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Introduction
Proximal suspensory desmitis (PSD) is a common diagnosis in sporthorses. Whilst Magnetic resonance imaging (MRI) is currently considered the gold standard for assessment of the proximal suspensory ligament (PSL), Computed tomography (CT) continues to be more widely used in equine orthopaedic imaging. The objective of this study was to evaluate soft-tissue and bone window CT images of the proximo-plantar MTIII region in horses with and without PSD and to compare findings between observers.
Methods
Twenty horses with pain localized to the PSL origin and 20 horses with pathology non-related to the PSL region were included in this retrospective, blinded, controlled study. All horses underwent CT and radiographic examination. Images were reviewed by three independent observers (diplomate ECVDI, diplomate ECVS, third-year resident ECVS) who graded the severity and localization of pathological findings.
Results
CT examination identified significantly more pathology in the diseased group. Particularly scores for osseous exostosis (p=0.015) and PSL-enlargement (p=0.004) were higher in PSD horses when compared to the control group. Intra-observer agreement was overall high (82-100%) and inter-observer agreement substantial for the detection of mineralization and moderate for sclerosis, exostosis and PSL-enlargement. Measurements within soft-tissue window were significantly smaller than in bone window.
Conclusion
Pathological findings associated with PSD including osseous proliferation and sclerosis as well as soft-tissue enlargement, mineralizations and avulsion can be reliably detected using CT. Based on this study CT examination of the PSL is considered a valuable and time efficient alternative for the assessment of the PSL where MRI is not available.
33rd Annual Scientific Meeting proceedings
Stream: LA
|
Session: Orthopaedic Short Communications
Date/Time: 07-07-2023 (11:45 - 12:00) | Location: Theatre Hall
Date/Time: 07-07-2023 (11:45 - 12:00) | Location: Theatre Hall
How valuable is computed tomography for assessment of the equine proximal suspensory ligament?
Müller EMT1, Vanderperren K2, Merle R3, Rheinfeld S1, Leelamankong P1, Lischer CJ*1, Ehrle A*1
1Equine Clinic, Surgery and Radiology, Freie Universität Berlin, Berlin, Germany, 2Department of Medical Imaging of Domestic Animals and Orthopedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Ghent, Belgium, 3Institute for Veterinary Epidemiology and Biostatistics, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.
Introduction
Proximal suspensory desmitis (PSD) is a common diagnosis in sporthorses. Whilst Magnetic resonance imaging (MRI) is currently considered the gold standard for assessment of the proximal suspensory ligament (PSL), Computed tomography (CT) continues to be more widely used in equine orthopaedic imaging. The objective of this study was to evaluate soft-tissue and bone window CT images of the proximo-plantar MTIII region in horses with and without PSD and to compare findings between observers.
Methods
Twenty horses with pain localized to the PSL origin and 20 horses with pathology non-related to the PSL region were included in this retrospective, blinded, controlled study. All horses underwent CT and radiographic examination. Images were reviewed by three independent observers (diplomate ECVDI, diplomate ECVS, third-year resident ECVS) who graded the severity and localization of pathological findings.
Results
CT examination identified significantly more pathology in the diseased group. Particularly scores for osseous exostosis (p=0.015) and PSL-enlargement (p=0.004) were higher in PSD horses when compared to the control group. Intra-observer agreement was overall high (82-100%) and inter-observer agreement substantial for the detection of mineralization and moderate for sclerosis, exostosis and PSL-enlargement. Measurements within soft-tissue window were significantly smaller than in bone window.
Conclusion
Pathological findings associated with PSD including osseous proliferation and sclerosis as well as soft-tissue enlargement, mineralizations and avulsion can be reliably detected using CT. Based on this study CT examination of the PSL is considered a valuable and time efficient alternative for the assessment of the PSL where MRI is not available.
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