CT is a feasible imaging technique for detecting lesions in horses with elbow lameness: A study of 139 elbows in 99 horses

Abstract

Computed tomography (CT)is increasingly available in veterinary referral practices; however, published studies describing CT lesions of the equine elbow are currently lacking. In this single‐center, retrospective, observational study, horses undergoing elbow CT at Equitom between July 2015 and October 2018 were reviewed. Subchondral bone sclerosis; resorption of the radius, ulna, and humerus; osteophyte; and enthesophyte lesions were graded. One hundred thirty‐nine elbows of 99 horses (16 with elbow pain and 123 control elbows) were included (median age, 9 years). Osseous cyst‐like lesions (n = 13), only seen in the proximomedial radius and medial humerus, were the most common cause of lameness in horses with elbow pain (n = 16), with significantly higher grades of bone resorption (including osseous cyst‐like lesions) in this group. One elbow had an avulsion fracture of the lateral epicondyle, two others showed signs of osteoarthritis. Significantly higher grades of sclerosis in the proximomedial radius were seen in horses with elbow pain; however, mild to moderate subchondral bone sclerosis was seen in all horses at the medial aspect of the joint. Osteochondral fragmentation lesions of the weight‐bearing surface of the medial radius (2/16 vs 1/123; P = .0025) and intra‐articular gas (4/16 vs 2/123; P < .0001) were significantly more common in horses with elbow pain compared to control horses. Mild linear resorptive subchondral bone lesions were often not clinically relevant (32/123 vs 5/16 in medial humerus; 19/123 vs 2/16 in medial radius). In conclusion, elbow CT is a feasible method for detecting clinically relevant lesions in adult Warmblood horses with elbow pain.

Computed tomography of the equine elbow: A subchondral bone lesion in a novel location

“…CT descriptions of cyst-like resorptive lesions within the elbow are currently limited to the proximomedial radius and medial humeral trochlea (Zimmerman et al, 2022), similar to radiographic reports (Roquet et al, 2017). The authors add to the current literature, describing the use of CT in the diagnosis and treatment of a filly with resorptive elbow pathology within the medial humeral epicondyle.…”

“…Reports describing computed tomography (CT) of the equine elbow are limited to one retrospective study (Zimmerman et al, 2022) and several case reports (Barba & Lepage, 2013; Fridel et al, 2022; Vandekerckhove et al, 2021). A variety of elbow pathology has been identified, including osseous cyst‐like lesions (Zimmerman et al, 2022), fractures (Vandekerckhove et al, 2021), physitis (Barba & Lepage, 2013) and osteochondrosis (Zimmerman et al, 2022).…”

“…Reports describing computed tomography (CT) of the equine elbow are limited to one retrospective study (Zimmerman et al, 2022) and several case reports (Barba & Lepage, 2013; Fridel et al, 2022; Vandekerckhove et al, 2021). A variety of elbow pathology has been identified, including osseous cyst‐like lesions (Zimmerman et al, 2022), fractures (Vandekerckhove et al, 2021), physitis (Barba & Lepage, 2013) and osteochondrosis (Zimmerman et al, 2022). CT descriptions of cyst‐like resorptive lesions within the elbow are currently limited to the proximomedial radius and medial humeral trochlea (Zimmerman et al, 2022), similar to radiographic reports (Roquet et al, 2017).…”

“…A variety of elbow pathology has been identified, including osseous cyst‐like lesions (Zimmerman et al, 2022), fractures (Vandekerckhove et al, 2021), physitis (Barba & Lepage, 2013) and osteochondrosis (Zimmerman et al, 2022). CT descriptions of cyst‐like resorptive lesions within the elbow are currently limited to the proximomedial radius and medial humeral trochlea (Zimmerman et al, 2022), similar to radiographic reports (Roquet et al, 2017). The authors add to the current literature, describing the use of CT in the diagnosis and treatment of a filly with resorptive elbow pathology within the medial humeral epicondyle.…”

Highlights of recent clinically relevant papers

“…In this retrospective study, Marieke Zimmerman and co‐workers in France and Belgium evaluated the feasibility of computed tomography (CT) as an imaging technique for detecting lesions in horses with elbow lameness .…”