Computed tomographic and radiographic morphology of the pastern and coffin joints of One-Humped Camel (Camelus dromedarius)

The objective of the current study was to describe the structures of the pastern and coffin joints in dromedary camel using x-ray, bone and soft tissue windows computed tomography (CT) and three-dimensional volume rendering (3DVR) of CT imaging. 3DVR of CT was obtained at the slight flexed dorsal view, plantar view, dorsolateral view and lateral view which explained all the surfaces and structures of the digit bony parts even the parts of the articular surface. The processed images of 3DVR of CT showed different patterns of the cortical, cancellous, subchondral bones and medullary cavity of the bones of the digits. The present study showed clearly all the hard and soft tissues in the pastern and coffin joints of the camel in CT images; however, the plantar ligaments of the pastern joint and ligaments of the navicular cartilage identified on CT images. The CT soft tissue window visualized the joint cavity and their pouches and tendon sheath of the flexor tendons better than the bone window CT. The radiographic, CT and 3D images could be used as a normal reference for the interpretation of some clinical diseases in the pastern and coffin joints of the camel.     

Gross anatomy,computed tomography,magnetic resonance imaging and bone mineral densitometry of the ovine metacarpo/metatarsophalangeal joint

This study was aimed to provide anatomical atlas of the ovine metacarpo/metatarsophalangeal joints using computed tomography (CT) scan and magnetic resonance imaging (MRI), as well as to investigate bone mineral density (BMD) and morphometric features of this joint. The limbs of twenty adult Sanjabi sheep were examined. Imaging was performed using a 16-slice multi-detector CT scanner and a 1.5 Tesla MRI scanner. The obtained images were correlated with corresponding anatomical sections. BMD was measured by Dual Energy X-ray Absorptiometry (DEXA) method. Also morphometric features included distance between metacarpal and metatarsal heads, width of metacarpal and metatarsal head, length, width and the height of the proximal sesamoid bones were measured. In MRI images, compact bones, ligaments and tendons showed less signal intensity (hypointense). The fatty tissue and bone marrow had more signal intensity (hyperintense), but articular cartilage and synovial fluid showed moderate signal intensity. BMD in the left hind limb was significantly higher than other three limbs (p ≤ 0.05). The length of proximal sesamoid bones in left forelimb was higher than right forelimb (p ≤ 0.05). The thickness of proximal sesamoid bones in left limbs was higher than those in their counterparts (p ≤ 0.05). The width of the medial head in the forelimbs was significantly greater than the hind limbs (p ≤ 0.05). The present results might be useful in managing the clinical techniques on this joint. Larger volume of the proximal sesamoid bones and wider medial head in the forelimbs compared to the hindlimbs impel this speculation that the centre of gravity is closer to the forelimbs.     

Comparisons of computed tomography, contrast-enhanced computed tomography and standing low-field magnetic resonance imaging in horses with lameness localised to the foot. Part 2: Lesion identification

Reasons for performing study: No previous study compares computed tomography (CT), contrast‐enhanced computed tomography (CECT) and standing low‐field magnetic resonance imaging (LFMRI) to detect lesions in horses with lameness localised to the foot. This study will help clinicians understand the limitations of these techniques. Objectives: To determine if CT, CECT and LFMRI would identify lesions within the distal limb and document discrepancies with lesion distribution and lesion classification. Methods: Lesions in specific structures identified on CT and MR images of feet (31 limbs) from the same horse were reviewed and compared. Distributions of lesions were compared using a Chi‐squared test and techniques analysed using the paired marginal homogeneity test for concordance. Results: Lesions of the deep digital flexor tendon (DDFT) were most common and CT/CECT identified more lesions than LFMRI. Deep digital flexor tendon lesions seen on LFMRI only were frequently distal to the proximal extent of the distal sesamoid and DDFT lesions seen on CT/CECT only were frequently proximal to the distal sesamoid. Lesions identified on LFMRI only were core (23.3%) or splits (43.3%), whereas lesions identified only on CT were abrasions (29.8%), core (15.8%), enlargement (15.8%) or mineralisation (12.3%). Contrast‐enhanced CT improved lesion identification at the DDFT insertion compared to CT and resulted in distal sesamoidean impar ligament and collateral sesamoidean ligament vascular enhancement in 75% of cases. Low‐field MRI and CT/CECT failed to identify soft tissue mineralisation and bone oedema, respectively. Conclusions and potential relevance: Multiple lesions are detected with CT, CECT and LFMRI but there is variability in lesion detection and classification. LFMRI centred only on the podotrochlear apparatus may fail to identify lesions of the pastern or soft tissue mineralisation. Computed tomography may fail to identify DDFT lesions distal to the proximal border of the distal sesamoid.     

Morphological and Imaging Evaluation of the Metacarpophalangeal and Metatarsophalangeal Joints in Healthy and Lame Donkeys

The donkey is of socio-economic value yet imaging techniques in both healthy and abnormal limbs are a limiting factor in research and medicine. The objective was to determine anatomical features of both healthy and clinically abnormal donkey metacarpophalangeal and metatarsophalangeal joints (n = 13) using anatomical dissection, casting, X-ray and computed tomography. The joint capsule contained two palmar/plantar and two dorsal recesses. The proximal–palmar or plantar recess was larger than the distodorsal recess and potential sites of approaches to the recesses were determined. Soft tissue structures were distinguished using computed tomography at 300 mA, which was superior to 120 mA. This methodology gave better assessments of the synovial tendon sheath, joint recesses, and cruciate, collateral, and short sesamoidean ligaments. Computed tomography provided outstanding discrimination between the cortex and medulla of the third metacarpal, the proximal sesamoid bones, the proximal phalanx, and excellent details of the osseous structures. Although the joints appeared free from exostosis using X-ray; the position and extension of exostosis in pathologically affected donkeys (a novel finding) were revealed using computed tomography with 300 mA in comparison to 120 mA. The study also provided an anatomical record of the metacarpophalangeal and metatarsophalangeal joints using the latest technology, which could impact on clinical situations including anesthesia injection sites.     

Computed Tomography of the Normal Bovine Tarsus

The objective of this study was to provide a detailed multiplanar computed tomographic (CT) anatomic reference for the bovine tarsus. The tarsal regions from twelve healthy adult cow cadavers were scanned in both soft and bone windows via a 16‐slice multidetector CT scanner. Tarsi were frozen at ?20^o C and sectioned to 10‐mm‐thick slices in transverse, dorsal and sagittal planes respecting the imaging protocol. The frozen sections were cleaned and then photographed. Anatomic structures were identified, labelled and compared with the corresponding CT images. The sagittal plane was indispensable for evaluation of bone contours, the dorsal plane was valuable in examination of the collateral ligaments, and both were beneficial for assessment of the tarsal joint articulations. CT images allowed excellent delineation between the cortex and medulla of bones, and the trabecular structure was clearly depicted. The tarsal soft tissues showed variable shades of grey, and the synovial fluid was the lowest attenuated structure. This study provided full assessment of the clinically relevant anatomic structures of the bovine tarsal joint. This technique may be of value when results from other diagnostic imaging techniques are indecisive. Images presented in this study should serve as a basic CT reference and assist in the interpretation of various bovine tarsal pathology.     

Computed Tomography and Cross‐sectional Anatomy of the Normal Dromedary Camel Tarsus (One Humped Camel)

The purpose of this study was to provide a detailed computed tomographic (CT) anatomic reference for the dromedary camel tarsus. Six cadaver pelvic limbs, obtained from three clinically and radiographically sound dromedary camels, were scanned in both soft tissue and bone windows starting from the calcaneal tuber towards the proximal metatarsus. Limbs were frozen at ?20°C and sectioned transversely via an electric bone saw. The CT images were evaluated and correlated with their corresponding cryosections. The resulting images provided detailed anatomic features for bones, joints and soft tissue components of the tarsus and are intended to serve as a basic reference for the CT scanning of the dromedary camel tarsal pathology.     

Radiography,Computed Tomography and Magnetic Resonance Imaging of Craniofacial Structures in Pig

The pig has recently become popular as a large animal experimental model in many fields of biomedical research. The aim of this study is to evaluate the basic anatomical structures in the head region of the pig to lay the groundwork for its practical clinical usage or pre‐clinical research in the future. We used three different diagnostic imaging methods: radiography, computed tomography (CT) and magnetic resonance imaging (MRI). The analysis showed that radiographic imaging is suitable only for general evaluation of the facial area of the pig skull. CT images showed excellent spatial definition of bony structures of the whole craniofacial area, and MRI images revealed fine soft tissue details. Radiography is preferentially suited to general assessment of bone structures of the facial skeleton; however, the thick layer of adipose tissue in the craniofacial region of the pig makes the imaging of some parts difficult or even impossible. CT is useful for revealing morphological details of mineralized tissues, whereas MRI is more suitable for soft tissue analysis and the detection of subtle pathologic changes in both bone and soft tissues. Therefore, before using pigs as an experimental model in craniofacial research, it is necessary to evaluate the suitability and disadvantages of potential imaging methods and how appropriate they are for accurate visualization of desired structures.     

Feline hip joint anatomy in magnetic resonance images

The aim of this study was to develop an anatomical model of the feline hip joint for low‐field magnetic resonance imaging (LF‐MRI) based on high‐field magnetic resonance imaging (HF‐MRI). The study was performed on six adult clinically healthy European shorthair cats, aged 1–3 years, with body weight of 2.8–4.4 kg. The animals were examined with the use of the Vet‐MRI Grande Esaote LF (0.25 T) scanner and high‐field Siemens Magnetom TRIO (3 T) MRI scanner. In the LF‐MRI, most satisfactory results in T1‐weighted images were obtained when TE was 26 ms in all three planes and when TR was 350–950 ms in the transverse plane, 950–1150 ms in the sagittal plane and 520–750 ms in the dorsal plane. In T2‐weighted images, TE was 90 ms in the transverse and dorsal plane and 120 ms in the sagittal plane. The results were presented as images acquired with LF‐MRI scanners in three planes. The slice thickness was 3 mm for each plane. In LF‐MRI, muscles in the hip joint region and round ligament were well visualized. Unlike in LF‐MRI, the cross section of the femoral nerve was identified in HF‐MRI scans. In examinations of the feline hip joint, the main limitations of LF‐MRI were a lack of reliable contrast between articular cartilage and synovial fluid as well as longer scan time. Despite the above, LF‐MRI images were characterized by good contrast between bones and the surrounding soft tissues.     

Computed tomographic anatomy of the temporomandibular joint in the young horse

Reasons for performing study: The equine temporomandibular joint (TMJ) and its surrounding structures can be difficult to investigate in cases with a clinical problem related to the region. Little previous attention has been given either to a computed tomographic (CT) imaging protocol for the joint or an interpretation of the structures displayed in CT images of the normal joint. Objectives: To provide a CT atlas of the normal cross‐sectional anatomy of the equine TMJ using frozen and plastinated sections as anatomical reference. Methods: Eight TMJs from 4 immature pure‐bred Spanish horses were examined by helical CT. Scans were processed with a detailed algorithm to enhance bony and soft tissue. Transverse CT images were reformatted into sagittal and dorsal planes. Transverse, sagittal and dorsal cryosections were then obtained, photographed and plastinated. Relevant anatomic structures were identified in the CT images and corresponding anatomical sections. Results: In the CT images, a bone window provided excellent bone detail, however, the soft tissue components of the TMJ were not as well visualised using a soft tissue window. The articular cartilage was observed as a hyperattenuating stripe over the low attenuated subchondral bone and good delineation was obtained between cortex and medulla. The tympanic and petrous part of the temporal bone (middle and inner ear) and the temporohyoid joint were seen in close proximity to the TMJ. Conclusions: Helical CT provided excellent images of the TMJ bone components to characterise the CT anatomy of the normal joint. Potential relevance: Detailed information is provided that may be used as a reference by equine veterinarians for the CT investigation of the equine TMJ and serve to assist them in the diagnosis of disorders of the TMJ and related structures (middle and inner ear). The study was performed at an immature stage and further studies of mature individuals are required in order to confirm that the clinical interpretation is not affected by changes occurring with age.     

Arthroscopic Approach and Intra-articular Anatomy of the Palmaroproximal or Plantaroproximal Aspect of Distal Interphalangeal Joints

An arthroscopic approach to the palmaroproximal or plantaroproximal pouch of the distal interphalangeal joint was developed in six cadaver limbs and seven limbs of three clinically normal horses. The dorsal aspect of the proximal border and the proximal articular margin of the distal sesamoid (navicular) bone, the palmar aspect of the distal articular margin of the middle phalanx, the collateral sesamoidean ligaments of the distal sesamoid bone, and the joint capsule attachments were readily accessible. Distending the joints with fluid gave access to portions of the articular surface between the distal sesamoid bone and the middle phalanx in all joints, and to a small portion of the distal phalanx in two hind distal interphalangeal joints. Two horses allowed to recover from anesthesia were not lame on days 30 and 37, respectively. Problems encountered initially were difficulty entering the joint, hemarthrosis, and minimal iatrogenic cartilage damage.     

A technique for computed tomography (CT) of the foot in the standing horse

Computed tomography (CT) in equine orthopaedics is currently limited because of the price, availability, impossibility to transport the scanner into surgical theatre, and the contraindications of general anaesthesia in some patients. A pQCT (peripheral quantitative computerised tomography) scanner was designed by the authors to image the limbs of the horse, both in standing or recumbent position. Standing computed tomography of the foot with a pQCT scanner is feasible and well tolerated by the horse. It enables good visualisation of bony structures but is not suitable to evaluate soft tissues. The technique can also assist surgery by assessing the 3D configuration of bone lesions.     

Computed tomographic contrast tenography of the digital flexor tendon sheath of the equine hindlimb

Pre‐surgical investigation of digital flexor tendon sheath pathology remains challenging with current standard imaging techniques. The aim of this prospective, anatomical, pilot study was to describe the anatomy of the equine hind limb digital flexor tendon sheath using a combination of computed tomography (CT) and computed tomographic contrast tenography in clinically normal cadaver limbs. Ten pairs of hind limbs with no external abnormalities were examined from the level of the tarsometatarsal joint distally. Limbs initially underwent non‐contrast CT examination using 120 kVp, 300 mAs, and 1.5 mm slice thickness. Sixty millilitres of ioversol iodinated contrast media and saline (final concentration 100 mg/ml) were injected using a basilar sesamoidean approach. The computed tomographic contrast tenography examination was then repeated, before dissection of the specimens to compare gross and imaging findings. The combined CT and computed tomographic contrast tenography examinations provided excellent anatomical detail of intra‐thecal structures. The borders of the superficial and deep digital flexor tendons, and the manica flexoria were consistently identifiable in all limbs. Detailed anatomy including that of the mesotenons, two of which are previously undescribed, and the plantar annular ligament were also consistently identifiable. Dissection of all 10 pairs of limbs revealed there to be no pathology, in accordance with the imaging findings. In conclusion, the combination of CT and computed tomographic contrast tenography may be useful adjunctive diagnostic techniques to define digital flexor tendon sheath pathology prior to surgical exploration in horses.     

Comparison between magnetic resonance imaging,computed tomography,and arthrography to identify artificially induced cartilage defects of the equine carpal joints

While articular cartilage changes are considered to be one of the initial events in the pathological cascade leading to osteoarthritis, these changes remain difficult to detect using conventional diagnostic imaging modalities such as plain radiography. The aim of this prospective, experimental, methods comparison study was to compare the sensitivity of magnetic resonance imaging (MRI), magnetic resonance arthrography, computed tomography (CT), and CT arthrography in the detection of artificially induced articular cartilage defects in the equine carpal joints. Defects were created in the antebrachiocarpal and middle carpal joint using curettage by a board‐certified equine surgeon. Normal articular cartilage thickness varied from a maximum of 1.22 mm at the level of the distal aspect of the radius to a minimum of 0.17 mm in the proximal articular surface of the third carpal bone. Regarding cartilaginous defect measurements the remaining cartilaginous bed range from a maximum of 0.776 mm in the partial thickness defects, and 0 mm (defect reaches the subchondral bone) when total thickness defect were made. Computed tomography and magnetic resonance imaging were performed followed by CT arthrography and magnetic resonance arthrography after antebrachiocarpal and middle carpal intraarticular contrast administration. All images were reviewed by two board‐certified veterinary radiologists, both of whom were blinded to the location, presence of, and thickness of the cartilage defects. A total number of 72 lesions in nine limbs were created. Mean sensitivity for localizing cartilage defects varied between imaging modalities with CT arthrography showing the best sensitivity (69.9%), followed by magnetic resonance arthrography (53.5%), MRI (33.3%), and CT (18.1%) respectively. The addition of contrast arthrography in both magnetic resonance and CT improved the rate of cartilage lesion detection although no statistical significance was found. Computed tomographic arthrography displayed the best sensitivity for detecting articular cartilage defects in the equine antebrachiocarpal and middle‐carpal joints, compared to magnetic resonance arthrography, MRI, and CT.     

POSITRON EMISSION TOMOGRAPHY OF THE EQUINE DISTAL LIMB: EXPLORATORY STUDY

Positron emission tomography (PET) is a highly sensitive, noninvasive imaging technique for quantifying biological functions of tissues. However, at the time of this study, PET imaging applications had not been reported in the horse. The aim of this exploratory study was to determine whether a portable high‐resolution PET scanner could be used to image the equine distal limb. Images of the front feet and fetlocks of three research horses, with known lesions localized to the distal front limbs, were acquired under general anesthesia after administration of ¹⁸F‐fluorodeoxyglucose (¹⁸F‐FDG), with doses ranging from 1.5 to 2.9 MBq/kg. The radiation exposure measured during imaging was slightly higher than ^99mTechnetium scintigraphy. However, the use of general anesthesia allowed the proximity and the contact time with the patient to be minimized for the staff involved. ¹⁸F‐FDG uptake was evident throughout the soft tissues, with the highest uptake in the coronary band and the lowest uptake in the tendons. Anatomic structures could be discriminated due to the high contrast between soft tissue and bone. Detected lesions included lysis of the flexor cortex of the navicular bone, lesions of flexor tendons and suspensory ligament, and abnormal uptake through the lamina of a laminitic subject. Findings indicated that tomographic molecular imaging is feasible in the equine distal limb and could be useful as a future diagnostic technique for clinical and research studies, especially those involving tendinopathy/desmopathy and laminitis.     

A comparison of 3-T magnetic resonance imaging and computed tomography arthrography to identify structural cartilage defects of the fetlock joint in the horse

Articular cartilage defects are prevalent in metacarpo/metatarsophalangeal (MCP/MTP) joints of horses. The aim of this study was to determine and compare the sensitivity and specificity of 3-Tesla magnetic resonance imaging (3-T MRI) and computed tomography arthrography (CTA) to identify structural cartilage defects in the equine MCP/MTP joint. Forty distal cadaver limbs were imaged by CTA (after injection of contrast medium) and by 3-T MRI using specific sequences, namely, dual-echo in the steady-state (DESS), and sampling perfection with application-optimised contrast using different flip-angle evolutions (SPACE). Gross anatomy was used as the gold standard to evaluate sensitivity and specificity of both imaging techniques.CTA sensitivity and specificity were 0.82 and 0.96, respectively, and were significantly higher than those of MRI (0.41 and 0.93, respectively) in detecting overall cartilage defects (no defect vs. defect). The intra and inter-rater agreements were 0.96 and 0.92, respectively, and 0.82 and 0.88, respectively, for CT and MRI. The positive predictive value for MRI was low (0.57). CTA was considered a valuable tool for assessing cartilage defects in the MCP/MTP joint due to its short acquisition time, its specificity and sensitivity, and it was also more accurate than MRI. However, MRI permits assessment of soft tissues and subchondral bone and is a useful technique for joint evaluation, although clinicians should be aware of the limitations of this diagnostic technique, including reduced accuracy.     

COMPUTED TOMOGRAPHIC DETERMINATION OF TIBIAL TORSION IN THE DOG

The goal of this study was to develop a method for computed tomographic (CT) measurement of tibial torsion, and to compare this technique with direct anatomic measurement of tibial torsion in cadaveric canine tibiae. Paired hind limbs of 10 cadaveric dogs were mounted on a custom-designed limb holding apparatus. One-millimeter thick, contiguous, transverse CT slices were obtained from the distal femur to the proximal tibia and 2 mm CT slices were obtained from the distal tibia to the proximal tarsus. The tibiae were freed of soft tissues and digital photographic images of the proximal and distal articular surfaces were obtained with the camera lens aligned perpendicular to the long axis of the tibia. Multiple proximal and distal tibial axes were identified on the images; two proximal and two distal axes were found to be repeatable in all specimens in both the direct and CT methods. The torsion angle was calculated by determining the difference between the axis angles for each pair of proximal and distal axes. There was no significant difference in torsion angle identified between the direct photographic and CT method for any pair of proximal and distal axes. CT determination of tibial torsion is a rapid and accurate method, and warrants investigation in clinical patients.     

MAGNETIC RESONANCE IMAGING,GROSS POSTMORTEM,AND HISTOLOGICAL FINDINGS FOR SOFT TISSUES OF THE PLANTAR ASPECT OF THE TARSUS AND PROXIMAL METATARSAL REGION IN NON‐LAME HORSES

Injuries of the plantar soft tissues of the tarsus and proximal metatarsus can be a source of lameness in horses, however published information is lacking on high field MRI characteristics of these tissues. Objectives of the current anatomic study were to (1) describe high‐field MRI features of the plantar tarsal and proximal metatarsal soft tissues; and (2) compare MRI findings with gross and histological appearances of selected structures for a sample of cadaver limbs from non‐lame horses. Single hindlimbs for 42 horses, and right and left hindlimbs for eight horses were scanned using high‐field MRI. The MRI findings were described for the 50 single limbs; and the MRI, gross postmortem and histological findings were compared for the eight pairs of hindlimbs. The superficial digital flexor tendon had uniform low signal intensity, surrounded by the flexor retinaculum of intermediate to high signal intensity on all sequences. The lateral digital flexor tendon had slightly higher signal intensity, enclosed on the plantaromedial aspects by the low signal intensity metatarsocalcaneal ligament. The accessory ligament of the deep digital flexor tendon varied in size and signal intensity. The proximal and distal plantar ligaments, accessory ligament of the suspensory ligament, and calcaneoquartal ligament had low signal intensity. The long plantar ligament comprised a number of related parts, separated by lines of high signal intensity corresponding with fibrous septae seen in gross anatomical specimens. The plantar aspect of the ligament had uniform low signal intensity in all sequences, but the dorsal half was more heterogeneous with multifocal spots or lines of higher signal intensity.     

COMPUTED TOMOGRAPHIC ARTHROGRAPHY OF THE INTERCARPAL LIGAMENTS OF THE EQUINE CARPUS

Injuries of the intercarpal ligaments are an important cause of lameness in performance horses. The purpose of this prospective cadaver study was to determine whether computed tomography (CT) arthrography would be a feasible method for visualizing and characterizing intercarpal ligaments in the horse. One cadaver limb from each of eight nonlame horses was collected immediately after euthanasia. For each limb, overlapping 2.0 mm CT images were acquired before and after injection of iodinated contrast medium into the antebrachiocarpal joint, middle carpal joint, and carpal sheath. Spin echo magnetic resonance imaging (MRI) sequences were acquired in three planes using a 1.5 Tesla MRI scanner in three limbs. Following MRI, colored resin was injected into the synovial structures of these three limbs, limbs were frozen, and anatomic sections were obtained in three planes. Findings from CT arthrograms were compared to findings from precontrast CT, MRI, anatomic slices, and arthroscopy. Medial and lateral palmar intercarpal ligaments, radiocarpal and transverse intercarpal ligaments, and palmar carpal ligament were visible in CT arthrograms of all limbs. The proximal and distal entheses of all ligaments were readily identifiable. Findings indicated that CT arthrography is feasible for visualizing intercarpal ligaments and may be a useful adjunct imaging technique for diagnosing lameness due to suspected carpal ligament injury in horses.