M Gerwing

Accuracy of ultrasonography in detecting fragmentation of the medial coronoid process in dogs

OBJECTIVE To determine the accuracy of ultrasonography in detecting fragmentation of the medial coronoid process (FMCP) in dogs. DESIGN Cross-sectional study. ANIMALS 102 dogs (112 elbow joints) suspected to have FMCP. PROCEDURES Elbows were examined ultrasonographically prior to surgery for evidence of fragmentation, fissuring, or deformation of the medial coronoid process; thickening of the joint capsule; joint effusion; and secondary new bone formation. Results were compared with intraoperative findings. RESULTS At surgery, 51 (46%) joints had free fragments, 55 (49%) had nondisplaced fragments, and 6 (5%) did not have any fragments or fissures. Fragments were not seen ultrasonographically in 23 of the 51 (45%) joints in which a free fragment was found during surgery or in 50 of the 55 (91%) joints in which a nondisplaced fragment was found during surgery. Accuracy of using ultrasonographic evidence of any medial coronoid process abnormality (ie, a medial coronoid process fragment, deformation of the medial coronoid process, or both) for diagnosis of medial coronoid process fragmentation was 77%. The kappa coefficient for the level of agreement between ultrasonographic (ie, any medial coronoid process abnormality) and surgical findings was -0.014, indicating that there was no agreement. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that ultrasonography was of limited diagnostic value in detecting FMCP in dogs.

Magnetic Resonance Imaging Assessment of Intra-Articular Structures in the Canine Stifle Joint after Implantation of a Titanium Tibial Plateau Levelling Osteotomy Plate

OBJECTIVES  To determine the effectiveness of magnetic resonance imaging (MRI) in the evaluation of anatomical stifle structures with respect to implant positioning after tibial plateau levelling osteotomy (TPLO) using a titanium plate. METHODS  Selected sagittal and dorsal sequences of pre- and postoperative MRI (1.0 T scanner) of 13 paired (n = 26) sound cadaveric stifle joints were evaluated. The effect of susceptibility artifact on adjacent anatomical stifle structures was graded from 0 to 5. The impact of implant positioning regarding assessment score was calculated using Spearmans rank correlation coefficient. RESULTS  Sagittal turbo spin echo (TSE)-acquired images enabled interpretation of most soft tissue, osseous and cartilage structures without detrimental effect of susceptibility artifact distortions. In T2-weighted TSE images, the cranial cruciate ligament and caudal horn of the medial meniscus could be evaluated, independent of implant position, without any susceptibility artifact in all specimens. T2-weighted fast field echo, water selective, balanced fast field echo and short tau inversion recovery were most markedly affected by susceptibility artifact. CLINICAL SIGNIFICANCE  In selected TSE sequences, MRI allows evaluation of critical intra-articular structures after titanium TPLO plate implantation. Further investigations with confirmed stifle pathologies in dogs are required, to evaluate the accuracy of MRI after TPLO in clinical cases in this context.