Findings and interobserver agreement in radiography and ultrasonography of the vertebral column of a large population of normally performing horses

Diagnostic imaging is a mainstay in the investigation of equine neck and back pain, but interpretation of radiographic and ultrasonographic findings in the spinal column of horses is not straightforward for a variety of reasons including individual anatomical variations, progressive degenerative nature of most pathologies and superimposition as well as technical limits. These issues are even more relevant in the context of examinations of apparently sound horses with absent, mild or unclear complaints, like it is often the case in pre-purchase examinations or cases of failure to meet expected performance. The first aim was to report on the spectrum, degree and location of first-line imaging findings in the spine of a large population of normally performing horses. Limited data is available about agreement of interpretation of equine vertebral column imaging by radiologists. The second aim of this prospective study was to determine interobserver agreement on radiographic and ultrasonographic diagnostic imaging findings in the vertebral column of the same population between multiple observers with longstanding experience in equine diagnostic imaging at two different institutions. Seventy-one horses randomly selected from a larger population of 250 normally performing horses participating in a swiss project on equine back health were examined at one referral center. Radiographic and ultrasonographic examinations were performed in a standardized fashion and images graded separately by two experienced radiologists at two different institutions. Focus was placed on osteoarthrosis of the synovial intervertebral articulations (SIVAs), impinging and overriding of the spinous processes (SPs) and spondylosis. Cohen’s weighted kappa was calculated for each pathology, location and segment in each modality. Interobserver agreement was calculated for findings at specific locations, single pathologies and single grades. Most horses showed no changes and were allocated grades 0 at most locations. Few abnormalities were found throughout the vertebral column, with clusters of abnormalities of the SIVAs in the caudal cervical segment and cranial lumbar segment as well as a cumulation of changes at the dorsal spinous processes in the caudal thoracic segment. These coincide with previously reported predilection sites of imaging findings in symptomatic populations. Overall mean value of agreement for imaging findings was moderate (k= 0.7). Agreement was moderate for imaging findings regarding the synovial intervertebral articulations of the thoracolumbar spine in radiography (k=0.66) but weak in ultrasonography (k=0.58). There was moderate agreement in the imaging findings of the cervical spine in ultrasonography (k=0.61) as well as radiography (k=0.62). Strong agreement was found in the radiographic assessment of changes of the thoracolumbar spinous processes (k=0.80). Almost perfect agreement was found in the radiographic assessment of thoracolumbar spondylosis (k=0.95). Agreement between radiologists in detection and grading of pathologies of the equine vertebral column is weak to almost perfect depending on pathology and location. Our results confirm findings about distribution of specific pathologies found in other studies and support the importance of interpreting imaging findings along with clinical findings for definitive case management and decision making. Additional studies are needed for determination of the correlation of imaging findings among different modalities and correlation of diagnostic imaging with clinical findings

Improvement of the chondrocyte-specific phenotype upon equine bone marrow mesenchymal stem cell differentiation. Influence of TGF-ß1 or TGF-ß3, associated with BMP-2 and type I collagen siRNAs

International audienceArticular cartilage is a tissue characterized by its poor intrinsic capacity for self-repair. This tissue is frequently altered upon trauma or in osteoarthritis (OA), a degenerative disease that is currently incurable. Consequently, cartilage markers, such as type II collagen, are degraded whereas atypic molecules, such as type I collagen, are newly synthetized. Another essential phenomenon occurring in OA is the upregulation of HtrA1, a serine protease targeting upstream receptors of signalling pathways involved in the synthesis of articular cartilage markers. OA incurs considerable economic loss for the equine sector. In the view to develop new therapies for humans and horses, significant progress in tissue engineering has led to the emergence of new generations of cartilage therapy. Matrix-associated autologous chondrocyte implantation is an advanced 3D cell-based therapy that holds promise for cartilage repair. The aim of this study is to improve the autologous chondrocyte implantation strategy by enhancing the chondrogenic differentiation of mesenchymal stem cells (MSCs) in order to increase the type II collagen/ type I collagen ratio

A Ship ‘for which Great Neptune Raves’: The Sovereign of the Seas, la Couronne and Seventeenth-Century International Competition over Warship Design

Charles I’s great warship the Sovereign of the Seas is famed for its design, decoration and importance as a tool that heightened the image of English naval supremacy. By exploring its career, size, name and decoration, this article highlights the Sovereign of the Seas’ significance as a national symbol of political and cultural power. It argues that Charles’s leading warship was developed as a reaction to naval advances and current affairs in Europe. Through a diverse range of evidence including diplomatic correspondence, printed texts and artwork from both English and French institutions, as well as relating this to similar advances in the Netherlands and Sweden, the Sovereign of the Seas’ development is internationally contextualized. By comparing it with other contemporary warships, most importantly la Couronne of France, it is shown that Charles’s flagship was a product of a growing international theatre of maritime activity that was inspired by cultural and political competition, as much as it was by military escalation

Carpal Tunnel Syndrome: A Review of the Recent Literature

Carpal Tunnel Syndrome (CTS) remains a puzzling and disabling condition present in 3.8% of the general population. CTS is the most well-known and frequent form of median nerve entrapment, and accounts for 90% of all entrapment neuropathies. This review aims to provide an overview of this common condition, with an emphasis on the pathophysiology involved in CTS. The clinical presentation and risk factors associated with CTS are discussed in this paper. Also, the various methods of diagnosis are explored; including nerve conduction studies, ultrasound, and magnetic resonance imaging