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Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association2023; 64(4); 585-592; doi: 10.1111/vru.13229

Interobserver agreement of lateral and oblique radiography and standing cone beam CT of the caudal cervical articular process joints of horses.

Abstract: Caudal cervical articular process joint osteoarthritis (CAPJ OA) leads to career-altering clinical signs in the horse. Oblique radiographs and standing cone beam computed tomography (CBCT) facilitate the assessment of this area, however, the variability of interpretation of these images is currently unknown. This retrospective, secondary analysis, methods comparison study investigated interobserver agreement between clinicians and modality in grades of CAPJ OA on lateral and oblique radiographs and CBCT. We hypothesized that agreement between clinicians' grades of CAPJ OA would be lowest for oblique radiographs and highest for CBCT, and agreement between grades of CAPJ OA would be low for all pairs of modalities. Horses underwent lateral and oblique radiography and CBCT of the CAPJs of C5-C6 and C6-C7. Radiographs and CBCT images were graded retrospectively by four blinded clinicians using 3-point scales. Cohen's kappa analysis was used to evaluate interobserver agreement between grades of CAPJ OA, and agreement between grades of CAPJ OA between different modalities was explored using kappa-weighted analysis. Agreement between clinicians' grades of CAPJ OA was moderate for lateral radiographs (0.49), and fair for oblique radiographs (0.23) and CBCT (0.36). For all modalities, agreement was slight to fair between clinicians for CAPJs with grade 1 (normal, 0.21-0.32) or 2 (mild, 0.13-0.36) CAPJ OA, and moderate to substantial for grade 3 (moderate to severe, 0.45-0.77) CAPJ OA. Agreement between grades of CAPJ OA was fair for all pairs of modalities. This study provides important information regarding the inconsistency of interpretation of mild CAPJ OA on radiographs and CBCT amongst clinicians.
© 2023 American College of Veterinary Radiology.
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Publication Date: 2023-03-30 PubMed ID: 36994690DOI: 10.1111/vru.13229Google Scholar: Lookup
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  • Journal Article

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.

The research study conducted a comparative analysis among clinicians’ interpretations of images from lateral and oblique radiographs, and standing cone beam computed technology (CBCT). The images were graded based on the severity of caudal cervical articular process joint osteoarthritis (CAPJ OA) in horses. Results indicated variability in agreement among clinicians’ interpretations, which was predicted to be more consistent with CBCT.

Research Objectives and Hypothesis

  • The research aimed to understand the reliability of different imaging modalities, specifically lateral and oblique radiographs and CBCT, for grading CAPJ OA in horses.
  • It hypothesized that clinicians’ agreement on CAPJ OA grades would be lowest for oblique radiographs and highest for CBCT. Furthermore, the agreement between grades of CAPJ OA would be low for all pairs of image types.

Methodology

  • The methodologies involved performing lateral and oblique radiography and CBCT on the caudal cervical articular process joints (CAPJs) of C5-C6 and C6-C7 in horses.
  • The images generated were graded retrospectively by four separate clinicians on a 3-point scale. This was done in a blinded fashion, i.e., clinicians were unaware of each other’s assessment to avoid bias.
  • Interobserver agreement was assessed using Cohen’s kappa analysis while kappa-weighted analysis was employed to examine the agreement between different imaging modalities.

Findings

  • The findings showed moderate agreement among the clinicians’ CAPJ OA grades for lateral radiographs, a fair agreement for oblique radiographs, and CBCT.
  • For each imaging modality, the agreement was slight to fair between clinicians for CAPJs with grade 1 (normal) or 2 (mild) CAPJ OA, and moderate to substantial for grade 3 (moderate to severe) CAPJ OA.
  • The agreement between grades of CAPJ OA was generally fair for all pairs of imaging modalities.

Conclusion

  • The research concluded that there is a notable variability in the interpretation of mild CAPJ OA across imaging modalities among clinicians.
  • The findings suggest further investigation and standardization of grading criteria might be required to reduce the inconsistency in interpretation and enhance the diagnosis accuracy.

Cite This Article

APA
Brown KA, Davidson EJ, Johnson AL, Stefanovski D, Wulster KB, Ortved K. (2023). Interobserver agreement of lateral and oblique radiography and standing cone beam CT of the caudal cervical articular process joints of horses. Vet Radiol Ultrasound, 64(4), 585-592. https://doi.org/10.1111/vru.13229

Publication

Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association
ISSN: 1740-8261
NlmUniqueID: 9209635
Country: England
Language: English
Volume: 64
Issue: 4
Pages: 585-592

Researcher Affiliations

Brown, Kara A
  • Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.
Davidson, Elizabeth J
  • Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.
Johnson, Amy L
  • Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.
Stefanovski, Darko
  • Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.
Wulster, Kathryn B
  • Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.
Ortved, Kyla
  • Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.

MeSH Terms

  • Horses
  • Animals
  • Retrospective Studies
  • Observer Variation
  • Radiography
  • Cone-Beam Computed Tomography / veterinary

Grant Funding

  • Raymond Firestone Trust and Raker/Tulleners Fund Research Grant

References

This article includes 21 references
  1. Dyson SJ. Lesions of the equine neck resulting in lameness or poor performance.. Vet Clin North Am - Equine Pract 2011;27:417-437.
  2. Ricardi G, Dyson SJ. Forelimb lameness associated with radiographic abnormalities of the cervical vertebrae.. Equine Vet J 1993;25(5):422-426.
  3. Dyson SJ. Unexplained forelimb lameness possibly associated with radiculopathy.. Equine Vet Educ 2020;32(S10):92-103.
  4. Down SS, Henson FMD. Radiographic retrospective study of the caudal cervical articular process joints in the horse.. Equine Vet J 2009;41(6):518-524.
  5. Butler JA, Colles CM, Dyson SJ, Kold SE, Poulos PW. Chapter 12 The vertebral column.. 2020;531-608.
  6. Koenig JB, Westlund A, Nykamp S. Case-Control Comparison of Cervical Spine Radiographs From Horses With a Clinical Diagnosis of Cervical Facet Disease With Normal Horses.. J Equine Vet Sci 2020;92:1-6.
  7. Withers JM, Voûte LC, Hammond G, Lischer CJ. Radiographic anatomy of the articular process joints of the caudal cervical vertebrae in the horse on lateral and oblique projections.. Equine Vet J 2009;41(9):895-902.
  8. Brown KA, Davidson EJ, Johnson AL, Wulster KB, Ortved K. Inflammatory cytokines in horses with cervical articular process joint osteoarthritis on standing cone beam computed tomography.. Equine Vet J 2021;53(5):944-954.
  9. Lindgren CM, Wright L, Kristoffersen M, Puchalski SM. Computed tomography and myelography of the equine cervical spine: 180 cases (2013-2018).. Equine Vet Educ 2021;33(9):475-483.
  10. Rovel T, Zimmerman M, Duchateau L. Computed tomographic examination of the articular process joints of the cervical spine in warmblood horses: 86 cases (2015-2017).. J Am Vet Med Assoc 2021;259(10):1178-1187.
  11. Curtiss AL, Ortved KF, Dallap-Schaer B. Validation of standing cone beam computed tomography for diagnosing subchondral fetlock pathology in the Thoroughbred racehorse.. Equine Vet J 2021;53(3):510-523.
  12. Landis JR, Koch GG. The measurement of observer agreement for categorical data.. Biometrics 1977;33:159-174.
  13. Tudor GR, Finlay D, Taub N. An assessment of inter-observer agreement and accuracy when reporting plain radiographs.. Brain Lang 1997;52(3):235-238.
  14. De Lasalle J, Alexander K, Olive J, Laverty S. Comparisons Among Radiography, Ultrasonography and Computed Tomography for Ex Vivo Characterization of Stifle Osteoarthritis in the Horse.. Vet Radiol Ultrasound 2016;57(5):489-501.
  15. Groth AM, May SA, Weaver MP, Weller R. Intra- and interobserver agreement in the interpretation of navicular bones on radiographs and computed tomography scans.. Equine Vet J 2009;41(2):124-129.
  16. O'Brien T, Baker TA, Brounts SH. Detection of articular pathology of the distal aspect of the third metacarpal bone in thoroughbred racehorses: comparison of radiography, computed tomography and magnetic resonance imaging.. Vet Surg 2011;40(8):942-951.
  17. Butler JA, Colles CM, Dyson SJ, Kold SE, Poulos PW. Chapter 1 General Principles.. 2020;1-41.
  18. Veraa S, De Graaf K, Wijnberg ID. Caudal cervical vertebral morphological variation is not associated with clinical signs in Warmblood horses.. Equine Vet J 2020;52(2):219-224.
  19. Espinosa-Mur P, Phillips KL, Galuppo L. Radiographic and Ultrasonographic Findings of the Caudal Cervical Region in 105 Warmblood Horses.. Proceedings of the 64th Annual Convention of the American Association of Equine Practitioners 2018; December 1-5, 2018; San Francisco, California, USA.
  20. Rudy IS, Poulos A, Owen L. The correlation of radiographic findings and patient symptomatology in cervical degenerative joint disease: a cross-sectional study.. Chiropr Man Ther 2015;23(1):1-7.
  21. Stucke D, Hall S, Morrone B, Große Ruse M, Lebelt D. Latero-oblique radiography as a diagnostic tool for equine cervical osteoarthritis.. 2014; Clinical Research Abstracts of the British Equine Veterinary Association Congress 2014.

Citations

This article has been cited 4 times.
  1. Strootmann T, Peter VG, Körner J. Radiographic Prevalence of Anatomical Variations of the Ventral Lamina of the Sixth Cervical Vertebra, C6/C7 Articular Process Joint Modelling and Competition Outcomes in Warmblood Sport Horses. Animals (Basel) 2026 Jan 29;16(3).
    doi: 10.3390/ani16030424pubmed: 41681407google scholar: lookup
  2. Argue BJ, Ahern BJ. Evaluation of agreement for radiographic lesions and risk for racing in thoroughbred yearling sale repository radiographs. Front Vet Sci 2024;11:1430993.
    doi: 10.3389/fvets.2024.1430993pubmed: 39421830google scholar: lookup
  3. Davidson EJ, Stefanovski D, Slack J, Manzi TJ. Ultrasound-guided caudal cervical articular process arthrocentesis is accurate in live horses with and without arthropathy. Equine Vet J 2025 Mar;57(2):398-405.
    doi: 10.1111/evj.14133pubmed: 38989893google scholar: lookup
  4. Dyson S, Phillips K, Zheng S, Aleman M. Congenital variants of the ventral laminae of the sixth and seventh cervical vertebrae are not associated with clinical signs or other radiological abnormalities of the cervicothoracic region in Warmblood horses. Equine Vet J 2025 Mar;57(2):419-430.
    doi: 10.1111/evj.14127pubmed: 38938125google scholar: lookup
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