Usefulness of caudomedial-craniolateral oblique radiographic views for the diagnosis of injury to the origin of the cranial cruciate ligament in two horses.

The research article explores the usefulness of specific radiographic views for diagnosing injuries to the cranial cruciate ligament in two horses, demonstrating it can effectively identify certain types of injuries when correctly utilized.

Case Description and Clinical Findings

• The study describes the cases of two horses that were examined due to chronic lameness related to the stifle joint, which is equivalent to the human knee joint.
• The first horse, a 12-year-old mixed-breed mare, exhibited effusion in the right femoropatellar and medial femorotibial joints and a grade 3/5 lameness.
• The second horse, a 6-year-old Friesian Gelding, showed similar symptoms but on the left side and a grade 4/5 lameness.
• Both horses were diagnosed with cranial cruciate ligament (CCL) injury, with mineralization and ligament avulsion (partial tearing away of the ligament from the bone) observed in the first horse, and mineralization alone in the second.

Radiographic Diagnosis

• A specific radiographic view called ‘caudomedial-craniolateral oblique’ was applied which was found effective in highlighting the injuries.
• This view was achieved by positioning the X-ray beam 45° medial to the caudocranial (rear-front) line, to reveal the origin of the CCL on the lateral femoral condyle within the intercondylar fossa (a groove between two condyles of a bone).
• The identified lesions were later confirmed through Computerized Tomography (CT) scan.
• This indicates that the radiographic view was beneficial for diagnosing CCL injuries in horses, particularly in cases of ligament avulsion or mineralization.

Treatment and Outcome

• The first horse underwent arthroscopy of the femorotibial joints, which identified the bone fragment associated with the ligament, but it wasn’t possible to remove it.
• The second horse was euthanized because of the poor prognosis, as revealed by the CT scan while the horse was under anesthesia.

Conclusion and Clinical Relevance

• The study underscores the value of radiography in diagnosing CCL injuries in horses, especially for those not within hospital settings.
• The ‘caudomedial-craniolateral oblique’ radiographic view is particularly useful in diagnosing CCL injury when conditions such as avulsion or mineralization are present.
• Despite not being a routine part of the radiographic series for imaging of the stifle joint in horses, the use of this perspective should be considered for suspected CCL injuries.