COMPARISON BETWEEN COMPUTED TOMOGRAPHIC ARTHROGRAPHY, RADIOGRAPHY, ULTRASONOGRAPHY, AND ARTHROSCOPY FOR THE DIAGNOSIS...

Area of Science:

• Veterinary Medicine
• Equine Orthopedics
• Diagnostic Imaging

Background:

• Femorotibial joint lameness is prevalent in Western performance horses.
• Accurate diagnosis is crucial for effective treatment and prognosis.

Purpose of the Study:

• To compare the diagnostic efficacy of radiography, ultrasonography, computed tomographic arthrography (CTA), and arthroscopy for femorotibial joint abnormalities.
• To identify the most sensitive imaging modality for specific femorotibial joint structures.

Main Methods:

• Prospective study evaluating 25 stifles in 24 horses with lameness localized to the femorotibial joints.
• All four diagnostic methods (radiography, ultrasonography, CTA, arthroscopy) were performed on each stifle.
• McNemar's test was used to compare defect detection rates between modalities.

Main Results:

• Computed tomographic arthrography (CTA) detected more defects in cruciate ligaments, proximal tibia, and ligament entheses than other methods.
• Arthroscopy was most sensitive for cranial medial meniscotibial desmopathy and medial meniscal injuries.
• Arthroscopy demonstrated the highest sensitivity (96%) for detecting medial femoral condyle articular cartilage defects, with significant disagreement noted with CTA (60%).

Conclusions:

• CTA is valuable for identifying cruciate ligament and proximal tibia pathology but less reliable for medial femoral condyle cartilage defects.
• Arthroscopy remains the gold standard for evaluating femorotibial joint cartilage and meniscal injuries.
• A multimodal diagnostic approach may be necessary for comprehensive assessment of equine femorotibial joint lameness.