B-Mode Ultrasound Diagnostics of Orthopaedic Diseases in Clinical Avian Medicine: Comparative Study

Orthopaedic disorders represent a significant clinical challenge in avian medicine, affecting both pet and wild birds. B-mode ultrasound (US) examination is well established in small-animal and equine medicine; it has seen limited application in avian medicine thus far. This study aimed to assess the diagnostic efficacy of B-mode US in comparison to radiography (RX) for orthopaedic avian disorders. A total of 55 birds from six orders were assessed clinically, radiologically, and sonographically. Statistical analysis was conducted for the overall cohort (n = 55) and for a fracture subgroup (n = 51). Cohen's kappa was used to examine diagnostic agreement. Sensitivity, specificity, and positive and negative predictive values were also computed. Additionally, Fisher's exact test was employed to evaluate the representativeness and interpretability of both techniques. In the overall cohort, US demonstrated higher sensitivity (97.6%) and specificity (100%) than RX (sensitivity 70.7%, specificity 85.7%). In the fracture subgroup, US demonstrated superior sensitivity (97.3%) compared with RX (75.7%) while maintaining high specificity (100%). The agreement between imaging findings and the clinical reference standard was substantial to good (κ = 0.64 for the total cohort, p < 0.05; κ = 0.74 for the fracture subgroup, p < 0.05). No significant differences were identified between the two modalities in terms of representability and interpretability. However, these findings should be interpreted with caution, as US examinations were performed following RX assessment on a non-blinded basis, which may have introduced observational bias. Despite these limitations, B-mode US appears to provide valuable additional diagnostic information and may serve as a complementary imaging modality in the evaluation of avian orthopaedic conditions. In particular, it may be useful for assessing shoulder girdle injuries, inflammatory conditions of the shoulder joint, and fractures of the sternum and keel, as well as for monitoring bone healing following surgical or conservative treatment.