Diagnostic imaging of lameness in small animals.

The demand for advanced diagnostic imaging procedures such as nuclear scintigraphy, ultrasonography, computed tomography, and magnetic resonance imaging has increased dramatically over the past 10 years. Veterinarians, seeking to improve their diagnostic capabilities and clients willing to pursue "best medicine" have driven this demand, resulting in installation of advanced imaging facilities at most academic and private referral practices. Knowledge of potential benefits of various modalities will allow the veterinarian to optimize his or her use of diagnostic imaging in his or her own practice or in a referral practice.     

Prospective evaluation of techniques for differentiating shoulder pathology as a source of forelimb lameness in medium and large breed dogs

Objective— To assess lameness evaluation, shoulder abduction angles, radiography, and ultrasonography for determining presence, location, and severity of forelimb pathology. Study Design— Prospective cohort study. Animals— Dogs ≥20 kg (n=30). Methods— Each dog was assigned lameness scores. Shoulder abduction angles were determined. Radiographs of shoulders and elbows were subjectively graded for pathology. One investigator unaware of dog history (lameness, radiographic findings) performed ultrasonographic assessment of shoulders with subjective grading of pathology. Another investigator unaware of dog history (lameness, radiographic, ultrasonographic findings) performed arthroscopic assessment of shoulders with subjective grading of pathology. Elbows were disarticulated and evaluated for gross pathology. Histologic pathology scoring of shoulder tissues was performed. Data were compared for differences among groups, sensitivities, specificities, positive and negative predictive values, and positive and negative likelihood ratios were calculated. Results— Twenty‐seven forelimbs were considered clinically normal, 26 had shoulder pathology, 5 had elbow pathology, and 2 had pathology of both the shoulder and elbow. Dogs with shoulder pathology were twice as likely to be lame compared with dogs with elbow pathology. Limbs with medial shoulder instability had significantly higher abduction angles than normal limbs and those with elbow pathology. Radiographs were clinically useful for diagnosing elbow, but not shoulder, pathology. Ultrasonography was clinically useful for diagnosing shoulder pathology other than instability. Abduction angles, ultrasonographic evaluation, and arthroscopic assessments had strong, significant correlations with reference standards. Conclusions— Clinically relevant diagnostic techniques yielded characteristic, repeatable differences in objective and subjective assessments for distinguishing presence, location, and severity of forelimb lameness in dogs. Clinical Relevance— The diagnostic approach to forelimb lameness in dogs should include shoulder pathology as a differential with multiple assessments used to determine the clinical cause of lameness.     

Bone scintigraphy in the investigation of occult lameness in the dog

99mTechnetium methylene diphosphonate (99mTc-MDP) scintigraphy was performed in 14 dogs of different breeds after clinical lameness examination, radiography and synovial fluid analysis failed to localise lameness to a specific area of pain. The scintigraphic protocol included an intravenous injection of 17 MBq 99mTc-MDP/kg bodyweight and vascular, soft tissue and bone phase scans in standardised positions with a low-energy all-purpose collimator. Confirmation of diagnosis was achieved in nine dogs by arthroscopy, repeated lesion-orientated radiography, computed tomography and response to treatment. In seven cases, bone phase scans showed single elbow uptakes, in two cases unilateral limb uptake, and in one case each a single shoulder and tibia uptake; in three cases there was no increased uptake. Vascular and soft tissue phase images did not reveal additional information. Diagnosis of humeral condyle fissures, a fragmented medial coronoid process, panosteitis and arthropathy was possible in nine cases. Skeletal pathology was ruled out in three normal scintigrams. In two dogs with unilateral uptake of multiple joints, no diagnostic benefit was gained from scintigraphy. The highly sensitive and relatively specific uptake allowed localisation and characterisation or exclusion of skeletal lesions in most dogs.     

Local anesthetic techniques for diagnosis of lameness

Successful diagnostic local anesthesia is dependent upon a thorough knowledge of appendicular anatomy, application of correct technique, and accurate interpretation. Use of cadaver specimens to review anatomy and practice needle placement is strongly recommended. A marker solution, such as new methylene blue, can be injected into cadaver limbs, which can be subsequently dissected to verify accuracy. Detailed interpretation of local anesthetic blocks in the lame horse reaches beyond the scope of this article. Interpretive difficulties, however, can be responsible for the failure of a block to provide useful information to the examiner, even though the block may have been performed in a technically correct manner.     

A review of lameness attributable to the shoulder in the dog: part one

The scapulohumeral joint is a common site of forelimb lameness in the dog. Establishing a definitive diagnosis may be difficult because of the limitations of orthopedic examination and radiographs and the inherent elusiveness of the associated conditions. The intent of this review is to present, in a single reference, the pathophysiology, diagnosis, and treatment of reported causes of lameness intrinsically associated with the shoulder. Part One of this series discusses conditions associated with cartilage and bone maturation disorders and joint instability, while Part Two reviews tendon diseases, muscle disorders, synovial diseases, and soft-tissue mineralization disorders.     

A review of lameness attributable to the shoulder in the dog: part two

The scapulohumeral joint is a common site of forelimb lameness in the dog. Establishing a definitive diagnosis may be difficult because of the limitations of orthopedic examination and radiographs and the inherent elusiveness of the associated conditions. The intent of this review is to present, in a single reference, the pathophysiology, diagnosis, and treatment of reported causes of lameness intrinsically associated with the shoulder. Part One of this series discusses conditions associated with cartilage and bone maturation disorders and joint instability, while Part Two reviews tendon diseases, muscle disorders, synovial diseases, and soft-tissue mineralization disorders.     

The radiologic investigation of bovine lameness associated with infection

Infections, primarily of the limbs, are a significant part of our bovine lameness practice here at the Western College of Veterinary Medicine. The majority of these infections relate to the foot. More proximal lesions do occur, however, as detailed in the preceding section. It is interesting to note that such lesions are not assessed radiographically in practice until such time as antibiotics are judged to be ineffective. This period of medical treatment is often lengthy and expensive. The efficacy of potential, as well as ongoing, treatment often is better determined after a clinical and radiologic assessment of the animal. Indeed, radiology can be a paying proposition for both the producer and the practitioner, to say nothing of its obvious benefits to the animal.     

Diagnostic techniques in dermatology: The investigation and diagnosis of adverse food reactions in dogs and cats

Most veterinary clinicians recognize a population of patients in which dermatologic and/or gastrointestinal signs are related to the feeding of particular dietary components. This article briefly reviews the clinical signs associated with adverse food reactions in dogs and cats, and discusses the practical issues associated with confirming a diagnosis.     

Diagnostic techniques for dermatophytosis

This article reviews the use of common diagnostic tools for the identification and isolation of dermatophyte infections in small animals. The use of the Wood's lamp as a screening tool is discussed, along with its usefulness as an aid in the microscopic examination of hairs for fungal elements. Tests for the definitive diagnosis of dermatophytosis are highlighted and include: direct examination of hair for ectothrix spores, fungal cultures, and skin biopsy. Sampling techniques, procedures, and interpretation of test results are also detailed.     

A field investigation of the use of the pedometer for the early detection of lameness in cattle

The efficacy of the pedometer to predict lameness earlier than the appearance of the clinical signs in a herd of dairy cows was investigated by correlating pedometric activity (PA) with clinical cases of lameness. The computer program was set to identify cows with a reduction of 5% or more in PA compared with their own previous 10 days average; these animals were then examined for clinical lameness. At the same time, every lame cow was checked to see if and when its PA was reduced. Forty-six cows showed a reduced PA; 38 cases of lameness were identified by either a reduction in PA or clinical observation; of these, 21 lame cows (45.7%) showed a reduction in PA of 5% or more, 7 to 10 days prior to the appearance of clinical signs. This cohort comprised 55.3% of the lame cows. In 92% of the lame cows identified by PA, the decrease was above 15%.     

鸡传染性支气管炎的诊断技术

鸡传染性支气管炎（IB）是由鸡传染性支气管炎病毒（IBV）引起的鸡的急性、高度接触性传染病，该病是以损伤气管、引起肾脏病变、高死亡率、母鸡产蛋量下降和产畸形蛋为特征。因而，对本病进行快速、准确的诊断以便及时调整免疫战略，从而有针对性进行免疫预防是非常关键的。目     

Diagnostic techniques and sample collection

With the advancing knowledge of medicine, diagnostic techniques and laboratory equipment, practicing veterinary surgeons are increasingly capable of processing many of their patients' blood, urine, and tissue samples on-site. No case is better suited to this scenario than the dermatology case, which enjoys a unique privilege in the clinic because the clinician is frequently able to harvest, process, and analyze pathologic samples from affected animals during or shortly after the consultation, eliminating the need to wait for results from external laboratories and consequently reducing the time to recovery. Good sampling techniques are crucial for the acquisition of optimal data however, and this article highlights the key points of these procedures and recommends when they are best employed.