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Comparison of five radiographic views for assessment of the medial aspect of the humeral condyle in dogs with osteochondritis dissecans

Guillaume ChanoitDepartment of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.

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Nikita N. SinghaniDepartment of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.

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Denis J. Marcellin-LittleDepartment of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.

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Jason A. OsborneDepartment of Statistics, College of Agriculture and Life Sciences, North Carolina State University, Raleigh, NC 27606.

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Abstract

Objective—To compare 5 radiographic views for the detection of osteochondritis dissecans (OCD) in dogs with signs of elbow joint pain.

Animals—53 dogs (100 elbow joints) with forelimb lameness and signs of elbow joint pain.

Procedures—Mediolateral (ML), flexed ML, craniocaudal (CC), craniolateral-caudomedial oblique (Cr15L-CdMO), and distomedial-proximolateral oblique (Di35M-PrLO) radiographic views of the 100 elbow joints were obtained. Four examiners graded radiographs with regard to elbow joint OCD. Joints were assessed by use of arthroscopy. Receiver operating characteristic (ROC) curves, kappa measure of agreement, and Fisher exact tests for association between median diagnostic value and actual status were computed.

Results—47 joints had an abnormal medial aspect of the humeral condyle (MAHC), and among them, 11 had OCD. The presence of fractures of the medial coronoid process was significantly and positively correlated with the presence of abnormalities of the MAHC (r = 0.40), but was negatively correlated with the presence of OCD (r = −0.32). At 95% specificity, median sensitivities to detect OCD were 57% for Cr15L-CdMO, 56% for CC, 10% for flexed ML, 7% for ML, and 4% for Di35M-PrLO views. The areas under the ROC curves were significantly larger for the Cr15L-CdMO and CC views than for the ML, flexed ML, and Di35M-PrLO views for the detection of OCD. Only the Cr15L-CdMO and CC views allowed accurate detection of OCD.

Conclusions and Clinical Relevance—In dogs with signs of elbow joint pain, the Cr15L-CdMO view is excellent and the CC view was good for detection of OCD.

Abstract

Objective—To compare 5 radiographic views for the detection of osteochondritis dissecans (OCD) in dogs with signs of elbow joint pain.

Animals—53 dogs (100 elbow joints) with forelimb lameness and signs of elbow joint pain.

Procedures—Mediolateral (ML), flexed ML, craniocaudal (CC), craniolateral-caudomedial oblique (Cr15L-CdMO), and distomedial-proximolateral oblique (Di35M-PrLO) radiographic views of the 100 elbow joints were obtained. Four examiners graded radiographs with regard to elbow joint OCD. Joints were assessed by use of arthroscopy. Receiver operating characteristic (ROC) curves, kappa measure of agreement, and Fisher exact tests for association between median diagnostic value and actual status were computed.

Results—47 joints had an abnormal medial aspect of the humeral condyle (MAHC), and among them, 11 had OCD. The presence of fractures of the medial coronoid process was significantly and positively correlated with the presence of abnormalities of the MAHC (r = 0.40), but was negatively correlated with the presence of OCD (r = −0.32). At 95% specificity, median sensitivities to detect OCD were 57% for Cr15L-CdMO, 56% for CC, 10% for flexed ML, 7% for ML, and 4% for Di35M-PrLO views. The areas under the ROC curves were significantly larger for the Cr15L-CdMO and CC views than for the ML, flexed ML, and Di35M-PrLO views for the detection of OCD. Only the Cr15L-CdMO and CC views allowed accurate detection of OCD.

Conclusions and Clinical Relevance—In dogs with signs of elbow joint pain, the Cr15L-CdMO view is excellent and the CC view was good for detection of OCD.

Contributor Notes

The authors thank Drs. Laurent Blond, Philippe Haudiquet, and Lisa Jesse for technical assistance.

Address correspondence to Dr. Marcellin-Little (denis_marcellin@ ncsu.edu).