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Gastric adenocarcinomas have been sporadically reported in camelids. This report describes a primary gastric adenocarcinoma and subsequent peritoneal carcinomatosis in a 20-year-old female Bactrian camel (Camelus bactrianus). Numerous metastases were present throughout the omentum, liver, abdominal lymph nodes, intestinal serosa, kidneys and lungs. The primary tumour macroscopically resembled an ulcerated crater and originated from the distal four-fifths of the C3 compartment, an anatomical region with naturally prominent gastric rugae and true glands. Moderate numbers of Helicobacter spp colonies were present within gastric pits and necrotic areas of C3. Ménetrier's disease has previously been implicated as a predisposing condition for the development of gastric adenocarcinoma in another camel, but no evidence of this premalignant disorder was found in this case. This camel also suffered from a chronic skin wound of the hump and severe degenerative joint disease of the xiphisternum, the latter of which was presumably associated with excessive pressure on the sternum., Competing Interests: Declaration of competing interests The authors declared no conflicts of interest in relation to the research, authorship or publication of this article., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective:  The aim of this study was to determine if variations in Hounsfield units (HU) are present within the elbow between asymptomatic dogs of two breeds of dogs susceptible to elbow dysplasia., Study Design:  Guide Dogs and Border Collies that presented for routine computed tomography (CT) screening for elbow dysplasia prior to breeding were evaluated. All dogs had no documented history of lameness. Dogs diagnosed with CT as being free of elbow dysplasia were included. The CT images were randomized and assessed by three blinded observers. A standardised approach to CT image reconstruction to create consistent image planes was used. Hounsfield units were measured within a standardised region of interest (ROI) at the humeral trochlea and medial coronoid process. The minimum, mean and maximum HU within each ROI was recorded., Results:  Eighty-six elbows were included in the study with 32 Guide Dogs, and 11 Border Collies. Guide Dogs had significantly higher minimum (99.75 HU, 95% confidence interval [CI]: 15.02-184.48, p  = 0.022), mean (115.09 HU, 95% CI: 80.53-149.64, p  < 0.01) and maximum (74.00 HU, 95% CI: 44.58-103.42, p  < 0.01) difference in HU within the medial coronoid process ROI, and significantly higher mean (146.49 HU, 95% CI: 100.12-192.87, p  < 0.01) and maximum (147.77 HU, 95% CI: 102.57-192.97, p  < 0.01) difference in HU within the humeral trochlea ROI., Conclusion:  In this dataset breed variations in elbow HU were present between asymptomatic Guide Dogs and Border Collies. This needs to be considered in breeding screening programmes to avoid over-interpretation of elbow sclerosis, in the absence of elbow pathology., Competing Interests: None declared., (Thieme. All rights reserved.)

Background: Equine joint disease including septic arthritis (SA) and osteoarthritis (OA) is a critical cause of equine lameness. Platelet-rich plasma (PRP) is one of the most popular regenerative therapies to treat equine OA, even SA, but the evidence in support of the treatment is conflicting., Objectives: The aim of the study was to systematically review the current evidence on PRP products used for SA and OA, as well as the efficacy of PRP products as treatment for OA on the basis of a meta-analysis of the available literature., Study Design: Systematic review and meta-analysis., Methods: A systematic search of relevant databases (PubMed, Web of Science, Scopus) was performed to identify studies published from 2013 to 2023, in accordance with the PRISMA guidelines. Randomised controlled trials, non-randomised trials and controlled laboratory studies that used at least one type of PRP products were included. Dichotomous outcomes were presented using odds ratios (ORs) and 95% confidence intervals (95% CIs)., Results: A total of 21 publications were identified in the systematic review and 5 of them in the meta-analysis. These publications involved various types of PRP products and reported different outcomes. Although most of the studies were associated with a high risk of bias, the overall estimated effect was consistent with a significant improvement in the PRP products treatment group compared with the control group (OR: 15.32; 95% CI: 3.00-78.15; p < 0.05). There was a significant improvement in clinical performance outcomes between the groups (OR: 36.64; 95% CI: 3.69-364.30; p < 0.05)., Conclusion: PRP products as intra-articular treatment are likely efficacious for treatment of equine OA and have potential for treating SA. These conclusions might be affected by the limited number of randomised controlled studies and high variability of different types of PRP products. To better evaluate the efficacy of PRP, a widely recognised classification system and the utilisation of randomised, blinded, equivalency or non-inferiority trials are required., (© 2024 EVJ Ltd.)

Objective: To provide a video tutorial on ultrasound-guided arthrocentesis and injection of the canine hip and shoulder joints., Animals: Dogs undergoing arthrocentesis or intra-articular injection for diagnostic or therapeutic purposes., Methods: The target joint is visualized in long axis with a 70% isopropyl alcohol medium and linear array probe with a frequency range of 2 to 14 MHz and footprint of 50 mm after clipping a window and preparing the region sterilely. The needle is inserted, bevel up, in long axis with the probe angled at the appropriate trajectory to enter the joint space. The needle is advanced until the tip is visualized entering the joint. Aspiration to obtain synovial fluid can further confirm needle placement or provide diagnostic sampling prior to injection. The aspirate syringe is exchanged for that containing the therapeutic agent, and injectate can then be visualized entering and/or expanding the joint upon injection., Results: Ultrasound-guided arthrocentesis will help identify deep appendicular joints (hip and shoulder), avoid surrounding vasculature, confirm needle placement, and target joint fluid pocketing. Needle guidance into a joint can reduce iatrogenic tissue damage from inappropriate needle placement and/or by minimizing attempts., Clinical Relevance: For arthrocentesis, ultrasound guidance can maximize joint fluid volume acquisition for diagnostic purposes (cytology, culture, and fluid analysis) while also avoiding blood contamination. For joint injections, ultrasound will help ensure real-time intra-articular delivery of the injectate (regardless of attaining synovial fluid feedback) to maximize the therapeutic effect. For either purpose, iatrogenic tissue damage and procedure time are minimized.

Degenerative bone lesions are rarely described in reptiles and belong mainly to the broad spectrum of metabolic bone diseases. Here we describe a 7-y-old female central bearded dragon ( Pogona vitticeps ) with a complex unilateral neoplastic lesion in the hip joint. The animal was presented because of severe progressive swelling of the left hindlimb, apathy, and weight loss. The swelling was soft and surrounded the left femur. Full-body radiographs were performed in 2 orthogonal projections. The main radiologic findings were severe soft tissue swelling centered on the proximal third of the left femur and an absent left femoral head. The caretaker elected euthanasia, and a postmortem examination was performed, followed by subsequent histologic examination. The swelling consisted of variably sized myxomatous proliferations and cysts that invaded the femoral bone. Furthermore, several long bones had lesions consistent with metabolic bone and degenerative joint diseases. Synovial myxomas are rare lesions of the joints that have, to our knowledge, not been described previously in reptiles., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: To establish the pharmacokinetics of the cyclin-dependent kinase-9 inhibitor flavopiridol in equine middle carpal joints, using an extended-release poly lactic-co-glycolic acid (PLGA) microparticle formulation., Animals: 4 healthy horses without evidence of forelimb lameness., Methods: A 6-week longitudinal pharmacokinetic study was conducted in 2 phases (6 weeks each) in 4 healthy horses. The PLGA microparticles containing 122 μg flavopiridol in 3 mL saline were administered by intra-articular injection into 1 middle carpal joint, with empty PLGA microparticles injected into the contralateral joint as a control. Synovial fluid and plasma were collected at time points out to 6 weeks, and drug concentrations in synovial fluid and plasma were determined using validated protocols. Synovial fluid total protein and total nucleated cell count and differential, CBC, serum biochemistry, and lameness exams were performed at each of the time points., Results: Synovial fluid flavopiridol averaged 19 nM at week 1, gradually reduced to 1.4 nM by 4 weeks, and was generally below the detection limit at 5 and 6 weeks. There was no detectable flavopiridol in the plasma samples, and no adverse effects were observed at any time point., Clinical Relevance: Intra-articular injection of PLGA microparticle-encapsulated flavopiridol was well tolerated in horses, with detectable levels of flavopiridol in the synovial fluid out to 4 weeks with negligible systemic exposure. Flavopiridol is a cyclin-dependent kinase-9 inhibitor with potent anti-inflammatory and analgesic activity. The extended-release microparticle formulation promotes intra-articular retention of the drug and it may be an alternative to other intra-articular medications for treatment of equine joint disease.

Sacroiliac dysfunction (SID) is a condition seen in horses associated with poor performance that affects hind limb gait and impulsion. The condition comprises pain and dysfunction but there lacks clarity around the aetiopathogenesis and whether SID encompasses abnormal joint pathology, abnormal joint movement, abnormal regional biomechanical function, joint laxity and pain, or various combinations of these that may vary over time. Clinical assessment remains challenging for equine clinicians due to the deep location of the sacroiliac joint (SIJ) and surrounding structures which limits access for palpation, diagnostic imaging and joint-specific injection. There is no recognised single reference standard diagnostic test for SID. Clinical diagnosis has been based on ruling out other causes of hind limb lameness, along with combinations of ultrasonography, scintigraphy and periarticular anaesthesia of the SIJ. Recent studies have highlighted the lack of specificity of injections targeting the SIJ, with significant dispersal of injectate into surrounding structures including around the lumbosacral joint (LSJ). Advanced imaging modalities such as computed tomography offers promise for assessment of the structure and pathology of the SIJ and surrounding bony structures. However, there is a need to improve the understanding of the significance of anatomic variation of the sacroiliac region structures, with recent studies reporting detailed anatomic variation in groups of horses with and without SID. There are also limitations around functional assessment of the joint which is still largely reliant on a thorough clinical examination. This review aims to present an update on clinical approaches to the diagnosis of horses with SID, and to consider the challenges and limitations., Competing Interests: Conflict of interest statement None of the authors of this paper has a financial or personal relationship with other people or organisations that could inappropriately influence or bias the content of the paper., (Copyright © 2024. Published by Elsevier Ltd.)

Objective: To describe the prevalence of elbow dysplasia (ED) in 13 dog breeds in France., Animals: A total of 18,870 elbow radiographs taken from 2002 to 2022 were evaluated by 2 independent examiners., Methods: For each breed, the incidence of each of the 4 International Elbow Working Group scoring classes was extracted from the database. Breeds were excluded if fewer than 150 radiographs had been read for that breed., Results: This study included 17,861 records for 13 dog breeds: American Akita, Alaskan Malamute, Old German Shepherd (Altdeutscher Schäferhund), American Staffordshire Terrier, Australian Shepherd, Belgian Shepherd, White Swiss Shepherd, Bernese Mountain Dog, Cane Corso, Czechoslovakian Wolfdog, Rhodesian Ridgeback, Rottweiler, and Dogue de Bordeaux. The overall prevalence of ED was 11.4%, ranging from 1.1% in the Czechoslovakian Wolfdog to 32.2% in the Dogue de Bordeaux. The Dogue de Bordeaux, Rottweiler, Bernese Mountain Dog, and Cane Corso breeds were most commonly affected by ED. The prevalence of ED was significantly higher in male dogs than in female dogs (17.5% vs 10.5%, P < .05). Joint incongruity and fragmented coronoid process were the 2 most common primary ED lesions identified. The prevalence of ED among the dogs evaluated decreased over the timeframe of the study., Clinical Relevance: The results of this study help to clarify the prevalence of ED in different breeds in France. These data should be interpreted with caution as this study included a small percentage of the total number of dogs born for each breed in France over the study period.

Objective:  The aim of this study was to assess the outcome of arthroscopic subtotal coronoidectomy in treating medial coronoid disease and the effect of concurrent autologous conditioned plasma (ACP) in dogs using force plate analysis., Study Design:  This study included 16 dogs with unilateral medial coronoid disease based on computed tomographic imaging. Treatment consisted of an arthroscopic subtotal coronoidectomy. As concurrent therapy, eight dogs received ACP at the end of the arthroscopy and eight dogs a placebo. Force plate analysis, including vertical forces, braking and propulsive forces, corresponding impulses and symmetry indices, was performed prior to arthroscopy and at 4, 12 and 26 weeks postoperatively., Results:  After an initial reduction of all force plate analysis parameters, vertical and propulsive parameters gradually improved to the level of healthy dogs at 26 weeks postoperatively. In contrast, braking parameters did not reach normal values at 26 weeks, demonstrating ongoing loss of elbow joint function. The ACP and placebo group did not show any significant difference in force plate analysis parameters during the 26 weeks study period., Conclusion:  Arthroscopic subtotal coronoidectomy did not result in complete normalization of ground reaction forces, impulses and symmetry indices. Concurrent treatment with ACP, immediately after arthroscopy, did not improve outcome. Our results show that outcome of arthroscopic subtotal coronoidectomy in treating medial coronoid disease is less favourable than previously reported., Competing Interests: None declared., (Thieme. All rights reserved.)

Objective: To investigate whether subchondral bone cysts (SBCs) were present in dogs with radiographic elbow osteoarthritis (OA) and to investigate their relationship with radiographic OA severity., Study Design: Retrospective cross-sectional study., Sample Population: Thirty-eight Labrador retrievers (total of 76 elbows)., Methods: Elbow computed tomography (CT) images of 18 young (≤2 years old) and 20 old (>2 years old) Labrador retrievers, which presented for elbow-associated lameness, were reviewed. Radiographic elbow OA was graded into four groups based on the largest osteophyte size on CT. The presence, number, and maximum diameter of SBCs were determined., Results: Subchondral bone cysts were only identified in elbows with osteophytic new bone formation. The number and size of SBCs were associated with radiographic OA severity (p < .001 and p = .041 respectively). Specifically, the rate at which SBCs were present increased for both moderate and severe OA in comparison with the mild OA (moderate OA RR = 2.46, 95% CI 2.08-2.92, p < .001; severe OA RR = 5.60, 95% CI 4.79-6.55, p < .001). For dogs with severe OA, there was an increased likelihood that their SBCs were larger than SBCs from dogs with mild OA (OR = 1.056, 95% CI 1.012-1.101, p = .012). No SBCs were observed in elbows without radiographic evidence of OA., Conclusion: Subchondral bone cysts were identified as a feature of radiographic elbow osteoarthritis in Labrador retrievers, and their number and size were indicative of the presence and severity of radiographic elbow OA., Clinical Significance: Subchondral bone cysts are a potential imaging biomarker for quantitative assessment for canine OA., (© 2023 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.)

Medial coronoid disease (MCD) is a common disease often associated with thoracic limb lameness in medium- and large-breed dogs. The term MCD includes subchondral changes of the medial coronoid process (MCP), as well as pathologies of both cartilaginous surfaces. As there are only a few comprehensive and detailed studies on the trabecular structure of the medial coronoid, the goal of this study was to compare the trabecular structure of the ulnar trochlear notch of canine cadavers with and without MCD using different micro-computed tomographic (micro-CT) parameters. Fifty-eight elbow joints from 29 canine cadavers of MCD-predisposed and non-predisposed breeds (control group) were examined radiographically, macroscopically and by microcomputed tomography. The study included elbow joints of eight Labrador Retrievers (21.6-37 kg), seven Golden Retrievers (26.3-42 kg), seven Bernese Mountain dogs (31-47 kg) and seven dogs of non-predisposed breeds (19.7-52 kg) (control group). The final diagnosis of MCD was based on necropsy and micro-computed tomographic examinations. Micro-CT examinations were performed using XtremeCT II (Scanco Medical, Zurich, Switzerland) and the following parameters were examined: bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), trabecular number (Tb.N), connectivity density (Conn.D) and degree of anisotropy (DA). Twenty-four elbows of 44 elbows of the predisposed breeds (Labrador Retrievers, Golden Retrievers Bernese Mountain dogs) showed subchondral changes and lesions of the cartilage surfaces. The result of this study is a higher density (BV/TV) of the trabecular bone of the ulnar trochlear notch in elbows affected by MCD compared to the control group. The increased density due to trabecular reconstruction in the ulnar trochlear notch is likely the result of selectively increased loading during life., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest related to this report. The research was not financially supported. The experiment was approved by the Animal Ethics Committee of the Faculty of Veterinary Medicine, Ludwig-Maximilians-University, Munich, Germany. Material preparation, data collection and analysis were performed by Tim Glück, Yury Zablotski and Andrea Meyer-Lindenberg. All authors read and approved the final manuscript., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Elbow dysplasia (ED) is an important cause of lameness in dogs. This study aimed to report long-term outcomes in dogs with elbow osteoarthritis., Methods: Demographic data, medical management, and scores from The American College of Veterinary Surgeons' Canine Orthopaedic Index (COI) were collected from owners of dogs radiographically screened for ED, graded as normal, mild, or moderate. Telephone interviews were performed in 2017 (Q1), followed by an email survey in 2020 (Q2). The association between ED grade and deterioration in COI scores over time was evaluated with logistic regression., Results: A total of 765 replies were collected for Q1 and 293 for Q2. At Q2, 222 dogs (76%) were alive, with a median age of 8 years (range 5-12 years). No association was found between ED and changes in COI score over time or between ED and survival (p = 0.071). Dogs with mild and moderate ED were treated with analgesic medications to a higher degree than dogs without ED (p < 0.05)., Limitations: Only owner-assed data were assessed; no clinical orthopaedic examination or follow-up radiographic evaluation was performed., Conclusions: No association was found between the grade of ED and the worsening of clinical signs in dogs with elbow osteoarthritis., (© 2023 The Authors. Veterinary Record published by John Wiley & Sons Ltd on behalf of British Veterinary Association.)

Mobility impairments associated with musculoskeletal diseases, such as osteoarthritis and degenerative joint disease, affect approximately 200,000 dogs annually and pose a notable challenge to canine health and welfare. Osteoarthritis causes the remodelling of synovial joints, alongside inflammation and impaired mechanical function which can be extremely debilitating. Secondary osteoarthritis commonly affects dogs and can be exacerbated by previous joint abnormalities, such as patellar luxation or cranial cruciate ligament rupture. Although musculoskeletal diseases can affect dogs of any age, the early subtle signs of gait abnormalities are perhaps missed by owners, thus, dogs may be in the latter stages of osteoarthritis progression when they are presented to veterinarians. Dogs showing subtle signs of gait abnormalities must be presented to veterinary practices for acute diagnosis to prevent long-term deterioration. Musculoskeletal diseases, such as osteoarthritis and degenerative joint disease, are commonly diagnosed via visible radiographic changes. However, veterinarians can use a combination of subjective and objective clinical scoring systems, such as clinical metrology instruments and gait assessment in conjunction with radiography to aid their diagnosis and longitudinal monitoring of musculoskeletal diseases. These scoring systems may be more sensitive to earlier signs of mobility impairments in dogs, ultimately, promoting increased canine health and welfare by enabling pain reduction, improvement of muscle strength and preservation of joint function. Current canine mobility scoring systems available to veterinarians will be discussed in turn throughout this review for implementation into clinical practice., (© 2023 The Authors. Journal of Small Animal Practice published by John Wiley & Sons Ltd on behalf of British Small Animal Veterinary Association.)

Orthopedic diseases are complex traits, meaning genetics and environmental factors affect risk, making identification of genetic associations difficult. In the United States, hip and elbow scores, patellar luxation scores, Legg-Calvé-Perthes disease, and shoulder osteochondrosis affectedness are available in the Orthopedic Foundation for Animals registry. Distraction indices and extended, ventrodorsal hip conformation scores are recorded by PennHIP. Application of estimated breeding values for hip and elbow dysplasia in breeder selection reduces the severity and prevalence of these traits. Genomic prediction and whole-genome sequence technologies and methods should improve knowledge of genetics underlying orthopedic diseases, leading to improved canine orthopedic genetic quality., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Intra-articular (IA) corticosteroids are regularly used in equine athletes for the control of joint inflammation., Objectives: The goal of this study was to use an acute synovitis inflammation model to determine the residual effects of IA betamethasone and triamcinolone acetonide on various inflammatory parameters and lameness., Study Design: Crossover randomised trial., Methods: Five mixed-breed, 2-year-old horses were randomly allocated to an IA treatment of the radiocarpal joint with 9 mg of either betamethasone or triamcinolone acetonide. Two weeks following treatment, horses were injected with 1 μg of lipopolysaccharide (LPS) diluted in 1 ml of saline. Following LPS injection, horses were crossed-over and both sets of injections were repeated after a washout period. Blood samples were collected at multiple time points for mRNA analysis, as well as serum amyloid A (SAA) and cortisol determination. At each time point, lameness was also subjectively scored. Additional injections with saline-only or LPS-only (twice) were conducted as negative and positive controls, respectively. Two-way repeated measures analysis of variance was used to analyse all data., Results: Corticosteroid-only treatments result in significant mRNA expression differences, as well as significant and prolonged cortisol suppression. Following LPS injection, there was a residual treatment effect with triamcinolone evidenced by a significant treatment effect on IL-6 and PTGS1 (cyclooxygenase-1), lameness, SAA and cortisol concentrations, while only IL-6 expression was affected by betamethasone., Main Limitations: The acute synovitis model used here results in significant inflammation and is not representative of the low-grade inflammation seen with typical joint disease and residual anti-inflammatory effects may be more profound in naturally occurring joint disease., Conclusions: Current regulatory guidelines may be insufficient if the concern is residual anti-inflammatory effects. Additionally, intra-articular corticosteroid administration is not without risk, as evidenced by a significant suppression of serum cortisol concentration and, as such, the benefits of their administration should be weighed against those risks., (© 2022 EVJ Ltd.)

Objective:  The aim of this study was to determine the factors related to functional patella alta, with which the proximodistal patellar position exceeds the reference range of healthy small dogs proximally when the stifle is at full extension., Study Design:  Mediolateral-view radiographs of dogs weighing less than 15 kg were obtained and classified into the medial patellar luxation (MPL) and control groups. The reference range of the proximodistal patellar position was determined from the control group. In both groups, a patellar position exceeding this reference range proximally was considered functional patella alta. Multiple logistic regression analysis was performed to examine the factors related to functional patella alta. A receiver operating characteristic (ROC) curve was made for each factor., Results:  Overall, radiographs of 127 stifles of 75 dogs were obtained. Eleven stifles in the MPL group and one stifle in the control group were determined to be functional patella alta. The factors associated with functional patella alta included a greater full extension angle of the stifle joint, longer patellar ligament, and shorter femoral trochlear length. The full extension angle of the stifle joint had the biggest area under the ROC curve., Conclusion:  Mediolateral radiographs of the stifle joint in full extension are clinically important in dogs with MPL because some dogs might have a proximally positioned patella that is recognizable only when the stifles are extended., Competing Interests: None declared., (Thieme. All rights reserved.)

Objectives: The aim of this blinded, nested case-control study was to compare cats with and without early owner-reported mobility changes using subjective and objective outcome measures (owner-completed questionnaires, orthopaedic examination)., Methods: A total of 57 cats with and without early owner-reported signs of impaired mobility were allocated to the case (n = 30) and control (n = 27) groups, respectively. Participating owners completed one inclusion and two pre-visit questionnaires (Feline Musculoskeletal Pain Index, VetMetrica). Cats were then visited in their own homes, where they underwent an orthopaedic examination, an assessment of their body condition score and temperament, and the placement of an accelerometer on their collar for 2 weeks., Results: There was no significant difference between groups for age category, breed, sex, temperament and body condition score. Case cats scored significantly lower for the Feline Musculoskeletal Pain Index ( P  = 0.003) and the VetMetrica domain of Comfort ( P  = 0.002), but not Vitality ( P  = 0.009) or Emotional Wellbeing ( P  = 0.018). Total pain ( P <0.0001), crepitus ( P  = 0.002) and thickening ( P  = 0.003) scores were higher in case cats, as was the presence of bilateral disease ( P  = 0.005, odds ratio 14) and the number of bilaterally affected joints ( P  = 0.001)., Conclusions and Relevance: Both the Feline Musculoskeletal Pain Index and orthopaedic examination were able to differentiate cats with early owner-reported signs of impaired mobility from healthy cats. VetMetrica Comfort domain scores indicated a compromised quality of life for cats with early owner-reported signs of impaired mobility compared with healthy cats. Being able to recognise signs of mobility impairment earlier would allow interventions aimed at slowing disease progression, thereby improving feline health and welfare.

Case History: Dogs (n = 15) that were presented to a single veterinary teaching hospital with elbow dysplasia-associated lameness between September 2021 and May 2022, and were determined to require arthroscopy based on imaging results, were prospectively recruited into the study. The median duration of lameness was 4 (min 1, max 24) months., Clinical Findings: Various breeds were represented with a median body weight of 31.6 (min 15, max 46.4) kg and median age at presentation of 14 (min 8, max 83) months. Results of imaging modalities (CT) were consistent with medial coronoid disease with fissured or fragmented medial coronoid process in all dogs., Arthroscopic Findings: Feasibility of the needle arthroscopy (NA) procedure was firstly assessed in a preliminary cadaveric study in forelimbs (n = 10) collected from 10 adult dogs euthanised for reasons unrelated to the study. Elbow exploration was performed through a medial approach beginning with NA (1.9 mm 0° angle scope) followed by standard arthroscopy (SA; 2.4 mm 30° angle scope). The quality and extent of visualisation (scored through the number of anatomical structures visualised) were recorded and statistically compared. As the cadaver study indicated that NA allowed safe inspection of all structures in medial/caudal compartments, this procedure was then used in the dogs requiring treatment. In the clinical setting, elbow exploration was successful in all dogs and the treatment (removal of osteochondral fragments) was performed without requiring conversion into SA. One month after surgery, all dogs had an improvement in their lameness score (0-5) and 12/15 dogs were no longer lame. There was a reduction in Canine Orthopaedic Index scores measured a median of 99 (min 47, max 180) days after surgery (24 (IQR 19.5-31.5)) compared to the pre-operative period (49 (IQR 46.5-57); p < 0.001)., Clinical Relevance: Needle arthroscopy-assisted removal of osteochondral fragments was performed in all dogs with satisfactory short-term clinical outcome. NA is a feasible technique for diagnosis and lesion assessment in dogs with a fissured or fragmented coronoid process. Larger clinical studies with longer follow-up are necessary to validate the NanoScope operative arthroscopy system as an alternative strategy to SA for video-assisted treatment of medial coronoid disease.

Objective:  The objective of this prospective study was to evaluate the use of ultrasonography in the diagnosis of medial coronoid process disease in unclear cases., Study Design:  Fifteen elbows (on thirteen dogs) for which radiography and computed tomography did not lead to a clear diagnosis of medial coronoid process disease were included. On each elbow, ultrasonography was performed with a high frequency linear transducer (12-18Hz). Then, arthroscopic examination of the joint was performed by a surgeon who was unaware of ultrasonographic findings to confirm medial coronoid process disease., Results:  At least one ultrasonographic lesion was detected in 13 out of 15 elbows. The main reported ultrasonographic lesions were joint effusion (10/15 elbows) and an abnormal shape of the medial coronoid process (irregular, ill-defined or fragmented) (9/15)., Conclusion:  Ultrasonography can be a helpful additional diagnostic tool to confirm medial coronoid process disease of the elbow joint before performing arthroscopy in unclear cases. Further studies will be needed to evaluate the use of higher frequency transducers and determine if it could improve the diagnostic value of ultrasonography., Competing Interests: None declared., (Thieme. All rights reserved.)

Objective: To describe type and distribution of tarsal collateral ligament (CL) injuries and to assess the long-term outcome in horses treated conservatively., Animals: 78 horses (median age, 7 years [IQR, 4 to 9.75 years]) of different breeds and disciplines., Procedures: Retrospective analysis (2000 through 2020) of horses with tarsal CL lesions diagnosed on ultrasound. The resting time, ability to return to work, and performance level after the injury were compared between horses having a single ligament (group S) or multiple ligaments (group M) affected and according to the case severity., Results: Most of the horses (57/78) presented a single CL injury, while 21 had multiple CLs affected simultaneously, for a total of 108 CLs injured and 111 lesions. In both groups, the short lateral CL (SLCL) was the most commonly affected (44/108), followed by the long medial CL (LMCL; 27/108). Enthesopathies (72.1%) were more frequent than desmopathies alone (27.9%) and involved mostly the proximal insertion of the SLCL and the distal attachment of the LMCL. Conservative treatment (n = 62) consisted mainly of stall rest. The median resting time (120 days [IQR, 60 to 180 days]) did not significantly differ between the 2 groups (group S vs M) or according to the severity. Most horses (50/62) were able to return to work within 6 months. Horses that did not return (12/62) were more likely to have severe lesions (P = .01). Thirty-eight horses were able to perform at a level equal to or higher than before the injury., Clinical Relevance: This study highlights the importance of thorough ultrasound assessment of tarsal CL injuries and demonstrates that conservative management is a viable option to allow these horses to return to previous performance level.

Objectives: The purpose of this study was to compare the radiographic and computed tomographic (CT) findings of dogs with diagnosed bilateral medial coronoid disease, which showed clinically only unilateral lameness of the forelimbs., Materials and Methods: Medical records, including radiographs and CT images of dogs with diagnosed bilateral MCD showing only a unilateral forelimb lameness clinically were reviewed retrospectively. Depending on the gait of each dog we established two groups to investigate their radiographs and CT data comparatively. Group I: affected non-lame limb. Group II: affected lame limb. Several evaluation systems were used to assess which factors are important for clinical decision making and a patient tailored therapeutic plan., Results: Data from 84 affected elbow joints (42 dogs) diagnosed with MCD by computed tomography were included. Both the radiological and the CT analysis showed that there are significant differences between Groups I and II. Group I had a lower modified International Elbow Working Group Score (IEWG), the values of the Trochlear notch sclerosis were only slightly deviated, and this group showed less often a dislocation of the fragment compared to group II. Furthermore, the size of the fragment (both the median and the mean value) of the forelimbs from group II was almost twice as big as the one from group I. The following sizes of the fragments were calculated (group I versus (vs.) group II)-median: 0.09 cm2 vs. 0.16 cm2, mean value: 0.112 cm2 vs. 0.202 cm2. It could be shown that a larger fragment is more likely to dislocate than a smaller one., Clinical Significance: This study provides some evidence towards a better understanding of which diagnostic parameters and findings might be important in clinical decision making. Nevertheless, a "decision tree" for the correct therapy of MCD could not be determined in this study., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Seidler et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Concurrent osteoarthritis is generally present in the stifle joints of dogs with cranial cruciate ligament disease (CCLD), but it is not known if the degree of osteoarthritis-related changes affects the prognosis. Development of osteophytes is a key radiographic feature of osteoarthritis. The aim of this study was to evaluate the association between the degree of osteophyte formation seen on radiographs and CCLD-related euthanasia in dogs with CCLD., Methods: A retrospective cohort study including 226 dogs treated for CCLD at two university animal hospitals was performed. Clinical and follow-up information was retrieved, and stifle radiographs taken during the 31 days before treatment for the CCLD were graded for osteophyte formation by three veterinary radiologists. A multivariable Cox proportional hazards model was applied to assess the association between the degree of osteophyte formation and CCLD-related euthanasia., Results: An association between the degree of osteophyte formation and CCLD-related euthanasia was found, with increased osteophyte formation associated with an increased hazard of CCLD-related euthanasia (hazard ratio 1.06, 95% confidence interval 1.01-1.11, p = 0.01)., Limitations: No clinical assessment of the outcome was performed., Conclusion: The findings suggest that evaluation of stifle radiographs for osteophyte formation could provide useful prognostic information for dogs with CCLD., (© 2022 The Authors. Veterinary Record published by John Wiley & Sons Ltd on behalf of British Veterinary Association.)

Objectives: The aim of this study was to compare the approximate center of rotation in normal and diseased elbows in dogs., Study Design: Cross-sectional study SAMPLE POPULATION: Computer tomography scans of nine dogs with unilateral fragmented medial coronoid process (FMCP)., Methods: A board certified radiologist confirmed that each dog had unilateral FMCP, and a normal contralateral elbow. Digital 3D models of all elbow joints were uploaded into a surgical planning software package. Four axes approximating the center of rotation (COR) of elbow joints were generated using five geometric shapes based on subchondral topography of the humeral condyle radius and ulna. Images showing the locations where axes exited the medial and lateral cortex of the humeral condyle were captured and imported into a second software package, for measurement of distances between exit points and the origin of a system of axes., Results: In normal joints 20/27 (74%) axes exited the medial cortex, and 25/27 (93%) axes exited the lateral cortex cranial and distal to the medial and lateral epicondyles, respectively. In diseased joints 22/27 (81%) axes exited medial cortex and 19/27 (70%) axes exited the lateral cortex, caudal and distal to the medial and lateral epicondyles, respectively., Conclusion: Based on CT- derived geometry, the COR of elbow affected with FMCP was generally more caudal than normal., Clinical Significance: External landmarks approximating the location of the elbow COR are provided, and while not validated, may assist in planning, creation, and assessment of procedures for FMCP., (© 2022 American College of Veterinary Surgeons.)

In this retrospective, analytical study, we developed a deep learning-based diagnostic model that can be applied to canine stifle joint diseases and compared its accuracy with that achieved by veterinarians to verify its potential as a reliable diagnostic method. A total of 2382 radiographs of the canine stifle joint from cooperative animal hospitals were included in a dataset. Stifle joint regions were extracted from the original images using the faster region-based convolutional neural network (R-CNN) model, and the object detection accuracy was evaluated. Four radiographic findings: patellar deviation, drawer sign, osteophyte formation, and joint effusion, were observed in the stifle joint and used to train a residual network (ResNet) classification model. Implant and growth plate groups were analyzed to compare the classification accuracy against the total dataset. All deep learning-based classification models achieved target accuracies exceeding 80%, which is comparable to or slightly less than those achieved by veterinarians. However, in the case of drawer signs, further research is necessary to improve the low sensitivity of the model. When the implant group was excluded, the classification accuracy significantly improved, indicating that the implant acted as a distraction. These results indicate that deep learning-based diagnoses can be expected to become useful diagnostic models in veterinary medicine., (© 2022 American College of Veterinary Radiology.)

Joint congruence is relevant for the assessment of elbow dysplasia, a development disorder in dogs. However, quantification of its variation with joint angle and weight-bearing, important factors in quadrupedal locomotion, is lacking. Our objective was to estimate those effects on the alignment of humeroradioulnar joint surfaces. The usual protocol for screening elbow dysplasia, including mediolateral extended and flexed elbow views, was preceded by a weight-bearing lateromedial standing radiographic view, without sedation. Minimum distances were measured at established points of the humeroradioulnar joints classified with a Grade 0 dysplasia. Sixty elbows (30 Portuguese Pointer dogs) were studied. The joint space between the anconeal process and the ulnar trochlear notch increased with flexion, decreasing with weight-bearing (p < .001). The distance between the humeral trochlea and the trochlear notch at the widest point increased with weight-bearing, while it decreased with flexion. Step and distance between the radial head and the base of the medial coronoid process increased with flexion and decreased with weight-bearing. At this point, physiological changes occurred at the humeroulnar joint space. The methodology allowed to quantify the variations on joint spaces with the elbow angle and weight-bearing, important for the interpretation of congruence in diagnosis and treatment of dysplasia. Reference absolute and indexed values obtained allow future comparisons with other breeds and dysplastic dogs. Physiological variations denoted that radioulnar joint became more incongruent under flexion, and more congruent under weight-bearing, while humeroulnar joint became more congruent under flexion, and more incongruent under weight-bearing., (© 2022 American Association for Anatomy.)

Background: High-power laser therapy gained popularity recently as a regenerative treatment for tendinitis and desmitis in the horse. However, studies evaluating the effects of laser therapy on tissue repair at the histological level in large mammals are lacking., Objectives: To evaluate the effects of high-power laser therapy on suspensory desmitis healing, using a model of suspensory ligament branch injury., Study Design: In vivo experiments., Methods: Standardised lesions were surgically induced in all four lateral suspensory branches of 12 healthy Warmblood horses. Laser therapy (class 4, 15W) was applied daily on two of four induced lesions for four consecutive weeks. Horses were randomly assigned to either short-term study (horses were sacrificed after 4 weeks) or long-term study (6 months). Suspensory ligament samples were scored after staining with haematoxylin-eosin and immunostaining for collagen 1- collagen 3- and factor VIII., Results: In the short-term study, significantly better (lower) scores for variation in density (17% above cut-off score in treated lesions vs. 31% above cut-off score in controls, P = .03), shape of nuclei (54% vs 92%, P = .02), fibre alignment (32% vs 75%, P = .003) and fibre structure (38% vs 71%, P = .02) were found in laser-treated lesions when compared to controls. Collagen 3 expression was significantly higher (32% vs 19%, P = .006) in control lesions. In both short- and long-term studies combined, parameters lesion size (44% vs 56%, P = .02) and shape of nuclei (53% vs 84%, P = .05) scored significantly better in treated lesions. Long-term, significantly better (lower) scores were found in the laser-treated group for lesion size (15% vs 45%, P = .008) and a higher percentage above cut-off score for density of the nuclei (27% vs 9%, P = .02), compared to controls., Main Limitations: The model of suspensory branch injury is not an exact representation of clinical overstrain lesions., Conclusions: These results suggest that high-power laser therapy enables better lesion healing than conservative treatment., (© 2022 EVJ Ltd.)

Objectives: To estimate, using CT imaging, differences in the regional bone density of the humeral condyle in Labrador retriever elbows with and without medial coronoid process disease., Materials and Methods: The elbows of Labrador Retrievers that had undergone CT were reviewed. Scans were divided into three categories: elbows without medial coronoid process disease; elbows with medial coronoid process disease involving fragmentation of the radial incisure; elbows with medial coronoid process disease involving fragmentation of the medial coronoid apex. A templating technique was employed to define the weight-bearing regions of the medial and lateral portion of the humeral condyle and estimates of volumetric bone density (defined by Hounsfield unit measurement) were compared across the three groups., Results: CT evaluation was performed on 122 elbows in 81 dogs. There was a higher mean Hounsfield unit measurement in the medial and lateral portions of the humeral condyles in elbows with medial coronoid process disease involving fragmentation of the medial coronoid apex compared with elbows with medial coronoid process disease involving fragmentation of the radial incisure., Clinical Significance: Dogs with apical fragmentation of the medial coronoid process exhibited significantly higher estimated bone mineral density within the medial portion of the humeral condyle when compared to dogs with radial incisure fragmentation. The medial portion of the humeral condyle may be associated with the pathogenesis of apical but not radial incisure medial coronoid process fragmentation in Labrador Retrievers., (© 2022 British Small Animal Veterinary Association.)

Case Series Summary: Cats with non-erosive immune-mediated polyarthritis (IMPA) were identified from seven referral hospitals between 2009 and 2020 for a multicentre retrospective case series. Data were obtained from hospital records and referring veterinarians were contacted for follow-up. Twenty cases were identified: 12 castrated males (60%), one entire male (5%) and seven spayed females (35%). Common clinical signs included lameness (n = 20/20) and pyrexia (n = 10/18). Three cats presented with and two cats developed ligament laxity during treatment. Thirteen cats (65%) were diagnosed with non-associative IMPA and seven (35%) with associative IMPA. Comorbidities identified included chronic enteropathy (n = x/7), feline immunodeficiency virus (n = x/7) feline herpesvirus (n = x/7), bronchopneumonia (n = x/7) and discospondylitis (n = x/7). Sampling of the tarsal joints most frequently identified an increased proportion of neutrophils, consistent with IMPA. Eighteen cats (90%) received immunosuppressants. Eleven cats were started on prednisolone; eight had a poor response resulting in the addition of a second agent, euthanasia or acceptance of the persisting signs. One cat received ciclosporin and required an alternative second agent owing to adverse effects. Five cats were started on prednisolone and ciclosporin; three had a poor response and required an alternative second agent. One cat received prednisolone and chlorambucil and had a good response. Two cats (10%) received meloxicam and had a good response, although the clinical signs recurred when medication was tapered. A good outcome was achieved in 14/20 cats (70%) with IMPA. In the cats with a poor outcome 4/6 were euthanased and 2/6 had chronic lameness., Relevance and Novel Information: Prognosis for feline IMPA can be good. Multimodal immunosuppression was often required. IMPA should be considered in lame cats, with or without pyrexia, when there is no evidence of trauma or infection. The tarsal joints should be included in the multiple joints chosen for sampling. Ligament laxity can occur in non-erosive feline IMPA.

Objectives: The purpose of this study was to evaluate the pain-alleviating and activity-enhancing effects of glucosamine/chondroitin sulfate (Dasuquin) in cats that had degenerative joint disease (DJD) and owner-noted mobility/activity impairment. We hypothesized that the nutritional supplement would produce pain-relieving and activity-enhancing effects in cats with painful DJD., Methods: In this prospective, randomized, stratified, double-blind, placebo-controlled clinical trial, 59 cats with DJD pain were assigned to receive a placebo (n = 30) or supplement (n = 29) for 6 weeks after 2 weeks of placebo. Outcome measures (at-home accelerometry and client-specific outcome measures [feline (CSOMf); Feline Musculoskeletal Pain Index (FMPI); quality of life (QoL)]; and veterinarian examination) were collected at days 14, 28, 42 and 56., Results: Twenty-seven cats in the treatment group and 30 in the placebo group completed the trial. Within the first 2 weeks (placebo administration to all cats), 78% of all cats had an improvement in CSOMf scores. Both groups showed significant improvement at most time points in CSOMf, FMPI, QoL and pain scores, with the placebo group showing greater improvement than the supplement group (significant for CSOMf [ P  = 0.01]). Overall, no differences in activity were seen between the groups. Cumulative distribution function analysis indicated that for most levels of activity, the placebo-treated cats were more active; however, the least active cats were more active on the supplement ( P  = 0.013)., Conclusions and Relevance: This study showed a strong placebo effect. The glucosamine/chondroitin sulfate supplement did not show pain-relieving effects when compared with placebo.

Case History: Dogs (n = 6) suffering from elbow-associated lameness for a median of 3.5 (min 2, max 12) months duration requiring arthroscopic exploration according to imaging results were prospectively included in this study., Clinical Findings: Dogs that met the inclusion criteria were of various breeds with a median body weight of 18 (min 13.2, max 34.5) kg and median age at presentation of 11 (min 6, max 96) months. Results of imaging modalities (radiographs and/or computed tomography (CT)) were consistent with developmental elbow disease in all of the dogs., Arthroscopic Findings: Feasibility of the needle arthroscopy procedure was first assessed in a preliminary cadaveric study. Disease-free cadaveric forelimbs (n = 12) were collected from adult dogs (n = 6) euthanised for reasons unrelated to the present study. Elbow exploration was performed, beginning with needle arthroscopy (1 mm, 0° angle scope) followed by standard arthroscopy (2.4 mm, 30° angle scope) through a medial approach. The ease of introduction, range of motion and the quality of visualisation were assessed subjectively and the presence of iatrogenic introduction lesions and extent of field of vision (assessed by the number of anatomical structures visualised) were scored and statistically compared. Needle arthroscopy allowed inspection of all structures at risk for medial/caudal compartment disease in all joints considering the occasional need for multiple portals. In the clinical setting, elbow exploration was found to be similar to that in cadaver joints in 4/6 dogs. The lower quality of vision provided by needle arthroscopy was a limitation of the technique, and 2/6 clinical cases required conversion to standard arthroscopy for full visualisation of the joint. No introduction lesions were noted with needle arthroscopy in either the cadaveric or clinical studies., Conclusions and Clinical Relevance: Needle arthroscopy allowed safe visualisation of all of the structures of the medial and caudal compartment in disease-free cadaveric elbows, suggesting that needle arthroscopy is an appropriate technique for diagnosis and assessment of lesions of developmental elbow disease. However, the low quality of vision provided by the 1 mm scope, and the small diameter of the sleeve, which limited fluid inflow, combined with fragility of the device were major drawbacks that prevented consistent full exploration of the joint and detailed lesion assessment in clinical situations. Improvement of the device is thus necessary before use of the technique in clinical practice can be recommended., Abbreviations: CCD: Caudal compartment disease; CT: Computed tomography; DED: Developmental elbow disease; DJD: Degenerative joint disease; LCL: Lateral collateral ligament; LCP: Lateral coronoid process; LHC: Lateral part of the humeral condyle; MCD: Medial compartment disease; MCL: Medial collateral ligament; MCP: Medial coronoid process; MHC: Medial part of the humeral condyle; MRI: Magnetic resonance imaging.

Conditions of the equine caudal neck (C5-C7) are thought to be associated with various clinical signs. However, little investigation has been undertaken to isolate clinical indicators associated with specific conditions of the equine caudal cervical spine. This systematic review aimed to evaluate associations of clinical signs with anatomical malformation of caudal cervical vertebrae, spinal cord compression of the caudal cervical spine, and arthropathy of the caudal cervical articular process joints (APJs). A literature search was carried out using Google Scholar in accordance with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Studies were selected for inclusion in this systematic review according to a set of inclusion criteria, resulting in a small group of eligible studies (n = 12) that addressed clinical signs associated with caudal cervical spine conditions in horses. The results of the included studies indicate that there are grounds for further investigation of clinical presentations of specific conditions of the equine caudal neck such as anatomical variations, myelopathy, and alteration to the APJs., (Copyright © 2022. Published by Elsevier Inc.)

Objective:  The aim of this study was to measure surface pressures and force distribution on radius and ulna in healthy and dysplastic elbow joints in different positions using the finite element analysis (FEA)., Study Design:  FEA was performed on computed tomographic data of healthy and fragmented coronoid process diseased elbow joints of Labrador Retrievers. It considered the articular cartilage, collateral ligaments, triceps and biceps muscle. The analysis of each joint was performed in four positions (standing position: 145 degrees and three positions of the stance phase of gait: beginning: 115 degrees, middle: 110 degrees, end: 145 degrees joint angle) in consideration of different ground reaction forces (standing: 88.3 N; stance phase of gait: 182.5 N)., Results:  Mean values of total force of 317.5 N (standing), 590.7 N (beginning), 330.9 N (middle) and 730.9 N (end) were measured. The percentual force distribution resulted in a total of 49.56 ± 26.58% on the ulna with a very inhomogeneous distribution. A significant difference was detected between the positions 'standing' and 'end' ( p  = 0.0497) regardless of the joint condition. In some FEA results, visual assessment of the surface pressures indicated an increase in pressure in the region of the medial compartment without a uniform pattern. An increase in pressure resulted in an area increase in the pressure marks on the joint surface and measurable pressure was increased at a larger joint angle., Clinical Significance:  FEA can provide information about the transmission of force in the joint. Prior to the use of FEA in scientific clinical research for the simulation of force, further model improvements are necessary., Competing Interests: None declared., (Thieme. All rights reserved.)

Objective: To determine the following: (1) whether an irrigation solution that is hyperosmolar (HYPER) relative to synovial fluid decreases tissue extravasation during an arthroscopic protocol when compared to a relatively hypoosmolar solution, (2) the safety of a HYPER solution based on viability of joint tissues following joint irrigation, and (3) if the use of a HYPER solution decreases water content in stifle joint tissue., Animals: 8 adult horses., Procedures: A prospective, blinded, randomized controlled trial was performed to compare lactated Ringer's solution (LRS; 273 mOsm/L) and a HYPER (600 mOsm/L) irrigation solution for routine medial femorotibial joint (MFTJ) arthroscopy. Primary outcomes included quantification of periarticular fluid retention based on measured changes in defined stifle joint girth and ultrasonographic (US) criteria. Water content of tissue samples was assessed. The viability of articular cartilage was determined using a microscopic fluorescent cell viability staining system., Results: No significant difference in postprocedural joint swelling was observed between LRS and HYPER treatment groups. Percent increments in femorotibial joint dimensions (mean ± SD) were seen in both treatment groups based on US (LRS, 83.9 ± 84.6%; HYPER, 131.2 ± 144.9%) and caliper measurements (LRS 5.5 ± 4.3%; HYPER 7.5 ± 5.8%) (P ≤ .05). Chondrocyte viability and tissue water content were maintained in both treatment groups, and differences were not statistically significant., Clinical Relevance: Doubling the osmolarity of an irrigation solution used routinely for arthroscopy does not result in detrimental effects on chondrocyte viability or tissue water content. However, use of a relatively HYPER irrigation solution did not attenuate procedural tissue swelling of the equine stifle joint.

Objective: To compare osteoarthritis scores assigned through radiographic evaluation of 18 anatomic regions in the elbow joint with scores assigned through evaluation of 3-D maximum intensity projection (MIP), 3-D surface rendering (TSR), and multiplanar reconstructed (MPR) CT images, and to evaluate intraobserver and interobserver agreement of radiographic and CT scoring., Sample: Radiographic and CT images of 39 elbow joints in 20 dogs., Procedures: Images were anonymized and graded independently by 5 observers. One observer graded 12 elbow joints 3 times. Intraobserver consistency and repeatability, interobserver agreement, consistency among methods, and bias between methods were calculated., Results: The most severe changes were observed at the proximal aspect of the anconeal process, and the medial and cranial aspects of the medial coronoid process. Intraobserver consistency was moderate or better for 11/16 regions with MIP images, 11/16 regions with TSR images, 17/18 regions with MPR images, and 14/18 regions with radiographic images. Interobserver agreement was moderate or better for 5/16 regions with MIP images, 9/16 regions with TSR images, 12/18 regions with MPR images, and 6/18 regions with radiographic images. Mean scores from CT-based methods were higher than mean radiographic scores., Clinical Relevance: Assessments of osteoarthritis severity in the elbow joints of dogs obtained by examining radiographic images were generally consistent with assessments obtained by examining CT scans. MPR scores were more consistent and more comparable to radiographic scores than were MIP or TSR scores.

Objective: To compare the attenuation of the medial coronoid process (MCP) in dogs with and without arthroscopically confirmed evidence of medial coronoid disease (MCD)., Animals: The database at our institution was searched for cases with thoracic limb lameness, diagnosed with MCD by arthroscopic examination that had CT as part of their investigation and compared with a control group of elbow joints from cadavers euthanized for reasons unrelated to MCD. A total of 84 elbow joints were included that met these criteria., Procedures: Following CT, a standardized measurement of the MCP was obtained from apex to base and the mean attenuation, SD, and total area were recorded. A comparative measurement was obtained from the proximal radial cortex at the level of the nutrient foramen. Elbow joint arthroscopy was carried out using standard portals, and the modified Outerbridge score was (MOS) used to score elbow joint cartilage. Descriptive and inferential statistics were carried out using MLwiN and R., Results: Attenuation of the MCP was reduced in dogs with MCD compared with those with no MCD (P < .002). No significant differences were observed in the attenuation between categories of severity (MOS). There was good inter- and intraobserver agreement between measurements (intraclass correlation coefficient = 0.89 and 0.95, respectively)., Clinical Relevance: MCP attenuation is reduced in dogs with MCD compared with dogs with no evidence of MCD. This finding may be a useful tool for early detection of MCD, but there is no relationship with arthroscopic lesion severity.

Objective: To evaluate the diagnostic capabilities of a novel helical fan beam CT system used for imaging of horses with a range of clinical distal limb problems., Animals: 167 horses., Procedures: Medical records were reviewed of horses presented for CT of the distal limb at 2 university-based veterinary hospitals. The following data were recorded: age, sex, breed, presenting complaint, sedation used for imaging, scanning time, procedure time, other diagnostic imaging methods performed, imaging diagnosis, clinical diagnosis, and complications during imaging., Results: Most horses were Thoroughbreds and Quarter Horses. Procedure times ranged from 15 to 40 minutes, with scanning completed in 15 to 45 seconds for each region of interest. The foot or pastern region was commonly scanned (88/167 [53%] horses), with navicular bone disease diagnosed in 42 of 88 (48%) horses. The fetlock region was also commonly scanned (42/167 [40%] horses), with palmar or plantar osteochondral disease diagnosed in 17 of 42 (40%) horses. Horses were compliant during scanning, and no complications with sedation or damage to the scanner occurred. A specific imaging diagnosis for the lameness was achieved more frequently with CT imaging (166/167 [99%]) than with planar digital radiography (26/58 [45%])., Clinical Relevance: The helical fan beam CT system could be used safely to scan sedated standing horses from the carpal or tarsal region distally. Subjectively, the machine was easy to operate, allowing CT to be incorporated into lameness investigations. CT imaging was very likely to result in a clinical diagnosis in horses with distal limb lameness.

Objective: To collect kinetic and kinematic data on the back movement in healthy dogs in comparison to chondrodystrophic dogs following hemilaminectomy while walking and trotting., Material and Methods: Gait analysis on the back movement was obtained from 19 healthy dogs and 21 chondrodystrophic dogs following hemilaminectomy procedure in consequence to disc herniation in the thoracic or lumbar region., Results: In transverse and sagittal planes the group of surgically treated dogs showed a higher range of motion (ROM) throughout the spine while walking and trotting. The difference in back movement depended on the region of the hemilaminectomy (thoracic, thoracolumbar, or lumbar). Operated dogs showed a significantly higher weight distribution towards their front limbs. When comparing the weight distribution among the hind limbs, there was a decreased Peak Vertical Force (PVF) and Vertical Impulse (VI) on the side corresponding to the hemilaminectomy., Conclusions: Following hemilaminectomy, dogs displayed increased instability within their spine, which - depending on the region and side of the hemilaminectomy - affected the back movement in different ways. Weight bearing was generally shifted away from the hind limb of the affected side, and towards the front limbs., Clinical Relevance: Even though hemilaminectomy has an effect on the back movement of dogs, it seems not to have relevant influence of quality of life., Competing Interests: Die Autoren bestätigen, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Objective: To determine the diagnostic performance of computed tomographic arthrography (CTA) and 3 Tesla magnetic resonance imaging (MRI) for detecting artificial meniscal, meniscotibial ligament (MTL) lesions and cruciate ligament (CL) lesions in horses., Study Design: Ex vivo controlled laboratory study., Animals: Nineteen stifles from adult horses., Methods: Stablike defects (n = 84) (16 mm long, 10 mm deep) were created in the menisci (n = 35), CLs (n = 24), and MTLs (n = 25) via arthroscopy prior to MRI and CTA (80 mL contrast at 85 mg/mL per joint). Two radiologists, unaware of the lesions, reached a consensus regarding the presence of lesions, based on 2 reviews of each study. Sensitivity and specificity of MRI and CTA were determined using arthroscopy as a reference and compared with McNemar's tests., Results: The sensitivity and specificity of MRI (41% and 86% respectively) and CTA (32% and 90% respectively) did not differ (P = .65). The sensitivity (MRI: 24%-50%; CTA:19%-40%) and specificity (MRI: 75%-92%; CTA 75%-100%) of imaging modalities did not differ when detecting lesions of the menisci, MTLs, and CLs (P = .1-1.0). The highest sensitivities were achieved when MTLs were evaluated with MRI (50%) and CLs with both modalities (40%)., Conclusions: The diagnostic performance of CTA was comparable with that of MRI, with a low to moderate sensitivity and high specificity., Clinical Significance: Computed tomographic arthrography should be considered as an adjunct to diagnose CL injuries. This is important for equine clinicians, as the CL cannot be visualized adequately using basic imaging techniques preoperatively., (© 2022 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.)

Previous studies have reported evidence that thoracolumbar articular process hyperplasia and degenerative joint disease may be a cause of stenotic myelopathy in large breed dogs; however, detailed descriptions of imaging characteristics are currently lacking. The aim of this retrospective, multi-center, case series report was to describe imaging findings in six large breed dogs diagnosed with thoracolumbar articular process hyperplasia and degenerative joint disease causing vertebral canal stenosis. All dogs presented with progressive paraparesis, proprioceptive ataxia of the pelvic limbs, and neuroanatomical localization of T3-L3 myelopathy. All dogs underwent magnetic resonance imaging (MRI) of the thoracolumbar spine and had articular process malformations at T13-L1 (three German Shepherd dogs (GSD) and a Boxer dog) or T12-T13 (two mixed-breed dogs). Five cases were managed surgically. Findings provided more detailed imaging descriptions and supported previously published studies indicating that maldevelopment of articular processes and secondary degenerative changes can be a cause of thoracolumbar spinal stenosis and myelopathy in large breed dogs. While uncommon, this condition should be included as a differential diagnosis for large breed dogs presenting with a T3-L3 myelopathy., (© 2022 American College of Veterinary Radiology.)

Objective: To verify the existence of intertransverse joints (ITJs) in young foals., Animals: 11 warmblood foals., Procedures: Postmortem examination of the lumbar area in foals < 200 days old using CT, MRI, dissection, and histomorphology. Data were analyzed with descriptive statistics., Results: Age of foals varied between 1 and 200 days (median, 11 days). Ten foals had 6 lumbar (L) vertebrae, and 1 foal had 5. All 11 foals, irrespective of age, had ITJs between the first sacral and last lumbar vertebrae and between the last and second-to-last lumbar vertebrae. In 6 foals (all with 6 L vertebrae), ITJs also existed between the fourth and fifth L vertebra. One foal, also with 6 L vertebrae, additionally had a unilateral (right) ITJ between the transverse processes of the third and fourth L vertebra. Based on CT, width of ITJs was seemingly greater in young (< 1 month old) foals because of the incomplete ossification of the transverse processes. The ITJs were confirmed and further characterized by MRI, dissection, and histomorphology., Clinical Relevance: ITJs already exist in very young warmblood foals and are present at birth. During the first months of life, these juvenile ITJs develop similarly to other synovial joints with increasing ossification and concomitant decrease of thickness of the cartilage layer. Knowledge of the presence of these ITJs in young animals is clinically relevant, as they should be recognized as nonpathologic when for instance a young foal is presented for presumed arthropathy and examined with advanced imaging techniques.

Background: Until recent years, arthroscopic subtotal coronoidectomy has been the universally accepted treatment for medial coronoid disease but has variable clinical outcomes. The aim of this study was to evaluate the completeness of arthroscopic medial coronoid debridement and to detect the most vulnerable location of failure., Methods: Eighty-three dogs with a diagnosis of medial coronoid disease were included in the study. Arthroscopic debridement was performed in 92 elbow joints, and the completeness of removal was assessed by postoperative computed tomography scans., Results: Pathological changes were confined to the coronoid apex in 92/92 (100%) of cases and combined with radial incisure lesions in 39/92 (42%). Apical lesions were completely removed in 66/92 (72%) of cases and radial incisure lesions in 2/39 (5%). Bony remnants were detected at the apex (46%) and base (24%) of the medial coronoid process, free within the elbow joint (9%), and/or within the instrument port (84%). Fissures were positively associated with the occurrence of bony remnants (p = 0.038) and a 37% higher probability of incomplete removal of radial incisure lesions (p = 0.001)., Conclusion: In this study, incomplete removal was more likely to occur in the presence of radial incisure lesions. Thorough assessment of this region during arthroscopy is strongly recommended., (© 2021 British Veterinary Association.)

Background: Injuries to the oblique (ODSL) or straight (SDSL) distal sesamoidean ligaments are a recognised cause of distal limb lameness in the horse. However, there are only limited publications addressing common diagnostic features and prognosis., Objectives: (a) Report findings on ultrasonography and standing low-field magnetic resonance imaging (sMRI) in horses with ODSL or SDSL injury; (b) Identify clinical variables associated with lesion type and (c) Identify factors associated with return to soundness in horses with ODSL or SDSL injury., Study Design: Retrospective case series., Methods: Horses with a primary diagnosis of ODSL or SDSL injury confirmed with a combination of diagnostic analgesia and detection of a lesion on imaging (ultrasonographic ± advanced imaging) were included. Return to soundness and performance follow-up data were obtained., Results: Fifty-one horses were included. SDSL injuries were more common in the forelimb (13/21, 62%), while ODSL injuries had equal frequency in fore- (15/30, 50%) and hindlimbs (15/30, 50%). ODSL injuries were more likely than SDSL injuries to affect the proximal third of the ligament (OR =13; 95% CI 2.3-74.3; p = 0.004) and often presented with periligamentar swelling (20/30;67%) and focal pain (22/28;79%). Lesions were frequently detected using ultrasonography (35/42;83%) and sMRI examination (18/25;72%). Only 27/49 cases (55%) returned to soundness, with only 15/49 (31%) returning to intended use. There were no significant associations between outcome and clinical features or treatment., Main Limitations: There was no comparative "gold standard" to validate lesions such as high-field MRI or histopathology., Conclusions: In contrast to previous studies, ODSL and SDSL injuries were readily identified ultrasonographically using appropriate views, and with sMRI. Given the limited availability, cost and general anaesthetic risks associated with high-field MRI, more focus should be placed on optimising the ultrasonographic examination. Owners of affected horses should be informed of the guarded prognosis for return to full use., (© 2021 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.)

Background: Carpal osteochondral fragmentation and subsequent post-traumatic osteoarthritis (PTOA) are leading causes of wastage in the equine athlete. Identification of synovial fluid biomarkers could contribute to the diagnosis and understanding of osteoarthritis (OA) pathophysiology., Objective: The aim of this study was to identify differentially expressed metabolic and glycosylation pathways in synovial fluid from healthy horses and horses with naturally occurring carpal OA., Study Design: Cross-sectional, in vivo metabolomics and glycomics study., Methods: In cohort 1, carpal synovial fluid (n = 12 horses; n = 6 healthy, n = 6 OA) was analysed using high-resolution liquid chromatography mass spectrometry (LC-MS). In cohort 2 (n = 40 horses; n = 20 healthy, n = 20 OA), carpal synovial fluid was analysed using lectin microarrays and a lubricin sandwich ELISA., Results: Metabolomic analysis identified >4900 LC-MS features of which 84 identifiable metabolites were differentially expressed (P < .05) between healthy and OA joints, including key pathways related to inflammation (histidine and tryptophan metabolism), oxidative stress (arginine biosynthesis) and collagen metabolism (lysine metabolism). Principle Component Analysis and Partial Least Squares Discriminant Analysis demonstrated separation between healthy and OA synovial fluid. Lectin microarrays identified distinct glycosylation patterns between healthy and OA synovial fluid, including increased Core 1/Core 3 O-glycosylation, increased α-2,3 sialylation and decreased α-1,2 fucosylation in OA. O-glycans predominated over N-glycans in all synovial fluid samples, and synovial fluid lubricin was increased in OA joints as compared to controls., Main Limitations: The sample size in cohort 1 was limited, and there is inherent variation in severity and duration of joint injury in naturally occurring OA. However, LC-MS identified up to 5000 unique features., Conclusions: These data suggest new potential diagnostic and therapeutic targets for equine OA. Future targeted metabolomic and glycomic studies should be performed to verify these results. Lectin microarrays could be investigated as a potential screening tool for the diagnosis and therapeutic monitoring of equine OA., (© 2021 EVJ Ltd.)