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Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association2022; 63(6); 681-690; doi: 10.1111/vru.13131

Palmar/plantar oblique projections improve radiographic detection of fractures of the palmar/plantar processes of the equine distal phalanx.

Abstract: Radiography is a standard diagnostic test for horses with suspected fractures of the palmar/plantar processes (PP) of the distal phalanx, however published studies evaluating the diagnostic utility for radiography are currently lacking. The objectives of this retrospective, diagnostic case-control study were to determine the sensitivity of radiographs for the detection of PP fractures, and determine the diagnostic utility of the palmar/plantar oblique projections of the PP for the identification of PP fractures compared to standard radiographic series. The medical records of horses undergoing MRI examination were reviewed and 23 horses diagnosed with a PP fracture were included as cases for analysis. Forty-six control horses were selected. Radiographs, including palmar/plantar oblique (palmaro/plantaro50 -proximal 45 -medial(lateral)-dorsodistolateral (medial) oblique (PPrM(L)-DDiL(M)O) projections, and MRI images were assessed independently for the presence or absence of PP fractures and the sensitivity and specificity of radiographs for their detection were calculated, using MRI as the gold-standard. A second, blinded, radiographic evaluation excluding the palmar/plantar oblique views was performed. Twenty-seven PP fractures were identified in the 23 case horses on MRI examination. Twenty-two fractures were identified in 20/23 horses on examination of the full radiographic series (sensitivity and specificity of 81.5% and 100% respectively). Fractures were most frequently identified on the palmar/plantar oblique projections (19/22 fractures), followed by the lateromedial projection. Radiographic assessment excluding the palmar/plantar oblique projections identified 18 PP fractures in 16/23 horses. Careful assessment of a standard radiographic series of the foot will allow identification of PP fractures but palmar/plantar oblique projections will improve the detection of these fractures.
© 2022 American College of Veterinary Radiology.
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Publication Date: 2022-07-24 PubMed ID: 35871471DOI: 10.1111/vru.13131Google 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.

The research explores the effectiveness of using palmar/plantar oblique projections during radiography for better detection of fractures in the palmar/plantar processes of a horse’s distal phalanx. It demonstrates that these projections show a higher sensitivity and specificity in identifying such fractures compared to standard radiographic series.

Objective of the Study

  • The study aimed to ascertain the sensitivity of radiographs for detecting fractures of the palmar/plantar processes.
  • It also aimed to assess the diagnostic potential of palmar/plantar oblique projection in spotting these fractures compared to standard radiographic series.

Methodology

  • The researchers conducted a retrospective, diagnostic case-control study.
  • The medical records of horses undergoing MRI examinations were reviewed. From these, 23 horses diagnosed with a PP fracture were included as cases for the study, and 46 other horses were chosen as controls.
  • For each horse, radiographs were taken, including palmar/plantar oblique projections. These were independently assessed to determine the presence or absence of PP fractures.
  • The sensitivity and specificity of radiographs for fracture detection were calculated, using MRI examinations as the reference standard.
  • A separate, blinded radiographic evaluation excluding the palmar/plantar oblique views was also conducted for comparison.

Findings

  • A total of 27 PP fractures were identified in the 23 case horses through MRI examination.
  • Examination of the full radiographic series picked out 22 of these fractures in 20 out of the 23 horses, showing a sensitivity and specificity of 81.5% and 100% respectively.
  • Fractures were most frequently identified in the palmar/plantar oblique projections (19 out of the 22 fractures), followed by the lateromedial projection.
  • The radiographic assessment excluding palmar/plantar oblique projections identified 18 PP fractures in 16 out of the 23 horses.

Conclusion

  • The study concludes that a standard radiographic series can identify PP fractures but the addition of palmar/plantar oblique projections enhances the detection of such fractures.

Cite This Article

APA
Fairburn AJ, Sherlock CE, Mair TS. (2022). Palmar/plantar oblique projections improve radiographic detection of fractures of the palmar/plantar processes of the equine distal phalanx. Vet Radiol Ultrasound, 63(6), 681-690. https://doi.org/10.1111/vru.13131

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: 63
Issue: 6
Pages: 681-690

Researcher Affiliations

Fairburn, Alison J
  • Bell Equine Veterinary Centre, Kent, UK.
Sherlock, Ceri E
  • Bell Equine Veterinary Centre, Kent, UK.
Mair, Tim S
  • Bell Equine Veterinary Centre, Kent, UK.

MeSH Terms

  • Horses
  • Animals
  • Horse Diseases / diagnostic imaging
  • Retrospective Studies
  • Case-Control Studies
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / veterinary
  • Radiography

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This article includes 22 references
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Citations

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