Observer variability and sensitivity of radiographic diagnosis of canine medial coronoid disease.

OBJECTIVE: Medial coronoid disease (MCD) is a very common form of elbow joint disease and it's radiographic diagnosis can be challenging since it is frequently based on the detection of rather subtle primary or secondary changes than on a large primary lesion. We hypothesized that accuracy of radiographic diagnosis of MCD is highly dependent on training and experience level. METHODS: Radiographs of 102 canine elbows were evaluated for MCD by four observers with different levels of training and experience. All elbows underwent CT scans and arthroscopy. Sensitivity and specificity of radiographic and CT interpretation was determined using arthroscopy as a gold standard. Interobserver and intraobserver agreement (reliability and repeatability) were assessed by using Cohen's Kappa (κ) statistic. RESULTS: The sensitivity (92.4-96.7%) of the two experienced observers was almost comparable to that of CT (100%) and significantly higher than that of the two less experienced observers (77.2-80.4%). Reliability of the radiographic diagnosis of MCD was better between observers with higher experience level (κ= 0.74) than between observers of lower or different experience levels (κ=0.07-0.42). Repeatability was better in experienced (κ= 0.73-0.88) than in less experienced observers (κ= 0.31-0.42). CONCLUSION: Our results confirm that training and experience play important roles in reaching high sensitivity, reliability and repeatability for the radiographic diagnosis of MCD. CLINICAL RELEVANCE: Although radiography is inferior to CT in imaging of the medial coronoid process itself, sensitivity of radiographic diagnosis MCD can be significantly improved with observer experience almost reaching that of CT. Therefore, it is advised that radiographic screening for MCD should be performed by specialists experienced in the radiographic evaluation of elbow joint disease.

[Diagnostic value of CT and MRI for the diagnosis of coronoid pathology in the dog]. / Diagnostische Wertigkeit von Computertomographie und Magnetresonanztomographie für die Diagnose einer Koronoiderkrankung beim Hund.

OBJECTIVE: The diagnostic value of CT and MRI regarding the diagnosis of coronoid pathology in the dog. MATERIAL AND METHODS: Computed tomography (CT) and magnetic resonance imaging (MRI) of the elbow joint were performed in dogs with clinical and radiological signs of coronoid pathology. Afterwards, all dogs underwent arthroscopic surgery. For the computed tomographic examination, a 16-slice-CT-scanner spiral-CT (Philips Brilliance 16) was used. The MRI-examination was performed with a 1-Tesla superconducting magnet (Phillips Intera 1.0). T1 and T2 weighted images with different sequences were acquired. RESULTS: In total, 44 elbow joints from 44 patients (total of 12 breeds, including mixed breeds) were examined. The most represented breeds were Labrador Retrievers (38.6%, n=17), mixed breed dogs (22.7%, n=10) and Golden Retrievers (11.4%, n=5) were represented most. The age of the 30 male dogs (68%) and 14 female dogs (32%) ranged from 6 to 117 months (mean 2.25 years). Using CT, the following results could be evaluated: a) fissure at the level of the Processus coronoideus medialis ulnae (PCM) in 66% (n=29); b) fragments at the level of the PCM in 55% (n=24); c) deformation at the level of the PCM in all 44 joints; d) increased opacity at the level of the base of the PCM in all 44 joints; e) heterogenous opacity at the apex of the PCM in 91% (n=41). With MRI, the following results could be evaluated: a) fissure at the level of the PCM in 59% (n=26); b) fragments at the level of the PCM in 57% (n=25); c) deformation at the level of the PCM in 86% (n=38); d) increased opacity at the level of the base of the PCM, thus making assessment impossible; e) heterogenous opacity at the apex of the PCM, thus making assessment impossible. CONCLUSION AND CLINICAL RELEVANCE: Both diganostic imaging modalities are appropriate for evaluating coronoid pathology in the dog.

Medullary cavity diameter of metacarpal and metatarsal bones in cats. A cadaveric radiographic and computed tomographic analysis.

OBJECTIVES: To compare radiography and computed tomography (CT) for the evaluation of medullary cavity diameters of metacarpal and metatarsal bones in cats and to analyse their correlation with intramedullary pin size. METHODS: Radiography and CT were performed in cadavers (n = 12). The mid-diaphysis was determined and the medullary cavity diameter was measured by two observers. Each bone was osteotomized at the mid-diaphysis, Kirschner wires were inserted, and pin size was documented. Intra- and interobserver variability was evaluated (hierarchical analysis of variance). Radiography and CT were compared (correlation analysis, a t-test for dependent samples, a Bland-Altman analysis) and pin size, radiography and CT were compared (regression and correlation analysis). RESULTS: Intra-observer variability was low for radiographs and CT, with an estimated median variation of 0.10 mm for radiographs and 0.12 mm for CT. Inter-observer variability was low, with a median variation of 0.03 mm for radiographs and 0.21 mm for CT. There was a high correlation between radiography and CT for the assessment of the medullary cavity diameter. A high correlation was found between pin size and measurement on radiographs, and between pin size and measurements on CT. In two cats, pin insertion was difficult or impossible. CLINICAL SIGNIFICANCE: Mid-diaphyseal measurements are applicable methods for the assessment of the medullary cavity diameter in feline metacarpal and metatarsal bones regarding intramedullary pins. In some cats the medullary cavity diameter may be too small for intramedullary pinning techniques, which can be identified preoperatively on radiographs.

[Assessment of the inter- and intraobserver variability for sonographical measurement of intestinal wall thickness in dogs without gastrointestinal diseases]. / Inter- und Intraobserver-Variabilität bei der sonographischen Bestimmung der Darmwanddicke von Hunden ohne gastrointestinale Erkrankungen.

OBJECTIVE: The aim of the present study was to determine inter- and intraobserver agreement for transabdominal ultrasonographic measurements of the intestinal wall in dogs without gastrointestinal diseases. MATERIAL AND METHODS: This prospective study included 30 dogs diagnosed with a non-gastrointestinal disease and were evaluated using a transabdominal ultrasound scan in our clinic. Transverse ultrasonographic images for each segment (duodenum, jejunum, colon descendens) were obtained. These images were masked, randomized and imported as DICOM files in the OsiriX® version 5.0 program for Mac Os X. Two observers independently determined the intestinal wall thicknesses using the software inherent measurement tools. The measurements were repeated five times for each segment in all patients on 4 consecutive days. Therefore, each observer performed 1800 measurements, and 3600 measurements in total were analyzed. RESULTS: The mean values for each intestinal segment were comparable to those in the literature. The statistical analyses showed a significant positive correlation (p  <  0.01) for the inter- and intraobserver measurements at all intestinal locations. There was very high intraobserver repeatability for the measurements, with deviations of <  10%. In addition, the study displayed good interobserver reproducibility for the measurements of all intestinal segments, with variances of <  20% for the duodenum and jejunum, and <  50% for the colonic wall thickness. Even with these variances the interobserver variability for all segments was much less than the mean deviance between normal and diseased dogs. CONCLUSION AND CLINICAL RELEVANCE: Transabdominal ultrasonography is a practicable tool to assess intestinal wall thickness and integrity in small animal medicine. Our results are comparable to established reference ranges for the normal canine intestinal wall thickness. In addition, we found a good inter- and intraobserver agreement for the measurements of the canine wall thicknesses in dogs without gastrointestinal diseases.

Spinal fracture in a dog with diffuse idiopathic skeletal hyperostosis.

A six-year-old, spayed female Weimaraner dog was first presented with the complaint of hindlimb paresis and then hindlimb paralysis two years later after colliding with a tree. Radiographs and computed tomography revealed spinal fractures at lumbar vertebrae (L)2-3 and at L4-5. In addition, the spinal column was affected by new bone formation along the vertebral bodies, bridging the disc spaces, as seen in diffuse idiopathic skeletal hyperostosis (DISH). Open reduction and internal fixation was achieved with standard vertebral body plating. This is the first report of DISH-associated spinal fractures after minor trauma in a dog. Surgery resulted in return of the full function after the first, and in improvement of neurologic function after the second incident.

[Musculotendinopathy of the gastrocnemius muscle in a Labrador Retriever. A case report]. / Muskulotendinopathie des Musculus gastrocnemius bei einem Labrador Retriever. Ein Fallbericht.

Musculotendinopathy at the origin of the gastrocnemius muscle is a rare disease mostly described in herding dogs. The etiology is based on repeated myotendinous strain of the muscle in athletic dogs. Clinically, the patient displays chronic pelvic limb lameness and pain at the lateral fabella during palpation of this area. There is no instability of the stifle present. Radiographic findings (osteophyte formation at the origin of the muscle and the lateral fabella) support the potential diagnosis. Magnetic resonance tomography shows edematous changes and enhancement after intravenous application of contrast agent in the area of the origin of the lateral gastrocnemius head. With conservative treatment (i. e. leash confinement, NSAID application and physiotherapy) the prognosis is good. This case report describes clinical findings, diagnostic imaging, therapy and long-term outcome of an athletic Labrador Retriever presented with this disease.

[Enterocutaneous fistula formation in a dog as a result of colonic foreign body perforation]. / Enterokutane Fistelbildung infolge Perforation des Kolons durch einen hölzernen Fremdkörper bei einem Hund.

A 5-year-old female Poodle was presented with a 3-month history of recurrent abscess and fistula formation on the right abdominal wall. Radiographic and ultrasonographic examinations demonstrated an enterocutaneous fistula formation secondary to foreign body perforation of the colon. Additionally, the diagnosis of a pyometra was made. Twenty-four hours after surgical therapy (ventral midline coeliotomy, foreign body removal, closure of the colon perforation, abdominal lavage and drainage, revision of the fistula) the patient was euthanized due to sepsis and incipient multiorgan dysfunction.

[Computed tomography in cats with craniofacial trauma with regard to maxillary and orbital fractures]. / Computertomographische Untersuchung des Schädels von Katzen mit kraniofazialem Trauma im Hinblick auf Maxilla- und Orbitafrakturen.

OBJECTIVE: Computed tomographic examination of the skull of cats with craniofacial trauma. Analysis of diagnostic findings with regard to the occurrence of isolated and combined maxillary and orbital fractures. MATERIAL AND METHODS: Prospective study (August 2006 - June 2010): Computed tomography (CT) of the skull of cats with craniofacial trauma. RESULTS: Thirty-eight cats met the inclusion criteria. Breeds were 36 Domestic Shorthair cats, one Maine Coon and one Somali cat. Age at admission ranged from 11 to 187 months. The ratio of the numbers of males to females was 22:16 (1.4). Computed tomographic examination revealed a maxillary fracture in 27 (71%) animals. Sixteen (42%) cats had multiple maxillary fractures (≥2). Twenty-eight animals (74%) displayed orbital fractures. Combined maxillary and orbital fractures occurred in 26 (68%) patients. The odds ratio of this combined occurrence was 87 (p<0.001). Sixteen (57%) of 28 cats with orbital fractures showed multiple orbital fractures (≥2). The incidence of bilateral orbital fractures was 67% (25 patients). The medial orbital wall was the most commonly fractured orbital wall (66%), and the orbital floor the second most common (61%). CONCLUSION: Computed tomographic examination of the skull of cats with craniofacial trauma showed that maxillary and orbital fractures are more common than previously described. Combined maxillary and orbital fractures occurred in more than half of the patients. In cats, orbital fractures mainly affect the medial orbital wall and the orbital floor. CLINICAL RELEVANCE: Cats with craniofacial trauma often have maxillary and orbital fractures. The additional information taken from the computed tomographic examination could lead to an optimised therapeutical concept.

Cephalometric measurements and determination of general skull type of Cavalier King Charles Spaniels.

The general skull morphology of the head of the Cavalier King Charles Spaniel (CKCS) was examined and compared with cephalometric indices of brachycephalic, mesaticephalic, and dolichocephalic heads. Measurements were taken from computed tomography images. Defined landmarks for linear measurements of were identified using three-dimensional (3D) models. The calculated parameters of the CKCS were different from all parameters of mesaticephalic dogs but were the same as parameters from brachycephalic dogs. However, the CKCS had a wider braincase in relation to length than in other brachycephalic breeds. Studies of the etiology of the chiari-like malformation in the CKCS should therefore focus on brachycephalic control groups. As Chari-like malformation has only been reported in brachycephalic breeds, its etiology could be associated with a higher grade of brachycephaly, meaning a shorter longitudinal extension of the skull. This has been suggested for other breeds.