Improved radiological diagnosis of palmar osteochondral disease in the Thoroughbred racehorse

Background Proximal sesamoid bone (PSB) fractures are the most common fatal musculoskeletal injury in North American racehorses. Computed tomography has the potential to detect morphological changes in bone structure but can be challenging to analyse reliably and quantitatively. Objectives To develop a radiomics platform that allows the comparison of features from micro‐CTs (µCT) of PSBs in horses that sustained catastrophic fractures with horses that did not. To compare features calculated with a radiomics approach with features calculated from a previously published study that used quantitative µCT in the same specimens. Study design Retrospective study of cadaver specimens of µCT images of PSBs using prospectively applied radiomics. Methods Radiomics features were computed on standardised CT datasets to benchmark the software. Features from µCT images of PSBs from eight horses that sustained PSB fracture and eight controls were computed using the contralateral, intact forelimb from horses sustaining PSB fracture (cases, n = 19) and all available forelimbs for controls (n = 30). Two‐hundred and fifteen radiomic features were calculated, and similar or comparable features were compared with those reported in a previous study that used the same specimens. Results Morphologic features computed with the radiomics approach, such as volume, minor axis dimensions and anisotropy were highly correlated with previously published data. A high number of imperceptible radiomic features, such as entropy, coarseness and histogram features were also found to be significantly different (P < .01). The extent of the differences in image features for the cases and controls PSBs depends on radiomic calculation settings. Main limitations Only datasets obtained from cadaver specimens were included in the study. Conclusions A radiomics approach for analysing µCT images of PSBs was able to identify and reproduce differences in image features in cases and controls. Furthermore, radiomics revealed many more imperceptible image features between cases and control PSBs.

Section: Discussionmentioning

confidence: 99%

A radiomics platform for computing imaging features from µCT images of Thoroughbred racehorse proximal sesamoid bones: Benchmark performance and evaluation

Basran

Gao

Palmer

et al. 2020

“…Some of the most important conditions involving the racehorse MCP/MTP joint, if radiologically evident at all can only be detected satisfactorily using the flexed dorsopalmar/plantarodorsal projection . Such conditions (palmar/plantar osteochondral disease, unicortical condylar fracture) if present could significantly influence clinical and performance outcomes independent of the presence of osteochondral chip fracture. Unlike previous publications the majority of radiographic series in the present study included this projection, and care was taken to document concurrent pathology that could influence management decisions or clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

Nonsurgical and surgical management of metacarpo/metatarsophalangeal joint dorsal chip fracture in the Thoroughbred racehorse

Ramzan

Wylie

2019

Summary Background Arthroscopy is considered the treatment of choice for dorsal osteochondral chip fractures of the metacarpo/metatarsophalangeal (MCP/MTP) joints in the racehorse; however, there is no published research on non‐surgical management of this injury. Objectives To compare clinical features, intra‐articular medication use and return to racing in Thoroughbred racehorses with non‐surgically (non‐SX) or surgically (SX) managed MCP/MTP dorsal chip fracture. Study design Retrospective observational study conducted between 2006 and 2014. Methods Radiographs of Thoroughbred racehorses were reviewed to identify MCP/MTP dorsal osteochondral chip fractures. Clinical and intra‐articular medication data were obtained from veterinary records, and return to racing data from a public online resource. Results A total of 98 MCP/MTP horses with dorsal chip fractures were identified (70 non‐SX, 28 SX). Median age was 2 years (range 2–7 years). Osteochondral chip fractures predominantly involved the forelimbs (n = 92, 93.9%) and the majority were considered by the treating clinician to be clinically active (n = 85, 86.7%). Significantly more SX horses had a reported ongoing problem associated with the affected joint than non‐SX horses (P = 0.002), however there was no significant difference between non‐SX and SX horses in the number of intra‐articular medications of affected joint per month of follow‐up (P = 0.22). The proportion of horses racing post‐diagnosis was not significantly different between non‐SX (55/70; 78.6%, 95% CI 69.0, 88.2%) and SX horses (24/28; 85.7%, 95% CI 72.8, 98.73%) (P = 0.57). Median time to first start following diagnosis for non‐SX (106 days, range 1–326) was significantly shorter than for SX horses (203 days, range 9–559) (P = 0.002). Main limitations Management technique was not randomised or blinded, with few surgically managed horses. Conclusions The results contribute to the current evidence base used to guide management of osteochondral chip fractures of the MCP/MTP joints in the racehorse, and indicate that non‐surgical management may be a valid treatment option for some injuries.

“…Consequently, there is a need to undertake future studies including only ante‐mortem samples of both cases and controls in order to confirm the significance, if any, of this finding. In addition, although MRI is an accurate representation of cartilage and SCB density , gross and histological examination of the condyles would have improved the accuracy of grading of disease severity however this was not possible given the design of the study.…”

Section: Discussionmentioning

confidence: 99%

Metabolomic analysis of synovial fluid from Thoroughbred racehorses diagnosed with palmar osteochondral disease using magnetic resonance imaging

Graham

Anderson

Phelan

et al. 2019

Summary Background Palmar osteochondral disease (POD) is a common cause of lameness in competition horses. Magnetic resonance imaging (MRI) is the most sensitive diagnostic modality currently available, however it may not be financially or logistically practical for routine screening of POD. There is increasing interest in the use of metabolomics for diagnosis prior to progression to irreversible damage. Objectives To determine metabolite levels in synovial fluid (SF) of horses with a clinical diagnosis of POD based on diagnostic analgesia and MRI, with the hypothesis that metabolomic profiles differ between diseased and healthy joints. Study design Prospective clinical study. Methods Synovial fluid was collected from metacarpo/tarsophalangeal joints (MC/TPJ) of 29 horses (n = 51 joints), including 14 controls (n = 26) and 15 cases (n = 25), the latter with lameness localised to the MC/TPJ and MR changes consistent with POD (n = 23). Spectra were produced using 1H‐nuclear magnetic resonance (NMR) spectroscopy and analysed. Results Twenty‐five metabolites were recognised associated with various biosynthetic and degradation pathways. The metabolite abundances within the controls demonstrated increased variability compared with the clinical group. The low level of variance between the spectra of the two groups was explained by five principal components. Cross‐validation of the cohort demonstrated modest separation of predictive power (R2 = 0.67; Q2 = 0.34). Although statistical significance was not achieved, the most influential metabolites were glucose and lactate. Main limitations The modest sample size and variation in signalment, background and presenting condition of the controls may have impacted the discriminative power of the constructed models. The lack of matched controls, differences in time of fluid collection and freezing times may have also reduced accuracy when representing metabolite profiles. Conclusions This study identified and quantified metabolites present in MC/TPJ SF of clinical cases with POD.