Dataset Information

Identification of Naturally Occurring Cartilage Damage in the Equine Distal Interphalangeal Joint Using Low-Field Magnetic Resonance Imaging and Magnetic Resonance Arthrography.

ABSTRACT: Objectives: To describe detectable and non-detectable naturally occurring cartilage damage of the equine distal interphalangeal (DIP) joint using plain magnetic resonance (MR) imaging and gadolinium and saline MR arthrography. The second objective was to quantify the sensitivity, specificity and accuracy in detection of cartilage damage. Methods: In a pilot study, the distal limbs of two horses with confirmed osteoarthritis of the DIP joint were imaged with low-field MR. Magnetic resonance images were assessed in consensus by three observers and compared to gross pathological findings. Subsequently, a prospective analytical cross-sectional study design was created to compare pre-contrast MR imaging and saline and gadolinium MR arthrography of isolated equine distal limbs to gross observation findings. Hallmarq® low-field MR (0.27T) scans were performed prior to DIP joint injection, saline/gadolinium post-injection scans were performed at 15 min intervals for 2 h. Joints were inspected and the articular cartilage graded subjectively for cartilage damage (0-3). The presence of detectable or non-detectable cartilage damage on MR images was identified, characterized and recorded in consensus by three observers. Sensitivity, specificity and accuracy in detection of cartilage damage related to gross pathology were calculated. Results: The two clinical cases from the pilot study with confirmed osteoarthritis had full thickness cartilage defects; however, only one of these was correctly identified using low-field MRI. In the prospective study, the majority of naturally occurring cartilage damage could not be identified on plain MR or MR arthrography including extensive partial thickness cartilage erosions. Saline and gadolinium MR arthrography did not improve the detection of cartilage damage. The accuracy of cartilage damage detection was 0.63 with a sensitivity of 0.14 and specificity of 0.92. Clinical Relevance: Both, plain low-field MRI and MR arthrography are not sensitive in detection of naturally occurring cartilage damage of the DIP joint. However, if an abnormal contour is seen in the articular cartilage, cartilage damage is likely to be present.

SUBMITTER: van Zadelhoff C

PROVIDER: S-EPMC6999043 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Identification of Naturally Occurring Cartilage Damage in the Equine Distal Interphalangeal Joint Using Low-Field Magnetic Resonance Imaging and Magnetic Resonance Arthrography.

van Zadelhoff Claudia C Schwarz Tobias T Smith Sionagh S Engerand Antoine A Taylor Sarah S

Frontiers in veterinary science 20200128

<b>Objectives:</b> To describe detectable and non-detectable naturally occurring cartilage damage of the equine distal interphalangeal (DIP) joint using plain magnetic resonance (MR) imaging and gadolinium and saline MR arthrography. The second objective was to quantify the sensitivity, specificity and accuracy in detection of cartilage damage. <b>Methods:</b> In a pilot study, the distal limbs of two horses with confirmed osteoarthritis of the DIP joint were imaged with low-field MR. Magnetic r ...[more]

PMID: 32064268

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Project description:BackgroundThis study aimed to systematically evaluate the value of magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) in the diagnosis of acetabular labral tears.MethodsDatabases including PubMed, Embase, Cochrane Library, Web of Science, CBM, CNKI, WanFang Data, and VIP were electronically searched to collect relevant studies on magnetic resonance in the diagnosis of acetabular labral tears from inception to September 1, 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias in the included studies by using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. RevMan 5.3, Meta Disc 1.4, and Stata SE 15.0 were used to investigate the diagnostic value of magnetic resonance in patients with acetabular labral tears.ResultsA total of 29 articles were included, involving 1385 participants and 1367 hips. The results of the meta-analysis showed that the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio, pooled diagnostic odds ratio, area under the curve of the summary receiver operating characteristic, and Q* of MRI for diagnosing acetabular labral tears were 0.77 (95% confidence interval [CI], 0.75-0.80), 0.74 (95% CI, 0.68-0.80), 2.19 (95% CI, 1.76-2.73), 0.48 (95% CI, 0.36-0.65), 4.86 (95% CI, 3.44-6.86), 0.75, and 0.69, respectively. The pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio, pooled diagnostic odds ratio, area under the curve of the summary receiver operating characteristic, and Q* of MRA for diagnosing acetabular labral tears were 0.87 (95% CI, 0.84-0.89), 0.64 (95% CI, 0.57-0.71), 2.23 (95% CI, 1.57-3.16), 0.21 (95% CI, 0.16-0.27), 10.47 (95% CI, 7.09-15.48), 0.89, and 0.82, respectively.ConclusionMRI has high diagnostic efficacy for acetabular labral tears, and MRA has even higher diagnostic efficacy. Due to the limited quality and quantity of the included studies, the above results should be further validated.

Project description:BackgroundThe frequency of surgical site infection (SSI) following orthopaedic implant placement in horses has been reported but not compared with respect to specific antibiotic protocols administered.ObjectivesTo determine factors associated with SSI in horses undergoing proximal interphalangeal joint (PIPJ) arthrodesis including perioperative antibiotic protocols.MethodsRecords were evaluated (2010-2019), and horses undergoing PIPJ arthrodesis were identified. Patient signalment, supervising surgeon, reason for surgery, limb, implants placed, anaesthetic time, duration casting/coaptation postoperatively, antibiotic regimen and incidence/onset SSI were recorded. Bayesian and frequentist logistic regressions were used to estimate the contribution of covariates to infection occurrence.ResultsFifty-four PIPJ arthrodeses were performed. SSI occurred in 2/54 (3.7%) on day 15,30. Arthrodesis was performed most commonly for osteoarthritis (33/54, 61.1%), fracture (11/54, 20.4%), and subluxation (5/54, 9.3%). Perioperative systemic antibiotics were administered 1-3 days (15/54, 27.8%) or > 3 days (39/54, 72.2%). Antibiotic protocols included cefazolin/gentamicin (20/54, 37%), cefazolin/gentamicin/doxycycline (14/54, 25.9%) and potassium penicillin/gentamicin (10/54, 18.5%). Regional limb perfusion was performed preoperatively 31/54 (57.4%) and postoperatively 7/54 (13%). Survival to dismissal was 98.1% (53/54 horses) with one horse euthanized due to support limb laminitis. No association was identified between antibiotic selection or duration (1-3 vs. > 3 days), pre-operative regional antibiotic perfusion, intraoperative antibiotic lavage or anaesthetic time (< or > 3 h) and SSI; however, modelling was complicated by quasi-complete or complete separation of the data. Bayesian analysis (but not frequentist analysis) indicated an association between post-operative regional antibiotic perfusion and SSI. Limitations include the retrospective nature of data collection and the low rate of infection overall.ConclusionsThe prevalence of SSI in this population was lower than that in previous reports of equine orthopaedic internal fixation. There was no difference in SSI rate in cases administered systemic antibiotics for 1-3 days or >3 days, or for those horses that did or did not receive preoperative regional antibiotic perfusion.

Dataset Information

Identification of Naturally Occurring Cartilage Damage in the Equine Distal Interphalangeal Joint Using Low-Field Magnetic Resonance Imaging and Magnetic Resonance Arthrography.

Publications

Identification of Naturally Occurring Cartilage Damage in the Equine Distal Interphalangeal Joint Using Low-Field Magnetic Resonance Imaging and Magnetic Resonance Arthrography.

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