Ultrasonographic Evaluation of Dogs with Cranial Cruciate Ligament Rupture Undergoing to Arthrotomy

Background: The cranial cruciate ligament rupture (CrCLR) is the most common disease of the stifle joint in dogs. One of the major concerns in the assessment of these animals is diagnosing the presence of a medial meniscus tears, which is a frequent consequence due to the instability of the joint. Ultrasonography is indicated in the evaluation of the menisci from human and canine patients, and the results are similar to magnetic resonance imaging. The aim of this study was to compare the ultrasonography and the arthrotomy in the evaluation of the cranial cruciate ligament and medial meniscus of dogs with CrCLR undergoing surgery for stifle stabilization.Materials, Methods & Results: Ultrasonographic examination was performed prior to arthrotomy in 23 dogs with diagnosis of complete CrCLR and five with suspected partial CrCLR undergoing for stifle joint stabilization surgery. The ultrasonography identified the complete rupture in 82.6% and the arthrotomy in 100% of the joints with this diagnosis. In the joints with suspected CrCLR during the clinical exam, arthrotomy and ultrasonography identified respectively three and four joints with partial CrCLR, and two and one with healthy ligaments. There was no difference between the two techniques in the assessment of the cranial cruciate ligament (P = 0.20). The ultrasonography identified medial meniscal tears in 39.3%, while arthrotomy was found in 21.4% (P = 0.0006) of the joints. The most frequent meniscal tear type observed in the arthrotomy was folded caudal horn. The ultrasonography was able only in differentiate presence and absence of meniscal injury. Besides the real tear that affects the meniscus morphology, the ultrasound also identified echogenicity and echotexture changes in the medial (5/28) and lateral (8/28) menisci. Other changes observed in all joints evaluated by ultrasound were the presence of effusion and synovial membrane thickening.Discussion: The complete and almost complete CrCLR are diagnosed by clinical examination through the evaluation of instability of the stifle joint, which is not possible in partial CrCLR in stable joints. In this study of the five evaluated stable joints, the ultrasound correctly identified the partial CrCLR in three joints and the ligament integrity in one of the joints when compared to arthrotomy. In animals with stifle joint instability the meniscus assessment is fundamental as it is one of the main causes of persistent lameness in dogs subjected to conservative or surgical treatment. Ultrasonography cannot differentiate the types of meniscal tears but identified approximately 1.8 times more medial meniscus tears compared to arthrotomy. Despite the bucket handle being the most common tear of medial meniscus in dogs with CrCLR, four of the six meniscal tears identified by arthrotomy were folded caudal horn. This lesion causes cranial displacement of the caudal horn which may have facilitated its identification by minimally invasive arthrotomy, being the probable reason for its high incidence in this study. Echogenicity and echotexture changes without affecting the meniscus morphology were related with intrasubstance degeneration described in human medicine. Ultrasonography is not the better technique to assess the CrCL but can assist in identifying partial ruptures. Because it has results similar to magnetic resonance imaging, ultrasonography is an important tool in the diagnosis of meniscus tears

Utilização da ultrassonografia como método auxiliar no posicionamento de marcadores em análise de movimento de equinos

A análise cinemática do movimento é baseada na reconstrução de pontos anatômicos específicos identificados por marcadores de superfície. Esses pontos de referência geralmente não correspondem a pontos, mas a áreas relativamente grandes e curvas de difícil identificação pela palpação. A colocação precisa dos marcadores de superfície é ainda mais difícil e há grande variabilidade entre examinadores. Neste estudo 16 examinadores foram submetidos à identificação da borda lateral da tuberosidade isquiática esquerda de um cavalo usando a palpação e a ultrassonografia para colocar um marcador de superfície. Imagens de cada procedimento de marcação foram adquiridas utilizando duas câmeras de vídeo digital e processadas utilizando o sistema de videogrametria DVideow.  O software Matlab foi usado para determinar a posição dos respectivos vetores. As posições dos marcadores foram comparadas para avaliar a variabilidade entre os examinadores e a precisão do método empregado através do teste de Bartlett e teste t pareado respectivamente. A ultrassonografia melhorou significativamente a localização dos pontos anatômicos de cada examinador (p = 0,04) e reduziu a variabilidade no posicionamento dos marcadores de superfície quando comparada a palpação (p = 0,0028). A variabilidade das distâncias calculadas (média ± dp) foi de 2,89 ± 2,24 cm e 1,63 ± 0,98 cm usando a palpação e a ultrassonografia respectivamente. A ultrassonografia reduziu a variabilidade entre examinadores e permitiu a visualização do ponto anatômico correspondente.Kinematic motion analysis is based on the reconstruction of selected bony anatomical landmarks identified by surface markers. Anatomical landmarks generally do not correspond to points but rather to relatively large and curved areas and their identification by palpation is not easy. Precise placement of surface markers is even more difficult and there is great variability between operators. In this study 16 examiners were asked to identify the lateral border of the left ischial tuberosity in a horse using palpation and ultrasonography for placement of a corresponding skin surface marker. Images of each marking procedure were captured using two video cameras and processed using the DVideow videogrammetry. A custom-written Matlab code was used to determine the position of the respective vectors. The positions of the markers were then compared to assess inter-examiner variability and the precision of the methods employed using the Bartletttest and the paired t-test respectively. Ultrasonography significantly improved the location of the anatomical landmark by each examiner (p = 0.04) and reduced the variability in the position of the surface marker when compared to palpation (p = 0.0028). The variability of the calculated distances (mean ± SD) was 2.89 ± 2.24 cm and 1.63 ± 0.98 cm using palpation and ultrasonography respectively. Ultrasound guidance reduced inter-examiner variability and allowed visualization of the corresponding bony anatomical landmark

Ultrasonography as an ancillary method for the positioning of markers in equine motion analysis

Kinematic motion analysis is based on the reconstruction of selected bony anatomical landmarks identified by surface markers. Anatomical landmarks generally do not correspond to points but rather to relatively large and curved areas and their identification by palpation is not easy. Precise placement of surface markers is even more difficult and there is great variability between operators. In this study 16 examiners were asked to identify the lateral border of the left ischial tuberosity in a horse using palpation and ultrasonography for placement of a corresponding skin surface marker. Images of each marking procedure were captured using two video cameras and processed using the DVideow videogrammetry. A custom-written Matlab code was used to determine the position of the respective vectors. The positions of the markers were then compared to assess inter-examiner variability and the precision of the methods employed using the Bartletttest and the paired t-test respectively. Ultrasonography significantly improved the location of the anatomical landmark by each examiner (p = 0.04) and reduced the variability in the position of the surface marker when compared to palpation (p = 0.0028). The variability of the calculated distances (mean ± SD) was 2.89 ± 2.24 cm and 1.63 ± 0.98 cm using palpation and ultrasonography respectively. Ultrasound guidance reduced inter-examiner variability and allowed visualization of the corresponding bony anatomical landmark

The correlation between score-based protocol for equine joint assessment and subsequent arthroscopic intervention outcomes

This study aimed to grade joint abnormalities in horses submitted to therapeutic arthroscopy using score-based protocols for equine joint assessment, correlated with arthroscopic treatment outcomes and owner satisfaction. In this prospective study, we evaluated 126 joints of athletic horses referred for arthroscopy. The joints were scored according to findings of medical history and physical, radiographic, ultrasonographic and arthroscopic examination. Lameness, positive response to flexion test and decreased maximum joint flexion angle were detected in more than 50% of joints. Soft tissue swelling, sclerosis, subchondral bone osteolysis and single osteochondral fragments were the most common radiographic findings. Ultrasonographic examination revealed changes in synovial fluid volume and appearance, and subchondral bone irregularities. Increased vascularity of the synovial villi, chondral fibrillation, chondral fissures and superficial cartilage erosions were the most significant arthroscopic findings. The approaches that demonstrated greater sensitivity and correlation with treatment outcome and owner satisfaction were medical history, ultrasonographic and arthroscopic examination. The scoring protocol employed to grade joint abnormalities enabled the creation of a joint score system for the objective assessment, thus determining the most frequent findings and establishing an injury severity score for each joint.O objetivo desse estudo foi avaliar as anormalidades articulares observadas em equinos submetidos à artroscopia terapêutica, utilizando protocolos baseados em pontuações e correlacionando os resultados do tratamento cirúrgico com a satisfação do proprietário. Neste estudo prospectivo, foram avaliadas 126 articulações de cavalos atletas, encaminhados para artroscopia. As articulações foram pontuadas de acordo com os achados da anamnese e exame físico, exame radiográfico, exame ultrassonográfico e avaliação artroscópica. A claudicação, resposta positiva ao teste de flexão e diminuição do ângulo máximo de flexão articular foram detectados em mais de 50% das articulações. Aumento de volume dos tecidos moles, esclerose subcondral, osteólise subcondral e fragmentos osteocondrais únicos foram os achados radiográficos mais comuns. O exame ultrassonográfico revelou, com frequência, as alterações no volume e na aparência do líquido sinovial, além de irregularidades osteocondrais. O aumento da vascularização das vilosidades sinoviais, fibrilação condral, fissuras condrais e erosões superficiais da cartilagem foram os achados artroscópicos mais significativos. As abordagens diagnósticas que demonstraram maior sensibilidade e melhor correlação entre o resultado do tratamento e satisfação do proprietário foram história médica, exame ultrassonográfico e artroscópico. O protocolo de avaliação utilizado, baseado em um sistema de pontuação das anormalidades articulares observadas em cada exame, permitiu uma avaliação objetiva, ressaltando os achados mais frequentes e estabelecendo um escore de gravidade da lesão para cada articulação

Agenesis of the seventh cervical vertebra with spinal cord compression in a goat

A 4-year-old male goat was presented to the Hospital of Bovines and Small Ruminants, University of São Paulo - Brazil, showing fasciculation in all limbs, ataxia progressing to paralysis and opisthotonos. After determination of the vital parameters and the specific evaluation of the nervous system, sensitivity in the region corresponding to the sixth cervical vertebrae (C6) and first thoracic vertebrae (T1) was observed on palpation. Further investigation using X-ray, myelography, and ultrasound revealed the decrease of the intervertebral space between C6 and T1, the presence of spondylosis and the absence of the seventh cervical vertebra (C7), which contained only the vertebral arch and local spinous process and the compression of the spinal cord. Goat congenital malformations are underdiagnosed, therefore, requires further discussion, and studies regarding the genetic variations

Relação entre exame clínico e radiográfico no diagnóstico da osteoartrite equina

oint disease, specifically osteoarthritis, is one of the most prevalent and debilitating diseases affecting athletic horses. Despite technological advances in recent decades, clinical and radiographic examinations are still the most commonly used methods for diagnosis of equine osteoarthritis. Clinical data of 2872 horses were compiled and compared for this study, it were evaluated 146 cases of osteoarthritis and radiographies of 259 affected joints were reviewed in order to verify how far radiographic examination is consistent with the clinical examination, and to correlate the clinical changes with physical activity performed by horses. Records showed that osteoarthritis in the fetlock and pastern joints (digit) when displaying radiographic changes makes horses more prone to show lameness, compared to others who also have osteoarthritis with radiographic evidence, but in the tarsocrural joint. However, radiographic scores do not correlate the radiographic image with the presence or absence of lameness. The type of physical activity performed by the horses had no influence on the frequency of clinical signs of osteoarthritis. The horses with osteoarthritis had an average of 8.4 ± 3.9 years old and were used for ride, western and work with cattle. Among the breeds studied, those that most frequently had horses with osteoarthritis were Mangalarga Marchador, Crioulo and Quarter Horse.A doença articular, especificamente osteoartrite, é uma das afecções mais prevalentes e debilitantes que acometem os equinos atletas. Apesar dos avanços tecnológicos nas últimas décadas, os exames clínico e radiográfico ainda são os meios mais comumente utilizados para o diagnóstico da osteoartrite equina. Neste estudo foram compilados e confrontados dados clínicos de 2872 equinos. Foram avaliados 146 casos de osteoartrite e analisadas radiograficamente 259 articulações com osteoartrite, para verificar quanto o exame radiográfico é condizente com o exame físico, e relacionar alterações clínicas com a modalidade de atividade física executada pelos cavalos. Pode-se constatar que a osteoartrite interfalangeana e metacarpo/metatarso falangeana (dígito) quando exibe alterações radiográficas faz com que os cavalos sejam mais propensos a claudicar, comparativamente a outros que também apresentam osteoartrite evidenciada radiograficamente, porém na articulação do tarso. Contudo, os escores radiográficos não correlacionaram a imagem radiográfica com a presença ou não de claudicação. A modalidade de atividade física não interferiu na frequência dos sinais clínicos de osteoartrite. Os equinos que mais apresentaram osteoartrite possuíam idade média de 8,4 ± 3,9 anos e eram utilizados para romaria, provas de quarto de milha e trabalho com o gado. Dentre as raças estudadas, as que mais frequentemente apresentaram equinos com osteoartrite foram Mangalarga Marchador, Crioulo e Quarto de Milha

Ultrasonographic Evaluation of Dogs with Cranial Cruciate Ligament Rupture Undergoing to Arthrotomy

Background: The cranial cruciate ligament rupture (CrCLR) is the most common disease of the stifle joint in dogs. One of the major concerns in the assessment of these animals is diagnosing the presence of a medial meniscus tears, which is a frequent consequence due to the instability of the joint. Ultrasonography is indicated in the evaluation of the menisci from human and canine patients, and the results are similar to magnetic resonance imaging. The aim of this study was to compare the ultrasonography and the arthrotomy in the evaluation of the cranial cruciate ligament and medial meniscus of dogs with CrCLR undergoing surgery for stifle stabilization.Materials, Methods & Results: Ultrasonographic examination was performed prior to arthrotomy in 23 dogs with diagnosis of complete CrCLR and five with suspected partial CrCLR undergoing for stifle joint stabilization surgery. The ultrasonography identified the complete rupture in 82.6% and the arthrotomy in 100% of the joints with this diagnosis. In the joints with suspected CrCLR during the clinical exam, arthrotomy and ultrasonography identified respectively three and four joints with partial CrCLR, and two and one with healthy ligaments. There was no difference between the two techniques in the assessment of the cranial cruciate ligament (P = 0.20). The ultrasonography identified medial meniscal tears in 39.3%, while arthrotomy was found in 21.4% (P = 0.0006) of the joints. The most frequent meniscal tear type observed in the arthrotomy was folded caudal horn. The ultrasonography was able only in differentiate presence and absence of meniscal injury. Besides the real tear that affects the meniscus morphology, the ultrasound also identified echogenicity and echotexture changes in the medial (5/28) and lateral (8/28) menisci. Other changes observed in all joints evaluated by ultrasound were the presence of effusion and synovial membrane thickening.Discussion: The complete and almost complete CrCLR are diagnosed by clinical examination through the evaluation of instability of the stifle joint, which is not possible in partial CrCLR in stable joints. In this study of the five evaluated stable joints, the ultrasound correctly identified the partial CrCLR in three joints and the ligament integrity in one of the joints when compared to arthrotomy. In animals with stifle joint instability the meniscus assessment is fundamental as it is one of the main causes of persistent lameness in dogs subjected to conservative or surgical treatment. Ultrasonography cannot differentiate the types of meniscal tears but identified approximately 1.8 times more medial meniscus tears compared to arthrotomy. Despite the bucket handle being the most common tear of medial meniscus in dogs with CrCLR, four of the six meniscal tears identified by arthrotomy were folded caudal horn. This lesion causes cranial displacement of the caudal horn which may have facilitated its identification by minimally invasive arthrotomy, being the probable reason for its high incidence in this study. Echogenicity and echotexture changes without affecting the meniscus morphology were related with intrasubstance degeneration described in human medicine. Ultrasonography is not the better technique to assess the CrCL but can assist in identifying partial ruptures. Because it has results similar to magnetic resonance imaging, ultrasonography is an important tool in the diagnosis of meniscus tears

Development of osteochondrosis in Lusitano foals: A radiographic study

This study aimed to detect, by radiographic examination, the evolution of osteochondral lesions in the tarsocrural and femoropatellar joints of Lusitano foals. Within 1 month of age, 76.08% of foals had radiographic signs of osreochondrosis, but only 16.20% had lesions at 18 months. The radiographic signs resolved by 5 mo of age in most foals, but some cases that involved either joint, were not resolved until 12 mo of age. It is thought that the "age of no return" is 5 mo for the tarsocrural and 8 mo for the femoropatellar joint but this study demonstrated regression of osteochondral lesions in both joints of Lusitano foals up to 12 months of age.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (Fapesp)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP

Comparative study between radiology and ultrasound in the evaluation of extracardiac thoracic diseases in dogs and cats

This study compared radiographic and B-mode and Doppler ultrasound exams of the thoracic cavity, excluding the heart, in canine and feline species, in which the radiographs revealed the formation of a potential acoustic window. The objectives were to demonstrate the advantages and limitations of each technique and to determine whether the additional information influenced the differential diagnosis as well as the outcome of each case. The advantages of B-mode ultrasonography included: better qualitative and quantitative evaluation of pleural effusions, an improved ability to determine whether a nodule was solid or cystic and easier determination of the location in the pulmonary parenchyma. The Power Doppler ultrasound evaluated the blood supply pattern of the nodules and masses and differentiated between vessels and fluid bronchogram. A limitation of the ultrasound examination was the need to be guided by the previous radiography. The advantages of the radiographic examination included the possibility of localizing pulmonary lesions at any depth in the absence of a pleural effusion and providing a panoramic view of the extent of the thoracic disease. The ultrasound examination influenced the differential diagnosis in 18 (62.06%) cases and influenced the outcome of 8 (27.58%) cases.Este estudo comparou os exames radiográficos e ultrassonográficos modo-B e Doppler da cavidade torácica, excluindo o coração, em animais da espécie canina e felina, nos casos em que as radiografias torácicas revelaram formação de janela acústica em potencial. O objetivo foi demonstrar as vantagens e limitações de cada técnica e determinar se as informações adicionais influenciaram o diagnóstico diferencial, bem como no desfecho de cada caso. As vantagens do modo B incluíram: melhor avaliação qualitativa e quantitativa de efusão pleural; determinação da natureza sólida ou cística de nódulos, bem como a definição de sua localização no parênquima pulmonar. O ultrassom Doppler de Amplitude permitiu a avaliação do padrão de irrigação sanguínea de nódulos e massas e a diferenciação entre vasos e broncogramas fluidos. Uma limitação do exame de ultrassom foi a necessidade de se guiar pela radiografia prévia. As vantagens do exame radiográfico foram: possibilidade de localização de lesões pulmonares em qualquer profundidade na ausência de efusão pleural e proporcionar uma visão panorâmica do acometimento da cavidade torácica. O exame ultrassonográfico proporcionou impacto no diagnóstico diferencial de 18 (62,06%) dos casos e influiu no desfecho de 8 (27,58%)