Comparison of the Ultrasonographic Appearance of Osteochondrosis Lesions in the Canine Shoulder With Radiography, Arthrography, and Arthroscopy

Abstract

Osteochondrosis lesions in 29 shoulder joints (from 20 dogs) were evaluated with ultrasound (US) and the results were compared with survey radiography, arthrography, and arthroscopy. US was performed with a 7-12 MHz linear matrix transducer which was placed in cranio-caudal direction just distally to the acromion while the joint was adducted and maximally endorotated to visualize the caudal aspect of the humeral head. With US, the subchondral defect was completely visible in 21 joints and partially visible in 8 joints. The length of the subchondral defect measured on US was comparable with the length measured on survey radiographs. In two joints, the cartilage flap was mineralized and thus already visible on survey radiographs. The mineralized flap was visible on US as a straight hyperechoic line above the subchondral defect. In the other joints, survey radiographs could not assess the status of the articular cartilage. In 17 joints, the presence of a cartilage flap or cartilage fissuring was suspected based on the presence of a second hyperechoic line at the base of the subchondral defect, and this suspicion was confirmed by arthroscopic examination in 16 joints and also by arthrographic examination in 15 joints. One joint that was suspected of having a cartilage flap on US was normal on arthroscopy and arthrography. When US revealed only focal thickening of the anechoic cartilage layer (5 joints), the joints appeared normal on arthroscopic and arthrographic examination. Of the four joints where the subchondral defect was irregular and covered by heteroechogeneous material on US, arthroseopy revealed the presence of a lesion resembling chondromalacia in two joints, the presence of a small cartilage flap in one joint and the presence of scar tissue underneath the flap at the level of the subchondral defect in one joint. In conclusion, US is a helpful imaging modality in the identification of osteochondritic lesions in the canine shoulder joint. US also appears to be a satisfactory imaging tool for identifying lesions such as joint mice, joint effusion, and distinct new bone formation.

Diagnostic Sensitivity and Interobserver Agreement of Radiography and Ultrasonography for Detecting Trochlear Ridge Osteochondrosis Lesions in the Equine Stifle

“…A site was considered positive for a lesion when fragmentation and/or a subchondral bone defect were present. The severity of the lesion was graded using a four-point system, based on criteria previously reported in dogs, 15 and horses, 9 where 0 = no lesion, 1 = cartilage irregularity with a visible superficial echogenic articular surface that shows concave deviation but is contiguous, 2 = a hyperechoic subchondral bone surface with moderate irregularity and discontinuity, and 3 = complete disruption of the echogenic articular surface and a hyperechoic subchondral bone with severe irregularity and discontinuity overlaid by heterogeneously echoic material. Only the results of the experienced operator were used for analyses of ultrasonographic sensitivity and specificity, and the ability of ultrasonography to predict severity of the lesions.…”

Comparison of radiography and ultrasonography for the diagnosis of osteochondritis dissecans in the equine femoropatellar joint

“…Images were again reviewed and lesions scored retrospectively using a 4-point system, based on lesion description in a study of the dog (Vandevelde et al 2006), where 0 = no lesion, 1 = cartilage irregularity with a visible superficial echogenic articular surface that shows concave deviation but is continuous, 2 = a hyperechoic subchondral bone surface with moderate irregularity and discontinuity, and 3 = complete disruption of the echogenic articular surface and a hyperechoic subchondral bone surface with severe irregularity and stair like discontinuity overlaid by heterogeneously echoic material (Fig 4). Disruption of subchondral bone was deemed to be a fragment.…”

“…Lesions are flattened or irregular areas of the subchondral bone, especially in the proximal aspect of the trochlear ridges (TR), and may be accompanied by loose fragment(s). However, no abnormality can be seen on radiographs if the subchondral bone is unaffected (McIlwraith 1996;Vandevelde et al 2006). In one study, OCD lesions were undetected in 40% of 72 FP joints; however, they were found during arthroscopy and more than half were worse than expected (Sullins 2002).…”

“…[Paper received for publication 20.02.09; Accepted 17.04.09] permitted detection of cartilage fibrillation and irregularities of the trochlear surfaces of the femur in an experimental equine model of medial patellar desmotomy (Martins et al 2006). In dogs, it permitted visualisation of the outline of OCD-related femoral subchondral defects in more detail than with radiography, and detected focal cartilage thickening whereas arthrogram and arthroscopy were normal (Vandevelde et al 2006).…”

Musculoskeletal System

“…65,66 The caudal humeral head is imaged with the transducer in a craniocaudal orientation, and the shoulder is rotated medially to expose the articular cartilage. Articular cartilage defects of the caudal aspect of the humeral head (and femoral condyle) may be detected ultrasonographically, depending on the size and position of the defect.…”