Scintigraphic and Radiographic Evaluation of Appendicular Skeletal Lesions in Cold‐stunned Kemp's Ridley Sea Turtles

Abstract

Osteolytic appendicular skeletal lesions in eight-stranded, cold-stunned Kemp's ridley sea turtles (Lepidochelys kempii) were evaluated using radiography and skeletal scintigraphy. Radiographic studies were performed monthly in most animals. Follow-up scintigraphy was performed 45-120 days after the initial exams in six turtles. Radiographically, lesions slowly progressed from an early osteolytic process contained to either the proximal or distal end of long bones, to a later stage characterized by thickening of the affected bone, sclerosis, and remodeling of the lesion borders. In seven turtles, the initial scintigrams were characterized by at least one focus of abnormal radiopharmaceutical uptake that correlated with a lytic site noted in radiographs. In five turtles, scintigraphic lesions were characterized by asymmetric radiopharmaceutical uptake rather than by increased intensity of uptake. Scintigraphic studies obtained more than 4 months after the appearance of clinical and radiographic signs had minimal, if any, abnormal radiopharmaceutical uptake, despite the persistence of abnormal radiographic findings. Skeletal scintigraphy is an effective method for more precisely determining if and when these animals can be returned to the wild. Animals were released if normal radiopharmaceutical uptake was seen during initial examination, or if decreased uptake was noted between serial examinations. In four of the turtles, resolution of abnormal scintigraphic findings permitted an objective decision to discontinue antibiotic and antifungal therapy. Seven of the eight turtles were released after correlation of the clinical signs with the imaging findings. Radiographs, however, are still needed to facilitate the correct identification of lesions with scintigraphy.

Osteomyelitis in cold-stunned Kemp's ridley sea turtles (Lepidochelys kempii) hospitalized for rehabilitation: 25 cases (2008–2018)

“…Lesions could also be secondary to sterile necrosis of bone due to ischemic injury from hypothermia, as described in some humans with frostbite. 14,30 Osteomyelitis complicated by sepsis was the most common finding among sea turtles of the present study, as evidenced by concurrent isolation of the same bacteria from blood and osteolytic site samples in 8 individuals, concurrent severe infections in others, predilection for subchondral lesions as observed in other species, 31,32 and the presence of heterophilic and granulomatous osteomyelitis at the time of cytologic and histologic evaluation. 33 Similar lesions have been found in non-cold-stunned sea turtles with septicemia from traumatic injuries and other sources of infection.…”

“…Osteolytic lesions have been reported in sea turtles, but most descriptions include only single cases. 5,6,10,[14][15][16][17][18][19][20][21] Osteolytic lesions in the phalanges of sea turtles are fairly common but appear to be transient and have limited clinical impact. 5,6,14 However, some individuals develop more substantial radiographic lesions of various appendicular joints, including the shoulder, elbow, hip, carpal, and tarsal joints, resulting in joint swelling, lameness, lethargy, and hyporexia.…”

“…5,6,10,[14][15][16][17][18][19][20][21] Osteolytic lesions in the phalanges of sea turtles are fairly common but appear to be transient and have limited clinical impact. 5,6,14 However, some individuals develop more substantial radiographic lesions of various appendicular joints, including the shoulder, elbow, hip, carpal, and tarsal joints, resulting in joint swelling, lameness, lethargy, and hyporexia. 5,6,10,14,15 Previous reports 10,20,21 suggest that the likelihood of survival is variable, with some survivors receiving intense, long-term medical management, surgical management, or both for as long as 20 months.…”

“…5,6,14 However, some individuals develop more substantial radiographic lesions of various appendicular joints, including the shoulder, elbow, hip, carpal, and tarsal joints, resulting in joint swelling, lameness, lethargy, and hyporexia. 5,6,10,14,15 Previous reports 10,20,21 suggest that the likelihood of survival is variable, with some survivors receiving intense, long-term medical management, surgical management, or both for as long as 20 months. The purpose of this study was to characterize osteolytic lesions by utilizing several interrelated diagnostic modalities and to describe methods of medical and surgical management of such lesions in a population of hospitalized cold-stunned Kemp's ridley sea turtles.…”

Characterization of oral and cloacal microbial communities in cold-stunned Kemp’s ridley sea turtles (Lepidochelys kempii) during the time course of rehabilitation

“…Warming sea water temperatures are predicted to cause a continued trend of increasing numbers of stranded Kemp's ridley turtles by increasing the distribution of turtles to the northeastern United States and creating a bridge from the Gulf Stream to nearshore waters [9]. Common sequelae resulting from chronic cold-stunning include cardiorespiratory depression, dehydration, reduced renal function, pneumonia, sepsis, osteomyelitis, and death [10][11][12][13][14][15][16][17]. Kemp's ridley turtles comprise the majority of turtles that strand each year in the northeastern US, and when found alive, they are transported to wildlife hospitals, such as the New England Aquarium (NEAq), for medical care.…”