Osteochondral fragmentation of the cervical articular process joints; prevalence in horses undergoing CT for investigation of cervical dysfunction

Abstract

Clinical conditions of the cervical articular process joints (APJ) are well recognised as a cause of pain and loss of function in horses.Clinical presentation varies, depending upon the type, location and severity of APJ pathology. Signs of dysfunction may be localised to the musculoskeletal system, nervous system or affect a combination of the two. Musculoskeletal signs include reduced cervical range of motion, altered head carriage, pain on palpation and focal muscle atrophy. 1,2,3 Neurological signs due to cervical spinal cord compression include ataxia, paresis and proprioceptive deficits. 4 Injury to the cervical nerve roots at their exit from the intervertebral foraminae

Dynamic three‐dimensional computed tomographic imaging facilitates evaluation of the equine cervical articular process joint in motion

“…In a recent report, osteochondral fragments were identified in 24% of horses with cervical dysfunction. 19 The majority of fragments (19/22) were located within the APJ synovial outpouchings, in either a ventral axial or dorsal abaxial location adjacent to the articular margin.…”

Surgical removal of intra‐articular loose bodies from the cervical articular process joints in 5 horses

“…Computed tomography images were obtained from the occiput to the C7/T1 articulation with the horse under general anesthesia, as described by Tucker et al (2021). 6 Loose bodies were identified as discrete structures, partially or completely composed of mineral-attenuating material, located within an APJ. Loose bodies were identified in 14 horses, of which 5 underwent surgery.…”

“…The development of computed tomography (CT) systems capable of imaging the entire cervical spine of adult horses has significantly advanced diagnostic capability for conditions of the equine neck 1–3 . Where available, CT imaging may be used for investigation of reduced cervical range of motion, altered head carriage, pain on neck palpation, cervical ataxia and weakness, and occult forelimb lameness 4–6 . Computed tomography images reveal previously undescribed cervical abnormalities and provide new detail about recognized pathologies, raising questions regarding etiology and clinical relevance and providing new opportunities for treatment.…”

“…One such example is the identification of discrete, mineral‐attenuating loose bodies (LBs) within the articular process joints (APJs). These LBs, previously termed osteochondral fragments, have been identified with a prevalence of 22% (11/51) and 24% (13/55) in UK populations of horses with cervical dysfunction undergoing CT imaging 5,6 . In horses with LBs, concurrent cervical abnormalities such as vertebral dysplasia or APJ arthropathy are commonly present, 6 making the clinical significance of the LBs difficult to establish.…”

“…[1][2][3] Where available, CT imaging may be used for investigation of reduced cervical range of motion, altered head carriage, pain on neck palpation, cervical ataxia and weakness, and occult forelimb lameness. [4][5][6] Computed tomography images reveal previously undescribed cervical abnormalities and provide new detail about recognized pathologies, raising questions regarding etiology and clinical relevance and providing new opportunities for treatment.…”