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Reasons for Performing Study: Computed tomography (CT) is increasingly accessible in equine referral hospitals., Objectives: To document the level of agreement within and between radiography and CT in characterising equine distal limb fractures., Study Design: Retrospective descriptive study., Methods: Images from horses that underwent radiographic and CT evaluation for suspected distal limb fractures were reviewed, including 27 horses and 3 negative controls. Using Cohen's kappa and weighted kappa analysis, the level of agreement among 4 observers for a predefined set of diagnostic characteristics for radiography and CT separately and for the level of agreement between the 2 imaging modalities were documented., Results and Conclusions: Both CT and radiography had very good intramodality agreement in identifying fractures, but intermodality agreement was lower. There was good intermodality and intramodality agreement for anatomical localisation and the identification of fracture displacement. Agreement for articular involvement, fracture comminution and fracture fragment number was towards the lower limit of good agreement. There was poor to fair intermodality agreement regarding fracture orientation, fracture width and coalescing cracks; intramodality agreement was higher for CT than for radiography for these features., Potential Relevance: Further studies, including comparisons with surgical and/or post mortem findings, are required to determine the sensitivity and specificity of CT and radiography in the diagnosis and characterisation of equine distal limb fractures., (© 2013 EVJ Ltd.)

Reasons for Performing Study: Distal border synovial invaginations of the distal sesamoid bone are radiographically assessed during the selection process of horses admitted as breeding stallions or in purchase examinations. Nowadays, many moderately or some deeply penetrating proximally enlarged synovial invaginations are considered as moderate or severe radiographic findings., Objective: To measure the difference between and agreement of the morphology of distal border synovial invaginations on radiography vs. computed tomography (CT). It was hypothesised that the morphology of distal border synovial invaginations would be better evaluable on CT compared with radiography., Methods: Computed tomography scans and 3 dorsoproximal-palmarodistal oblique (DPr-PaDiO) radiographs were obtained on 50 cadaver forefeet from 25 Warmblood horses. Computed tomography was assumed to be the gold standard. The number, shape and depth of penetration of distal border synovial invaginations into the distal sesamoid bone were evaluated with both methods, and the comparison of their measurements was statistically described., Results: A statistically significant mean difference for number of distal synovial invaginations between CT and all 3 DPr-PaDiO projections was found and was approximately equal to 2, meaning that CT permits visualisation of an average of 2 more invaginations than radiography. In none of the cases did radiography have a higher number observed than CT. A large variation in the difference of measurements for depth of penetration against their mean difference between CT and the 3 radiographic projections was seen. Radiography underestimated the depth of invaginations, and more so when these were deeper. There was no statistically significant mean difference found between the techniques for depth. A moderate to good agreement between measurements on CT and the three DPr-PaDiO projections for shape was seen, in which the D55°Pr-PaDiO projection showed the best agreement. A high specificity (90-99%) and low sensitivity (65%) for all projections for shape were found., Conclusions and Potential Relevance: Radiography differs considerably from CT concerning the morphology of distal navicular border synovial invaginations. For the evaluation of the number, depth and shape of distal synovial invaginations in the distal sesamoid bone, radiography shows only partially the morphology seen on CT., (© 2012 EVJ Ltd.)

Objectives: To compare the difference and agreement of the morphology of distal border synovial invaginations on a dorsoproximal-palmarodistal oblique (DPr-PaDiO) projection with hoof-specific angle versus computed tomography., Methods: Computed tomography (CT) images and a DPr-PaDiO radiographic projection with hoof-specific angle were obtained on 50 cadaveric forefeet from 25 Warmblood horses. Computed tomography was assumed to be the gold standard. The number, shape and depth of penetration of distal border synovial invaginations into the distal sesamoid bone were evaluated with both methods, and the comparison of their measurements was statistically described., Results: Significantly more invaginations were seen on CT compared to radiography, with an observed average difference of 1.2. In none of the cases did radiography have a higher number than that observed with CT. No statistically significant difference for depth between CT and the DPr-PaDiO projection was seen, however, there was quite a large variation of the actual difference of measurements against their mean found. Radiography was underestimated when high mean values applied. The agreement between both modalities for shape was moderate to good. A very high specificity of the specific DPr-PaDiO projection for shape was found (97%)., Clinical Significance: The radiographic projection with hoof-specific angle differs significantly from CT concerning the number and depth of the distal border synovial invaginations. Therefore, this specific view may not be considered useful in the evaluation of these invaginations.

Objective: To compare computed tomography (CT) images of equine tarsi with cross-sectional anatomic slices and evaluate the potential of CT for imaging pathological tarsal changes in horses., Sample: 6 anatomically normal equine cadaveric hind limbs and 4 tarsi with pathological changes., Procedures: Precontrast CT was performed on 3 equine tarsi; sagittal and dorsal reconstructions were made. In all limbs, postcontrast CT was performed after intra-articular contrast medium injection of the tarsocrural, centrodistal, and tarsometatarsal joints. Images were matched with corresponding anatomic slices. Four tarsi with pathological changes underwent CT examination., Results: The tibia, talus, calcaneus, and central, fused first and second, third, and fourth tarsal bones were clearly visualized as well as the long digital extensor, superficial digital flexor, lateral digital flexor (with tarsal flexor retinaculum), gastrocnemius, peroneus tertius, and tibialis cranialis tendons and the long plantar ligament. The lateral digital extensor, medial digital flexor, split peroneus tertius, and tibialis cranialis tendons and collateral ligaments could be located but not always clearly identified. Some small tarsal ligaments were identifiable, including plantar, medial, interosseus, and lateral talocalcaneal ligaments; interosseus talocentral, centrodistal, and tarsometatarsal ligaments; proximal and distal plantar ligaments; and talometatarsal ligament. Parts of the articular cartilage could be assessed on postcontrast images. Lesions were detected in the 4 tarsi with pathological changes., Conclusions and Clinical Relevance: CT of the tarsus is recommended when radiography and ultrasonography are inconclusive and during preoperative planning for treatment of complex fractures. Images from this study can serve as a CT reference, and CT of pathological changes was useful.

The morphological features of the distal border synovial invaginations (SI) of the distal sesamoid bone (DSB) in horses were described by the use of computed tomography (CT). Transverse CT images were obtained on 50 cadaver forefeet from 25 Warmblood horses. Dorsal and sagittal planes were reformatted. The CT images allowed the evaluation of the number, shape, depth of penetration and direction of the SI into the bone. The total number of SI was 295 (mean 5.9). The number of invaginations in a particular DSB ranged from 3 (n = 3), 4 (n = 6), 5 (n = 11), 6 (n = 12), 7 (n = 13), 8 (n = 3), 9 (n = 1) to 11 (n = 1). The shape of the SI was 'conical' (n = 118), 'linear' (n = 109), 'lollipop' (n = 38) or 'branched' (n = 30). Penetration of the SI into the DSB was 'mild' in 195 cases, 'moderate' in 67 cases and 'deep' in 33 cases. The SI ran in a 'straight', 'dorsoproximal' and 'palmaroproximal' direction in 187, 28 and 80 cases, respectively. In only six DSBs, all SI ran in the same direction. The images obtained in this study may serve as reference for the radiographic evaluation of these SI.