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Equine veterinary journal2021; doi: 10.1111/evj.13497

Comparison of ultrasonography and radiography with arthroscopy for diagnosis of dorsoproximal osteochondral fragmentation of the proximal phalanx in 56 Thoroughbred racehorses.

Abstract: Osteochondral fragmentation of the proximal phalanx (DPP1 fragment) is a common finding in the racehorse. Whilst radiographic assessment has been reported to lack diagnostic sensitivity, ultrasonographic examination has been documented to be extremely sensitive for identification of bone fragments in the metacarpophalangeal joint. Objective: To determine the sensitivity and specificity of ultrasonography as an imaging modality for diagnosis of DPP1 fragmentation and to compare it with radiography in the Thoroughbred racehorse. Methods: Retrospective cohort study. Methods: Medical records (radiographs and ultrasonographic examinations) of 56 Thoroughbred racehorses in training (average age 26.4 months [SD ±5.9]) with a history of forelimb fetlock joint effusion and arthroscopically confirmed DPP1 fragmentation were evaluated. Inter-observer agreement was calculated between three blinded reviewers for both ultrasonographic and radiographic findings. Median values were used for statistical analyses. Ultrasonographic and radiographic identification of DPP1 fragmentation was considered correct if in agreement with arthroscopic findings. The McNemar test was used to compare correct proportions between radiography and ultrasonography. Analyses were performed to evaluate correct identification of presence of fragment(s), location of fragment(s) and presence and location of fragment(s) within the joints, with values P < .05 considered significant. Results: Eighty-one fetlock joints from 56 Thoroughbreds were evaluated. In total, 99 individual DPP1 fragments were confirmed arthroscopically. Ultrasonography was shown to have high levels of sensitivity (94%, 95% CI 89%-99%) and specificity (97%, 95% CI 92%-100%) for identification of DPP1 fragments, with transverse ultrasonographic images being more sensitive than sagittal ultrasonography (P = .001). Ultrasonography was also shown in this population to have significantly greater sensitivity than radiography (47%, 95% CI 37%-56%) (P < .001). Conclusions: Ultrasonography is an extremely sensitive and specific imaging modality for evaluation of DPP1 fragmentation, with transverse ultrasonographic imaging being the most sensitive technique. Radiographic evaluation was less sensitive than ultrasonography in this study.
© 2021 EVJ Ltd.
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Publication Date: 2021-08-22 PubMed ID: 34420230DOI: 10.1111/evj.13497Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research study evaluated the effectiveness of ultrasonography compared to radiography for detecting osteochondral fragmentation in the proximal phalanx of racehorses. The study found that ultrasonography was significantly more sensitive and accurate in identifying these bone fragments.

Methodology

  • The researchers used data from the medical records of 56 Thoroughbred racehorses, who had been diagnosed with osteochondral fragmentation of the proximal phalanx.
  • The horses all had a history of forelimb fetlock joint effusion, and the fragmentation diagnosis was confirmed arthroscopically.
  • The study was carried out as a blinded review, with three reviewers not knowing which modality the images were derived from.
  • The researchers looked at both ultrasound and radiographic images and compared each modality’s success rate in correctly identifying bone fragments. It also compared the accuracy of locating these fragments within the joint.
  • The study relied on statistical analysis to evaluate the effectiveness of each method. The McNemar test was used to compare the proportions of correct identification within each modality.

Results

  • The findings revealed that ultrasonography had a sensitivity rate of 94% and specificity rate of 97% in identifying bone fragments, demonstrating its strong effectiveness in diagnosing the condition.
  • Meanwhile, radiography had a significantly lower sensitivity rate of 47%, indicating it was less effective in accurately detecting bone fragments.
  • Furthermore, the use of transverse ultrasonographic imaging was found to be more effective than sagittal ultrasonography.

Conclusion

  • The study concludes that ultrasonography is an extremely sensitive and specific imaging technique for diagnosing osteochondral fragmentation in racehorses.
  • The failure of radiography to match the accuracy of ultrasound in this study suggests that ultrasound is a more reliable method for diagnosing this particular condition.

Cite This Article

APA
Plevin S, McLellan J. (2021). Comparison of ultrasonography and radiography with arthroscopy for diagnosis of dorsoproximal osteochondral fragmentation of the proximal phalanx in 56 Thoroughbred racehorses. Equine Vet J. https://doi.org/10.1111/evj.13497

Publication

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

Researcher Affiliations

Plevin, Sarah
  • Florida Equine Veterinary Associates, Ocala, FL, USA.
McLellan, Jonathan
  • Florida Equine Veterinary Associates, Ocala, FL, USA.

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This article includes 32 references
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Citations

This article has been cited 4 times.
  1. Van Cauter R, Serteyn D, Lejeune JP, Rousset A, Caudron I. Evaluation of the appearance of osteochondrosis lesions by two radiographic examinations in sport horses aged from 12 to 36 months. PLoS One 2023;18(5):e0286213.
    doi: 10.1371/journal.pone.0286213pubmed: 37220101google scholar: lookup
  2. Harada K, Akioka K, Izu I, Sasaki N. Ultrasonography-based diagnosis of hemorrhage syndrome in adipose tissues in the crest of the neck of heavy horse breeds. J Vet Med Sci 2023 Jun 13;85(6):637-641.
    doi: 10.1292/jvms.23-0084pubmed: 37183015google scholar: lookup
  3. Van Cauter R, Caudron I, Lejeune JP, Rousset A, Serteyn D. Distal sagittal forelimb conformation in young Walloon horses: Radiographic assessment and its relationship with osteochondral fragments. PLoS One 2024;19(10):e0311965.
    doi: 10.1371/journal.pone.0311965pubmed: 39392827google scholar: lookup
  4. Van Cauter R, Caudron I, Lejeune JP, Rousset A, Serteyn D. Nineteen years of radiographic screening: Impact of sepsis and evolution of osteochondrosis dissecans prevalence in Walloon sport horses born between 2004 and 2022. PLoS One 2024;19(9):e0308304.
    doi: 10.1371/journal.pone.0308304pubmed: 39255258google scholar: lookup
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