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Home / Equine Research Bank / Equine Vet J / Comparison of radiography and computed tomography for identi...
Equine veterinary journal2024; doi: 10.1111/evj.14131

Comparison of radiography and computed tomography for identification of third metacarpal structural change and associated assessment of condylar stress fracture risk in Thoroughbred racehorses.

Abstract: Catastrophic injury has a low incidence but leads to the death of many Thoroughbred racehorses. Objective: To determine sensitivity, specificity, and reliability for third metacarpal condylar stress fracture risk assessment from digital radiographs (DR) and standing computed tomography (sCT). Methods: Controlled ex vivo experiment. Methods: A blinded set of metacarpophalangeal joint DR and sCT images were prepared from 31 Thoroughbreds. Four observers evaluated the condyles and parasagittal grooves (PSG) of the third metacarpal bone for the extent of dense bone and lucency/fissure and assigned a risk assessment grade for condylar stress fracture based on imaging features. Sensitivity and specificity for detection of subchondral structural changes in the condyles and PSG, and for risk assessment for condylar stress fracture were determined by comparison with a reference assessment based on sCT and joint surface examination. Agreement between observers and the reference assessment and reliability between observers were determined. Intra-observer repeatability was also assessed. Results: Sensitivity for detection of structural change was lower than specificity for both imaging methods and all observers. For agreement with the reference assessment of structural change, correlation coefficients were generally below 0.5 for DR and 0.49-0.82 for sCT. For horses categorised as normal risk on reference assessment, observer assessment often agreed with the reference. Sensitivity for risk assessment was lower than specificity for all observers. For horses with a reference assessment of high risk of injury, observers generally underestimated risk. Diagnostic sensitivity of risk assessment was improved with sCT imaging, particularly for horses categorised as having elevated risk of injury from the reference assessment. Assessment repeatability and reliability was better with sCT than DR. Conclusions: The ex vivo study design influenced DR image sets. Conclusions: Risk assessment through screening with diagnostic imaging is a promising approach to improve injury prevention in racing Thoroughbreds. Knowledge of sensitivity and specificity of fetlock lesion detection provides the critical guidance needed to improve racehorse screening programs. We found improved detection of MC3 subchondral structural change and risk assessment for condylar stress fracture with sCT ex vivo.
© 2024 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2024-08-14 PubMed ID: 39143731DOI: 10.1111/evj.14131Google Scholar: Lookup
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Summary

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The research investigates the effectiveness of digital radiographs (DR) and standing computed tomography (sCT) in assessing the risk of third metacarpal condylar stress fractures in Thoroughbred racehorses, finding that sCT offers improved sensitivity and reliability in detecting structural changes and assessing fracture risks.

Methodology

  • The study used a controlled ex vivo experiment, conducted with a blinded set of metacarpophalangeal joint DR and sCT images from 31 Thoroughbreds.
  • Four observers were responsible for evaluating the condyles and parasagittal grooves (PSG) of the third metacarpal bone for dense bone and lucency/fissure, and they also assigned a risk assessment grade for condylar stress fracture based on imaging features.
  • The sensitivity and specificity for detecting subchondral structural changes and for determining the risk assessment for condylar stress fractures were determined by comparing with a reference assessment based on sCT and joint surface examination.
  • Agreement between observer and reference assessments and reliability between observers were measured, and intra-observer repeatability was also tested.

Results

  • The sensitivity for detecting structural changes was found to be lower than the specificity for both imaging methods and all observers.
  • Agreement with the reference assessment saw correlation coefficients generally below 0.5 for DR, and between 0.49-0.82 for sCT.
  • Observers often agreed with the reference assessment for horses classified as normal risk, but generally underestimated risk for horses assessed as high injury risk through reference.
  • Assessment of risk was improved with sCT imaging, particularly for horses classified as having an elevated injury risk from the reference assessment.
  • sCT also demonstrated better assessment repeatability and reliability than DR.

Conclusion

  • The study concluded that sCT imaging offers advantages over DR in assessing the risk of third metacarpal condylar stress fractures in Thoroughbred racehorses, with higher sensitivity, reliability, and repeatability.
  • The researchers also found that diagnostic imaging is a promising approach to improving injury prevention in racing Thoroughbreds, by enabling better screening and risk assessment*
  • The study affirms the importance of understanding the sensitivity and specificity of lesion detection in improving racehorse screening programs.

Cite This Article

APA
Irandoust S, O'Neil LM, Stevenson CM, Franseen FM, Ramzan PHL, Powell SE, Brounts SH, Loeber SJ, Ergun DL, Whitton RC, Henak CR, Muir P. (2024). Comparison of radiography and computed tomography for identification of third metacarpal structural change and associated assessment of condylar stress fracture risk in Thoroughbred racehorses. Equine Vet J. https://doi.org/10.1111/evj.14131

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Irandoust, Soroush
  • Department of Surgical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA.
  • Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA.
O'Neil, Linnea M
  • Department of Surgical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Stevenson, Christina M
  • Department of Surgical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Franseen, Faith M
  • Department of Surgical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Ramzan, Pieter H L
  • Rossdales Veterinary Surgeons, Newmarket, UK.
Powell, Sarah E
  • VetCT, Cambridge, UK.
Brounts, Sabrina H
  • Department of Surgical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Loeber, Samantha J
  • Department of Surgical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Ergun, David L
  • Asto CT, 7921 UW Health Ct., Middleton, Wisconsin, USA.
Whitton, R Chris
  • Department of Veterinary Clinical Sciences, Melbourne Veterinary School, Faculty of Science, University of Melbourne, Werribee, Victoria, Australia.
Henak, Corinne R
  • Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA.
  • Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA.
  • Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Muir, Peter
  • Department of Surgical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Grant Funding

  • Grayson-Jockey Club Research Foundation

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