Radiographic interpretation of normal skeletal variations and pseudolesions in the equine foot.

Effective radiographic interpretation requires a veterinarian who is knowledgeable of equine limb anatomy and the various principles that affect the resulting image. The normal and its variations must be recognized and understood before the abnormal can be confidently identified as pathologic. Proper patient positioning and sound radiographic technique are mandatory if reliable diagnostic radiographs are to be produced. This review emphasizes equine foot radiographic variations of normal and pseudolesions that occur with commonly used radiographic views performed in equine practice.     

INITIAL INFLUENCE OF RIGHT VERSUS LEFT LATERAL RECUMBENCY ON THE RADIOGRAPHIC FINDING OF DUODENAL GAS ON SUBSEQUENT SURVEY VENTRODORSAL PROJECTIONS OF THE CANINE ABDOMEN

Identification of the duodenum and potential abnormalities on survey abdominal radiographs is often difficult unless it contains gas. This study investigated the effect of patient positioning on the presence of duodenal gas in survey abdominal radiographs. One hundred dogs receiving a three‐view survey abdominal radiographic study were enrolled in a prospective, randomized study where all dogs were divided into two groups. Group A (n = 51) dogs had a left lateral projection first, followed by a ventrodorsal projection, ending with a right lateral projection. Group B (n = 49) dogs had a right lateral projection first, followed by a ventrodorsal projection, ending with a left lateral projection. The presence of gas within the duodenum and level of distribution of gas throughout the duodenum were recorded for all three projections. In addition, the presence or absence of duodenal pseudoulcers was evaluated on all three projections for each dog. The results for the two groups were compared using Chi‐square analysis with a P‐value of less than 0.05 being considered significant. Results showed that dogs first placed in left lateral recumbency were significantly more likely to have duodenal gas on the subsequent ventrodorsal and right lateral radiographic projections compared to dogs first placed in right lateral recumbency (P‐value < 0.0001). Pseudoulcers were seen in 11 dogs that had duodenal gas making the visualization of pseudoulcers on survey abdominal radiographs somewhat commonplace. This study emphasizes the benefit of using initial left lateral abdominal projections prior to other views for subsequent evaluation of the duodenum.     

A 200 CENTIMETER FOCAL SPOT-FILM DISTANCE (FFD) TECHNIQUE FOR EQUINE THORACIC RADIOGRAPHY

The construction of a variable kVp, variable mA radiographic technique chart for the equine thorax using linear regression analysis is described. The independent variables in the analysis were body weight (pounds) and thoracic girth (inches) and the dependent variables were the radiographic exposure techniques (mAs, kV.p). Four areas (lateral views only) of each horse's thorax were radiographed using a focal spot-film distance (FFD) of 200 cm with the animal standing. The four views were craniodorsal, cranioventral, caudodorsal and caudoventral. For comparison, an additional caudodorsal view was made at 100 cm FFD to quantitate the decrease in exposure, the increased magnification and the decreased area of the lung exposed on the x-ray tube side of the horse compared with 200 cm FFD technique. Body weight was a satisfactory means to determine radiographic technique factors for thoracic radiographs in the horse. Thoracic girth (inches) was also measured and used to determine radiographic technique factors but was less exacting and less convenient than body weight.     

Comparative evaluation of six different body regions of the dog using analog and digital radiography

In this study the quality of digital and analog radiography in dogs was compared. For this purpose, three conventional radiographs (varying in exposure) and three digital radiographs (varying in MUSI-contrast [MUSI = MUlti Scale Image Contrast], the main post-processing parameter) of six different body regions of the dog were evaluated (thorax, abdomen, skull, femur, hip joints, elbow). The quality of the radiographs was evaluated by eight veterinary specialists familiar with radiographic images using a questionnaire based on details of each body region significant in obtaining a radiographic diagnosis. In the first part of the study the overall quality of the radiographs was evaluated. Within one region, 89.5% (43/48) chose a digital radiograph as the best image. Divided into analog and digital groups, the digital image with the highest MUSI-contrast was most often considered the best, while the analog image considered the best varied between the one with the medium and the one with the longest exposure time. In the second part of the study, each image was rated for the visibility of specific, diagnostically important details. After summarisation of the scores for each criterion, divided into analog and digital imaging, the digital images were rated considerably superior to conventional images. The results of image comparison revealed that digital radiographs showed better image detail than radiographs taken with the analog technique in all six areas of the body.     

NORMAL XERORADIOGRAPHIC AND RADIOGRAPHIC ANATOMY OF THE GREAT HORNED OWL (BUBO VIRGINIANUS), WITH SPECIAL REFERENCE TO THE BARN OWL (TYTO ALBA)

The purpose of this study was to provide a reference for xeroradiographic and conventional radiographic anatomy of the great horned owl ( Bubo virginianus ) as a representative of the avian Order Strigiformes. The head, body, wing, and pelvic limb of three adult birds were radiographed using xeroradiographic and conventional radiographic techniques. Twelve xeroradiographs and their corresponding conventional radiographs were selected, and the xeroradiographs labeled to illustrate normal anatomy. Selected views of the barn owl ( Tyto alba ) were included to illustrate significant differences between this and other species of owls.     

NORMAL XERORADIOGRAPHIC AND RADIOGRAPHIC ANATOMY OF THE MALLARD DUCK (ANAS PLATYRHYNCHOS) WITH REFERENCE TO OTHER ANSERINE SPECIES

The purpose of this study was to provide a reference for xeroradiographic and conventional radiographic anatomy of the mallard duck ( Anas platyrhynchos ) as a representative of the avian Order Anseriformes. The head, body, wing, and pelvic limb of three adult birds were radiographed using xeroradiographic and conventional radiographic techniques. Nine xeroradiographs and their corresponding conventional radiographs were selected, and the xeroradiographs labeled to illustrate normal anatomy. Selected views of other anseriform species were included to illustrate certain anatomical features unique to those species.     

Multi‐modality diagnostic imaging of a cervical articular process fracture in a Thoroughbred horse including a novel C‐Arm imaging technique

Interpretation of cervical radiographs can be challenging due to the complex anatomy and superimposition of osseous structures on either side of the vertebrae. This report describes the investigation of neck pain in a Thoroughbred gelding following a traumatic fall. Several imaging modalities were used to demonstrate the presence of a fracture of the left cranial articular process of the fourth cervical vertebra (C4), including nuclear scintigraphy, ultrasonography, oblique radiographic projections and a novel cineradiographic technique. Oblique radiographs were superior to standard lateral‐lateral radiographs in both the diagnosis and for monitoring the progression of healing of the articular process fracture in this case.     

NORMAL XERORADIOGRAPHIC AND RADIOGRAPHIC ANATOMY OF THE RED-TAILED HAWK (BUTEO JAMAICENCIS), WITH REFERENCE TO OTHER DIURNAL RAPTORS

The purpose of this study was to provide a reference for xeroradiographic and conventional radio-graphic anatomy of the red-tailed hawk (Buteo jamaicencis) as a representative of the avian Order Falconiformes. The head, body, wing, and pelvic limb of three adult birds were radiographed using xeroradiographic and conventional radiographic techniques. Twelve xeroradiographs and their corresponding conventional radiographs were selected, and the xeroradiographs labeled to illustrate the normal anatomy of these regions.     

AN INNOVATIVE TECHNIQUE FOR DISPLAYING THREE DIMENSIONAL RADIOGRAPHIC ANATOMY OF SYNOVIAL STRUCTURES IN THE EQUINE DISTAL LIMB

Radiography is the most commonly applied imaging modality in equine practice and forms an essential part of the diagnostic work-up of lame horses. Radiographic signs of musculoskeletal pathology are frequently localized at sites of soft tissue attachment, which are often not clearly visible on radiographs. Different lesions carry different prognoses and require a variety of treatments, and a good knowledge of the position of the synovial structures in the distal limb of the horse is essential for practitioners in the interpretation of radiographs. This study describes a new technique for creating three-dimensional (3D) models of the synovial structures and superimposing them onto radiographs for the purpose of teaching radiographic anatomy. A set of standard radiographs was acquired of the metacarpophalangeal and the distal interphalangeal joints of a fresh cadaver leg while the leg was positioned in a material-testing machine to mimic the weight-bearing horse. Computed tomography of the same regions was performed after injection of negative contrast medium into the joints. 3D reconstructions of the joints were created using grayscale thresholding and polynomial surface meshing in Mimics. The resulting 3D reconstructions were superimposed on top of the radiographs using Adobe^© Photoshop^© CS3 Extended, thus allowing the visualization of the joint anatomy in relation to the bone on all projections. The main advantage of this technique is that it allows synovial structures to be visualized on radiographs where they are normally indistinct, which will serve as a teaching aid for anatomy.     

COMPARISON OF THE IMAGE QUALITY OF A HIGH‐RESOLUTION SCREEN–FILM SYSTEM AND A DIGITAL FLAT PANEL DETECTOR SYSTEM IN AVIAN RADIOGRAPHY

A conventional high‐resolution screen–film system was compared with a digital detector system. A total of 20 birds (14 pigeons and six psittacine birds) with an average body mass of 533 g were examined in dorsoventral as well as lateral projections. Digital radiographs were acquired with the same mAs as well as half the mAs used for the conventional radiographs. Three criteria and one overall assessment were defined for each of four anatomic regions and assessed by five veterinarians using a score system. Comparison of the ratings was done by visual grading analysis. For the majority of criteria, there was no significant difference regarding image quality between the digital and screen–film projections. However, for certain criteria the quality of the digital images was significantly superior. Using the same mAs as for the conventional radiographs, the humeral joint surfaces and the honeycomb structure of the lung were assessed as superior with the digital imaging system. The tracheal rings and the delineation of the trachea from the surrounding tissue were also superior with the digital system. Assessment of the trabecular structure of the humerus was superior when the full mAs was used compared with the reduced mAs. In conclusion the digital technique is equal or superior to the conventional screen–film high‐resolution system for pet birds of a medium size. With some limitations, a dose reduction is possible with the digital system.     

RADIOGRAPHY OF THE EQUINE THORAX: ANATOMY AND TECHNIC

Radiographic evaluation of the entire adult equine thorax in the standing position requires a minimum of four overlapping lateral radiographs. Small horses could often be studied with fewer radiographs. This basic examination provided the optimal radiographic opportunity for detecting lung diseases in the horse. An understanding of normal gross and radiographic anatomy is an absolute necessity if one is to avoid the potential diagnostic pitfalls inherent in radiographic interpretation of the equine thorax. Of equal importance is an appreciation for the technic required to produce thoracic radiographs. The advent of rare-earth intensifying screen and highspeed film systems has enhanced the opportunity for obtaining diagnostic standing lateral equine thoracic radiographs.     

RADIOGRAPHIC PROTOCOL AND NORMAL ANATOMY OF THE HIND FEET IN THE WHITE RHINOCEROS (CERATOTHERIUM SIMUM)

Foot pathology is a common and important health concern in captive rhinoceroses worldwide, but osteopathologies are rarely diagnosed, partly because of a lack of radiographic protocols. Here, we aimed to develop the first radiographic protocol for rhinoceros feet and describe the radiographic anatomy of the white rhinoceros (Ceratotherium simum) hind foot (pes). Computed tomographic images were obtained of nine cadaver pedes from seven different white rhinoceroses and assessed for pathology. A single foot deemed free of pathology was radiographed using a range of different projections and exposures to determine the best protocol. 3D models were produced from the CT images and were displayed with the real radiographs to describe the normal radiographic anatomy of the white rhinoceros pes. An optimal radiographic projection was determined for each bone in the rhinoceros pes focusing on highlighting areas where pathology has been previously described. The projections deemed to be most useful were D60Pr‐PlDiO (digit III), D45Pr45M‐PlDiLO (digit II), and D40Pr35L‐PlDiLO (digit IV). The primary beam was centered 5–7 cm proximal to the cuticle on the digit of interest. Articular surfaces, ridges, grooves, tubercles, processes and fossae were identified. The radiographic protocol we have developed along with the normal radiographic anatomy we have described will allow for more accessible and effective diagnosis of white rhinoceros foot osteopathologies.     

NORMAL XERORADIOGRAPHIC AND RADIOGRAPHIC ANATOMY OF THE BOBWHITE QUAIL (Colinus virginianus), WITH REFERENCE TO OTHER GALLIFORM SPECIES

The purpose of this study was to provide a reference for xeroradiographic and conventional radiographic anatomy of the bobwhite quail ( Colinus virginianus ) as a representative of the avian order Galliformes. The heads, bodies, wings, and pelvic limbs of four adult birds were radiographed using xeroradiographic and conventional radiographic techniques. Nine xeroradiographs and their corresponding conventional radiographs were selected, and the xeroradiographs labeled to illustrate the normal anatomy of these regions. A xeroradiograph of the transometatarsus of the domestic peacock ( Pavo cristatus ) was also included to demonstrate the metatarsal spur, which is not present in the quail.     

Unipodal stance influences radiographic evaluation of foot balance in horses

Lifting the contralateral forelimb (unipodal stance) is often used as a method of restraint in horses. This experimental one group pretest, posttest study was conducted to evaluate the effects of unipodal stance on quantitative radiographic parameters in equine forefeet. Seven nonlame horses were randomly selected. Lateromedial (LM) and dorsopalmar (DP) projections were acquired for both forefeet, squarely placed on blocks, using two X‐ray generators. Radiographs of each foot were acquired first in a bipodal stance, immediately followed by the same radiographic projections obtained in a unipodal stance. The following measurements were recorded for each stance: distal interphalangeal joint (DIPJ) space width on both projections; mediolateral joint balance as the difference between lateral and medial DIPJ space widths on DP projections; extensor process‐to‐middle phalangeal condyle distance; and deep digital flexor tendon angle on LM projections. A matched pairs design and Student's t‐test with a 95% confidence level were used to test for statistical significance. Compared to a bipodal stance, lateral DIPJ space width was significantly reduced on unipodal DP views, whereas mediolateral joint imbalance and to a lesser extent medial DIPJ space width were significantly increased. On unipodal LM views, there was a significant higher degree of DIPJ flexion. These findings suggest that stance should be carefully taken into consideration when measuring radiographic parameters in equine forefeet, especially if assessing foot balance and conformation, as unipodal stance significantly affects the mediolateral balance of the DIPJ on DP radiographs and significantly alters the phalangeal axis on LM radiographs.     

SENSITIVITY OF RADIOGRAPHIC DETECTION OF LUNG METASTASES IN THE DOG

Thoracic radiographs were taken in right lateral recumbent (RLR), left lateral recumbent (LLR), and ventrodorsal (VD) projections in 80 dogs with known or suspected malignant tumors. Radiographs in each projection were interpreted, independently of those in the other two projections, by four veterinary radiologists, and classified as positive or negative for one or more lung metastases. The four radiologists then met, to agree on a diagnosis for each patient by simultaneously reviewing all three views. This panel diagnosis became the standard for subsequently classifying individual views as either true positive or true negative. As determined by a consensus of the panel, 25 dogs had at least one positive thoracic radiograph.
The three radiographic projections differed in sensitivity for the detection of lung metastases. In this study, the RLR view was the most sensitive, and the VD view the least sensitive. The sensitivity of detection improved significantly with multiple readers. From these data we recommend that, for detection of lung metastases in the dog, the RLR view be included in any diagnostic protocol; a minimum of two readers be used; and a three-view protocol be used if only one reader is available.