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Equine veterinary journal2024; doi: 10.1111/evj.14048

Prospective, longitudinal assessment of subchondral bone morphology and pathology using standing, cone-beam computed tomography in fetlock joints of 2-year-old Thoroughbred racehorses in their first year of training.

Abstract: Catastrophic injuries of the fetlock joints occur in Thoroughbred racehorses and are preceded by stress-induced bone injury. Early detection of subchondral bone injury is essential to prevent irreversible damage or bone failure. Objective: To investigate the use of standing, robotic cone-beam computed tomography (CBCT) for assessing longitudinal changes in subchondral bone morphology and pathology of the fetlock joints associated with race training in young Thoroughbreds. Methods: Observational cohort study. Methods: Forty-one 2-year-old Thoroughbred racehorses were recruited prior to the start of race training. Standing CBCT and radiographs of all 4 metacarpo-/metatarsophalangeal (MCP/MTP) joints were obtained at 0, 6 and 12 months. Hyperdensity, as an estimate of subchondral bone sclerosis, was measured in the distal third metacarpal (MC3)/metatarsal (MT3) bone and proximal phalanx (P1) at each time point on computed tomography. CBCTs were examined for subchondral bone pathology consisting of areas of hypodensity within regions of hyperdensity. Results: Subchondral bone sclerosis increased significantly over time in the medial and lateral MC3/MT3 condyles and in the medial and lateral parasagittal grooves of MC3/MT3. The presence of subchondral bone pathology increased significantly over time in the medial and lateral palmar condyles of MC3/MT3, the lateral parasagittal groove, the medial dorsal condyle and the medial and lateral ridges of P1. Conclusions: There was attrition of horses due to relocation, change in ownership, and retirement from racing. Husbandry, training regimens and racing schedules were not controlled for in the study. Conclusions: Standing CBCT is an efficient and effective screening tool for assessing subchondral bone morphology and identifying pathology of the fetlock joint in young Thoroughbred racehorses. CBCT may facilitate early detection of bone pathology allowing for timely intervention and prevention of more serious injuries. Unassigned: Katastrophale Verletzungen der Fesselgelenke treten bei Vollblutrennpferden auf und folgen belastungsinduzierten Knochenschäden. Die frühe Erkennung von subchondralen Knochenschäden ist essenziell, um irreversiblem Schaden oder Knochenversagen vorzubeugen. Unassigned: Untersuchung des Gebrauchs von stehend durchgeführter, robotischer Kegelstrahl-Computertomographie (CBCT) für die Beurteilung longitudinaler Veränderungen in subchondraler Knochenmorphologie und Pathologie der Fesselgelenke im Zusammenhang mit Renntraining bei jungen Vollblutpferden. Methods: Beobachtende Kohortenstudie. Methods: Einundvierzig zweijährige Vollblutrennpferde wurden vor Beginn des Renntrainings rekrutiert. Am stehenden Pferd durchgeführte CBCT und röntgenologische Untersuchung aller vier Metacarpo-/Metatarsophalangealgelenke (MCP/MTP) wurde zu den Zeitpunkten 0, 6 und 12 Monate wiederholt. Überdichte als eine Schätzung von subchondraler Knochensklerose wurde im distalen dritten Metacarpal-(MC3)/Metatarsal-(MT3) Knochen und der proximalen Phalanx zu jedem Zeitpunkt mithilfe der Computertomographie gemessen. CBCT wurden auf subchondrale Knochenpathologien bestehend aus hypodensen Bereichen innerhalb hyperdenser Regionen untersucht. Unassigned: Subchondrale Knochensklerose nahm im Laufe der Zeit in den medialen und lateralen MC3/MT3 Kondylen sowie in den medialen und lateralen parasagittalen Furchen signifikant zu. Das Vorhandensein subchondraler Knochenpathologien nahm im Laufe der Zeit in den Bereichen der medialen und lateralen palmaren Kondylen von MC3/MT3, der lateralen parasagittalen Furche, des medialen dorsalen Kondylus und der lateralen und medialen Kämme von P1 signifikant zu. HAUPTEINSCHRÄNKUNGEN: Pferde schieden aus der Studie aufgrund Standortwechsel, Besitzerwechsel, und Austritt aus dem Rennsport aus. Haltung, Trainingsregimente, und Rennpläne wurden für diese Studie nicht kontrolliert. Unassigned: Stehend durchgeführte CBCT ist ein effizientes und effektives Screening-Tool für die Beurteilung subchondraler Knochenmorphologie und Identifikation von Pathologie im Fesselgelenk junger Vollblutrennpferde. CBCT könnte frühe Erkennung von Knochenpathologie ermöglichen, was die rechtzeitige Intervention und Prävention von schwerwiegenderen Verletzungen ermöglicht.
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Publication Date: 2024-01-21 PubMed ID: 38247205DOI: 10.1111/evj.14048Google 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.

This study explores the use of a medical imaging technique known as cone-beam computed tomography (CBCT) for identifying stress-related bone injuries in the fetlock joints of young Thoroughbred racehorses during their first year of training. The findings suggest that CBCT can help in tracking changes in bone morphology and detecting injuries early, potentially preventing catastrophic outcomes.

Objective and Methodology

  • The research aimed to use the standing, robotic CBCT as a tool for monitoring longitudinal changes in subchondral bone morphology and spotting pathological changes in the fetlock joints, which are associated with race training in young Thoroughbreds.
  • For the study, a cohort of 41 two-year-old Thoroughbred racehorses were enlisted, and their metacarpo-/metatarsophalangeal (MCP/MTP) joints were scanned using CBCT and radiographs at three intervals: at the start of race training, midway (at 6 months), and at the end of the first year (12 months).
  • Hyperdensity, indicating subchondral bone sclerosis, was calculated in the distal third metacarpal (MC3)/metatarsal (MT3) bone and proximal phalanx (P1) at each time point.
  • CBCT scans were specifically examined for pathology in the subchondral bone, identified as areas of hypodensity within regions of hyperdensity.

Results

  • It was observed that subchondral bone sclerosis significantly increased over time in the medial and lateral MC3/MT3 condyles and in the medial and lateral parasagittal grooves of MC3/MT3.
  • Similarly, the presence of subchondral bone pathology also significantly increased over time in various parts of the MC3/MT3 and P1.
  • These indicate that CBCT scans can effectively track changes in the bones over time, making it a useful tool for identifying early signs of stress-induced injuries.

Conclusions

  • Several horses had to be removed from the study due to reasons like relocation, change in ownership, and retirement from racing.
  • Factors like husbandry, training routines, and racing schedules were not controlled by the study, which could be treated as limitations.
  • Overall, standing CBCT is a movered as a highly efficient and effective method for longitudinal assessment of subchondral bone morphology and detecting early signs of injuries in young Thoroughbred racehorses.
  • By facilitating early detection of bone pathology, CBCT could aid in timely intervention and prevention of severe injuries.

Cite This Article

APA
Ciamillo SA, Wulster KB, Gassert TM, Richardson DW, Brown KA, Stefanovski D, Ortved KF. (2024). Prospective, longitudinal assessment of subchondral bone morphology and pathology using standing, cone-beam computed tomography in fetlock joints of 2-year-old Thoroughbred racehorses in their first year of training. Equine Vet J. https://doi.org/10.1111/evj.14048

Publication

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

Researcher Affiliations

Ciamillo, Sarah A
  • Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Wulster, Kathryn B
  • Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Gassert, Taryn M
  • Sports Medicine Associates of Chester County, Cochranville, Pennsylvania, USA.
Richardson, Dean W
  • Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Brown, Kara A
  • Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Stefanovski, Darko
  • Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Ortved, Kyla F
  • Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.

Grant Funding

  • Grayson-Jockey Club Research Foundation

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Citations

This article has been cited 7 times.
  1. Irandoust S, Whitton C, Henak C, Muir P. Tuning and validation of a virtual mechanical testing pipeline for condylar stress fracture risk assessment in Thoroughbred racehorses. R Soc Open Sci 2025 May;12(5):241935.
    doi: 10.1098/rsos.241935pubmed: 40370600google scholar: lookup
  2. Ciamillo SA, Bills KW, Gassert TM, Richardson DW, Brown KA, Stefanovski D, Ortved KF. Effect of high-speed exercise on subchondral bone in the metacarpo-/metatarsophalangeal joints of 2-year-old Thoroughbred racehorses in their first year of training. Equine Vet J 2026 Jan;58(1):40-48.
    doi: 10.1111/evj.14524pubmed: 40323137google scholar: lookup
  3. Nagy A, Dyson SJ. Combined standing low-field magnetic resonance imaging and fan-beam computed tomographic diagnosis of fetlock region pain in 27 sports horses. Equine Vet J 2025 Sep;57(5):1313-1327.
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  4. Malekipour F, Whitton RC, Lee PV. Advancements in Subchondral Bone Biomechanics: Insights from Computed Tomography and Micro-Computed Tomography Imaging in Equine Models. Curr Osteoporos Rep 2024 Dec;22(6):544-552.
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  6. Nagy A, Dyson S. Magnetic Resonance Imaging, Computed Tomographic and Radiographic Findings in the Metacarpophalangeal Joints of 31 Warmblood Showjumpers in Full Work and Competing Regularly. Animals (Basel) 2024 May 9;14(10).
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