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Equine veterinary journal2021; 53(3); 510-523; doi: 10.1111/evj.13414

Validation of standing cone beam computed tomography for diagnosing subchondral fetlock pathology in the Thoroughbred racehorse.

Abstract: Subchondral bone pathology is common in Thoroughbred racehorses and believed to precede more serious injury. Early identification of pathology is critical to allow for intervention. Objective: To determine interobserver variability of fetlock subchondral bone lesions using cone beam and fan beam computed tomography (CBCT, FBCT) and to validate a robotics-controlled CBCT to identify fetlock subchondral bone pathology in the Thoroughbred racehorse. Methods: Prospective cohort study. Methods: FBCT and CBCT images were acquired of 25 metacarpo-/metatarsophalangeal joints of Thoroughbred racehorses. Images were analysed for subchondral bone lesions commonly identified in Thoroughbred fetlocks by an imaging specialist and surgery specialist. Interobserver and intermodality equivalence were determined with a Pearson correlation analysis and Bland-Altman equivalence test. Results: Interobserver FBCT correlation was significant (P < .05) for 19 of 25 variables (Pearson R mean 0.77). Concordance was significant for all 25 variables (Bland Altman average difference 0.28 ± 0.21 mm). Interobserver CBCT correlation was significant for 21 of 25 variables (Pearson R mean 0.73). Concordance was significant for all variables (Bland Altman average difference 0.07 ± 1.90 mm). Intermodality (FBCT vs CBCT) correlation and concordance was significant for all variables as interpreted by the radiologist (Pearson R mean of 0.72, Bland Altman average difference 0.21 ± 0.47 mm). Intermodality correlation was significant for 19 of 25 variables as interpreted by the surgeon (Pearson R mean of 0.72). Concordance was significant for all variables (Bland Altman average difference 0.49 ± 0.52 mm). Conclusions: Neither FBCT nor CBCT images were compared with other imaging modalities/histopathology; limited number of cases included; inconsistent agreement of small lesions in specific categories. Conclusions: Standing CBCT is a valid diagnostic modality to identify subchondral bone lesions in Thoroughbred fetlocks. This technology may provide valuable information regarding the development and progression of fetlock pathology and yield insight into predisposing factors leading to more severe pathology.
© 2020 EVJ Ltd.
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Publication Date: 2021-01-19 PubMed ID: 33368443DOI: 10.1111/evj.13414Google 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 is on the validation of standing cone beam computed tomography for diagnosing a common Thoroughbred racehorse bone pathology. The results confirm that cone beam computed tomography effectively identifies these lesions and has the potential to provide valuable information about the development and progression of such conditions in these animals.

Research Objectives

The aim of the study is twofold:

  • To assess the degree of difference between observers analyzing fetlock subchondral bone lesions on both cone beam and fan beam computed tomography (CBCT and FBCT) images.
  • To validate a robotics-controlled CBCT system for early detection of subchondral bone pathology in the fetlocks of Thoroughbred racehorses, a condition believed to be precursor to more severe injuries.

Methods

This research was conducted as a prospective cohort study using the following steps:

  • FBCT and CBCT images were taken of 25 metacarpo-/metatarsophalangeal joints of Thoroughbred racehorses.
  • The images were then analyzed for subchondral bone lesions, commonly found in Thoroughbred fetlocks, by two specialists: one in imaging and another in surgery.
  • A statistical analysis was performed using the Pearson correlation analysis and Bland-Altman equivalence test to determine the interobserver and intermodality equivalence.

Results

The results revealed:

  • A significant correlation and concordance between observers while using FBCT images and a similar finding with CBCT images.
  • All variables showed significant correlation and concordance using the FBCT versus CBCT methods as interpreted by the radiologist.
  • Intermodality correlation was significant for 19 of 25 variables as interpreted by the surgeon. Concordance was significant for all variables.

Limitations

The researchers acknowledged several limitations of the study:

  • No comparison was made with other imaging modalities or histopathology.
  • The study included a limited number of cases.
  • There was inconsistent agreement on small lesions within specific categories.

Conclusions

Based on the findings, the study concluded that standing CBCT is a valid diagnostic modality to identify subchondral bone lesions in Thoroughbred fetlocks, helping in their early detection. The technology could potentially provide invaluable insights into the development, progression, and factors predisposing to more serious pathology.

Cite This Article

APA
Curtiss AL, Ortved KF, Dallap-Schaer B, Gouzeev S, Stefanovski D, Richardson DW, Wulster KB. (2021). Validation of standing cone beam computed tomography for diagnosing subchondral fetlock pathology in the Thoroughbred racehorse. Equine Vet J, 53(3), 510-523. https://doi.org/10.1111/evj.13414

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 53
Issue: 3
Pages: 510-523

Researcher Affiliations

Curtiss, Alexandra L
  • 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.
Dallap-Schaer, Barbara
  • Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Gouzeev, Sergei
  • 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.
Richardson, Dean W
  • 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.

MeSH Terms

  • Animals
  • Cone-Beam Computed Tomography / veterinary
  • Horses
  • Joints
  • Observer Variation
  • Prospective Studies
  • Tomography, X-Ray Computed

Grant Funding

  • Tamworth Research Grant / University of Pennsylvania

References

This article includes 18 references
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Citations

This article has been cited 8 times.
  1. Johnston GCA, Ahern BJ, Palmieri C, Young AC. Imaging and Gross Pathological Appearance of Changes in the Parasagittal Grooves of Thoroughbred Racehorses. Animals (Basel) 2021 Nov 24;11(12).
    doi: 10.3390/ani11123366pubmed: 34944142google 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. Scharf A, Acutt E, Bills K, Werpy N. Magnetic resonance imaging for diagnosing and managing deep digital flexor tendinopathy in equine athletes: Insights, advances and future directions. Equine Vet J 2025 Sep;57(5):1183-1203.
    doi: 10.1111/evj.14508pubmed: 40314097google scholar: lookup
  4. Spriet M, Vandenberghe F. Equine Nuclear Medicine in 2024: Use and Value of Scintigraphy and PET in Equine Lameness Diagnosis. Animals (Basel) 2024 Aug 28;14(17).
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  6. Faulkner JE, Joostens Z, Broeckx BJG, Hauspie S, Mariën T, Vanderperren K. Follow-Up Magnetic Resonance Imaging of Sagittal Groove Disease of the Equine Proximal Phalanx Using a Classification System in 29 Non-Racing Sports Horses. Animals (Basel) 2023 Dec 21;14(1).
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