Use of Ultrasonography in Diagnosis of Medial Compartment Disease of the Elbow in Dogs.

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.

Pilot study of the ultrasonographic examination of the intact and transected medial glenohumeral ligament in dogs.

Medial glenohumeral ligament injury is commonly reported during medial shoulder joint instability in dogs. Arthroscopy is considered the gold standard procedure, but it is invasive and requires distension of the joint. Ultrasonographic examination of the medial glenohumeral ligament has been studied as a possible, less invasive alternative to arthroscopy however it has not been considered a useful method of assessment due to the interference of the probe with the pectoral muscles. The aims of this prospective analytical randomized pilot study were to develop a standardized ultrasound protocol for visualizing the canine medial glenohumeral ligament and to compare goniometry and ultrasound findings in cadaver dogs with versus without transection of the medial glenohumeral ligament. Nine adult Beagle cadavers (18 shoulders) were used. The first six shoulders were used in a preliminary study to describe an ultrasound technique to identify the medial glenohumeral ligament. Arthroscopy was performed on the remaining 12 shoulders, with six randomly selected medial glenohumeral ligaments from these shoulders, transected during the procedure. Ultrasound examination was performed after each arthroscopic procedure by an ultrasonographer blinded to the patient group. Four medial glenohumeral ligaments (67%) were correctly identified during the preliminary study. Ultrasonographic examination failed to diagnose the transection of all six medial glenohumeral ligaments in the second part of the study. No difference was observed in the ligament thickness between the dogs with and without a transected medial glenohumeral ligament. Dogs with a transected medial glenohumeral ligament had a wider articular space compared to dogs without a transected ligament (P < 0.001), and an articular space wider than 8.2 mm was discriminatory of a transected medial glenohumeral ligament in all the shoulders. In conclusion, the medial glenohumeral ligament could be identified with a medial ultrasonographic approach of the shoulder and a wider articular space can be a sign of a medial shoulder joint instability. Further studies are needed to confirm these preliminary findings in living dogs, with and without shoulder instability.

Comparison of imaging techniques to detect migrating foreign bodies. Relevance of preoperative and intraoperative ultrasonography for diagnosis and surgical removal.

OBJECTIVE: To report the relative sensitivity of different diagnostic imaging (DI) techniques to detect migrating foreign bodies (FB) in subcutaneous and underlying soft tissue structures of dogs and evaluate the value of intraoperative ultrasonography (intraop-US). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Forty-one dogs. METHODS: Medical records (2007-2019) of dogs that underwent surgery for a chronic abscess or draining tract were included when preoperative US (preop-US), computed tomography (preop-CT), or preop-MRI, and at least 6 months of follow-up information were available. Collected data included the DI techniques used, DI findings, and surgical findings. The relative sensitivity of each preoperative DI (preop-DI) technique was calculated. Dogs were divided into two groups, dogs that underwent only a preop-DI examination (group A) and dogs that underwent an additional intraop-US (group B). The success rates for FB surgical removal were compared between groups. RESULTS: The relative sensitivity of preop-US and preop-CT/MRI was 88% (95% CI, 70%-95.8%) and 57.1% (95% CI, 32.6%-78.6%), respectively. The success rate for FB removal was higher in group B (89.5%) than in group A (59.1%; P = .038). Clinical resolution occurred in 90.2% of dogs for a median duration of follow-up of 4.2 years (6 months to 9.3 years). CONCLUSION: Preoperative US seems more suitable than preop-CT/MRI for detection of migrating FB in subcutaneous and underlying soft tissue structures. The use of intraop-US increases the success rate for FB surgical removal. CLINICAL SIGNIFICANCE: Intraoperative US should be used in combination with preop-US to increase the likelihood of migrating FB surgical removal in dogs.

Stress Radiography for the Diagnosis of Medial Glenohumeral Ligament Rupture in Canine Shoulders.

OBJECTIVES: This study aimed to describe a stress radiography to detect medial glenohumeral ligament rupture and to investigate the repeatability and reproducibility of this test. MATERIALS AND METHODS: Six adult Beagle cadavers were used. Both shoulders of each dog were randomly assigned into two groups: a normal shoulder group (NS group) and an affected shoulder group (AS group) where the medial glenohumeral ligament was arthroscopically transected. Goniometry, image analysis and radiography (normal and stress views) were performed before and after arthroscopic procedures. An abduction angle was determined for each stress view and an evaluation of the repeatability and the reproducibility was performed. RESULTS: Abduction angles were significantly larger in the AS group as measured by goniometer (p < 0.001), image analysis (p < 0.001) and radiographic stress view (p < 0.001) than in the NS group. The abduction angle difference varied from 12° to 29.3° (median difference of 19.4°) between NS and AS groups. There were good intra-observer and very good inter-observer agreements. A very good (r = 0.74; r = 0.72, respectively) significant (p < 0.001) positive correlation between goniometric and radiographic techniques and between image analysis and radiographic techniques was observed. CLINICAL SIGNIFICANCE: Shoulder abduction angles measured with a stress radiograph-specific view provide objective data that may contribute to diagnosis of medial shoulder instability in dogs.

Prospective evaluation of abdominal ultrasonographic findings in 35 dogs with leptospirosis.

Despite the emergence of new serovars, a detailed and current abdominal ultrasonographic description of dogs with leptospirosis is lacking. The purpose of this prospective, observational, single cohort study was to illustrate abdominal ultrasonographic findings in 35 dogs with confirmed leptospirosis. At least one ultrasonographic abnormality was seen in all of the dogs. Ultrasound renal abnormalities were found in all the dogs and included increased renal cortical echogenicity (100%), increased medullary echogenicity (86%), reduced corticomedullary definition (80%), cortical thickening (74%), renomegaly (60%), pelvic dilation (31%), and medullary band (14%). Hepatic changes were identified in 83% of the dogs, with diffuse hypoechoic parenchyma (71%) and hepatomegaly (60%). Biliary gallbladder abnormalities were found in 60% of the dogs, with biliary sludge (46%), wall thickening (29%), mucocele (26%), and hyperechoic wall (20%). The other most frequently observed abdominal abnormalities were perirenal (60%) and peritoneal (46%) effusions, small intestinal wall thickening (49%), and lymphadenopathy (38%). Two dogs (6%) presented with a small intestinal intussusception. No association was found between serogroups and the presence of ultrasonographic findings. This study is the first to prospectively and exhaustively describe abdominal ultrasonographic findings in dogs with leptospirosis. Our results should prompt clinicians to systematically perform abdominal ultrasounds on dogs with suspected leptospirosis even in the absence of abnormal physical signs. The presence of a gallbladder mucocele could be a warning sign of leptospirosis in dogs.

Evaluation of a new method to determine the tibial tuberosity advancement distance required to reduce the patellar tendon-tibial plateau angle to 90° with the modified Maquet technique in dogs.

OBJECTIVE To assess use of a new radiographic method to determine the distance by which the tibial tuberosity should be advanced to reduce the patellar tendon-tibial plateau angle (PTA) to 90° by means of the modified Maquet technique (MMT) in dogs. SAMPLE 24 pelvic limbs from 12 adult medium-sized to large-breed canine cadavers. PROCEDURES Radiographs of stifle joints at 135° extension in true lateral position were used to determine tibial tuberosity advancement distances for use in the MMT. A method was devised to incorporate the planned osteotomy axis; distal patellar translations of 0, 3, 5, or 10 mm; and advancement cage implant application level along the osteotomy site in advancement planning measurements. Concordance correlation coefficients (CCCs) were calculated to compare these adjusted advancement measurements with true advancement measurements obtained for the same joints in another study after treatment by MMT. Intraobserver, interobserver, and total agreement for selected measurements were determined by assessment of CCCs for results obtained by 3 blinded observers. RESULTS Agreement between true advancement measurements and measurements obtained with osteotomy axis and cage position method calculations that incorporated a 5-mm distal patellar translation distance was excellent (CCC, 0.96). Intraobserver and interobserver agreements for the planning measurements evaluated were good to excellent (CCC, 0.83 to 0.96). CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that the osteotomy axis and cage position method incorporating a 5-mm distal patellar translation distance has the potential to improve success rates for achieving a PTA of 90° in medium-sized to large-breed dogs undergoing MMT for treatment of cranial cruciate ligament rupture. Further research is warranted.

Comparison of desired radiographic advancement distance and true advancement distance required for patellar tendon-tibial plateau angle reduction to the ideal 90° in dogs by use of the modified Maquet technique.

OBJECTIVE To evaluate the validity of 2 radiographic methods for measurement of the tibial tuberosity advancement distance required to achieve a reduction in patellar tendon-tibial plateau angle (PTA) to the ideal 90° in dogs by use of the modified Maquet technique (MMT). SAMPLE 24 stifle joints harvested from 12 canine cadavers. PROCEDURES Radiographs of stifle joints placed at 135° in the true lateral position were used to measure the required tibial tuberosity advancement distance with the conventional (AM) and correction (AE) methods. The MMT was used to successively advance the tibial crest to AM and AE. Postoperative PTA was measured on a mediolateral radiograph for each advancement measurement method. If none of the measurements were close to 90°, the advancement distance was modified until the PTA was equal to 90° within 0.1°, and the true advancement distance (TA) was measured. Results were used to determine the optimal commercially available size of cage implant that would be used in a clinical situation. RESULTS Median AM and AE were 10.6 mm and 11.5 mm, respectively. Mean PTAs for the conventional and correction methods were 93.4° and 92.3°, respectively, and differed significantly from 90°. Median TA was 13.5 mm. The AM and AE led to the same cage size recommendations as for TA for only 1 and 4 stifle joints, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Both radiographic methods of measuring the distance required to advance the tibial tuberosity in dogs led to an under-reduction in postoperative PTA when the MMT was used. A new, more accurate radiographic method needs to be developed.