Evaluation of plasma fibrinogen concentration as an indicator of physeal or epiphyseal osteomyelitis in foals: 17 cases (2002-2007).

This study investigates the usefulness of high plasma fibrinogen levels as an indicator of a type of bone infection (physeal or epiphyseal osteomyelitis) in young horses (foals). The research shows that foals with these bone infections had significantly greater fibrinogen concentrations than those in other health conditions assessed, and suggests that this could serve as a useful diagnostic tool for osteomyelitis.

Methodology

• The researchers performed a retrospective case series on 17 foals with physeal or epiphyseal osteomyelitis, 17 with septic arthritis alone, 20 with a type of pneumonia (non-Rhodococcus equi), and 22 healthy foals for comparison.
• Medical records were examined for initial health status, total white blood cell (WBC) count, segmented neutrophil count, and plasma fibrinogen concentration on arrival at the hospital.
• The survival rate of the foals after their hospital stay was also noted.

Results

• Foals with physeal or epiphyseal osteomyelitis showed higher plasma fibrinogen concentrations when compared to the other three groups under study.
• Out of the foals suffering from osteomyelitis, 16 out of 17 had fibrinogen values above or equal to 900 mg/dL.
• The predictive values for a fibrinogen level between 900 to 1500 mg/dL pointing to osteomyelitis was 84.2% accuracy for a positive diagnosis (positive predictive value), and 98.2% accuracy for a negative diagnosis (negative predictive value).
• Foals with non-osteomyelitis conditions were mostly associated with fibrinogen levels between 200 to 400 mg/dL and 500 to 800 mg/dL.
• The presence of septic arthritis or pneumonia (non-R equi) was significantly linked with a fibrinogen concentration between 500 and 800 mg/dL, but the prediction accuracy for these diseases based on this range was low.
• Foals with osteomyelitis presented higher total WBC and segmented neutrophil counts than the ones with septic arthritis alone.

Conclusion

• The study concludes that a plasma fibrinogen concentration equal to or greater than 900 mg/dL could potentially be a strong indicator of physeal or epiphyseal osteomyelitis in foals.
• This newly identified marker helps in diagnosing this form of bone infection, which is essential for structuring appropriate treatment and improving prognosis.