, and bone. The MTZ plays a vital role in joint movement and overall joint health.
- The primary aim of the research is to determine if there are any differences in protein expression in the MTZ between neonatal (newborn) and weanling (older) foals. This focuses specifically on proteins that are involved in the development of cartilage and bone.
- The study focuses on families of proteins known to play significant roles in bone and cartilage development. These include matrix molecules, Wnt signaling family members, paracrine cell signaling molecules, and apoptotic factors.
Findings of the Research Study
- The study observed a differential protein expression in the MTZ from the lateral femoral trochlear ridge (a part of the thighbone joint) between neonatal and weanling foals.
- Protein expression of several paracrine signaling molecules (which help in communication between cells) such as Ihh, PTHrP, PDGF, VEGF, β-catenin, and cytochrome C within the MTZ cartilage was found to be higher in weanling-aged foals. These proteins play central roles in various cellular processes such as cell proliferation, angiogenesis, and apoptosis.
- Similarly, the expression of Collagen type II and lubricin was greater in weanling-aged foals. Collagen type II is the main component of joint cartilage, while lubricin helps to reduce friction within the joints.
- The study found lower expressions of matrix metalloproteinases in weanling foals. Matrix metalloproteinases are enzymes that play a crucial role in remodeling tissues such as cartilage and bone by breaking down the matrix proteins. The lower levels may indicate the ongoing process of tissue remodeling under the increased forces placed on the cartilage as the foal grows older.
Implications of the Findings
- The research findings shed light on the biochemical changes that occur during the development and growth of the joint structures within young animals.
- Understanding these differences could provide valuable insights into orthopedic growth disorders and degenerative joint diseases which could help in developing therapeutic strategies.
- The differential protein expression observed also helps in understanding the adaptive biochemical processes that support the strenuous physical activity as the foals grow and age.
Cite This Article
APA
Michotte M, Raes E, Oosterlinck M.
(2024).
Diagnostic accuracy of plain radiography to identify synovial penetration in horses with traumatic limb wounds.
Equine Vet J, 57(1), 62-68.
https://doi.org/10.1111/evj.14050 Publication
Researcher Affiliations
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
MeSH Terms
- Animals
- Horses / injuries
- Retrospective Studies
- Radiography / veterinary
- Synovial Membrane / diagnostic imaging
- Horse Diseases / diagnostic imaging
- Horse Diseases / diagnosis
- Female
- Male
- Sensitivity and Specificity
- Forelimb / diagnostic imaging
- Forelimb / injuries
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