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Comparison of radiography and computed tomography for identification of third metacarpal structural change and associated assessment of condylar stress fracture risk in Thoroughbred racehorses. | LitMetric

AI Article Synopsis

  • - The study investigates how effective digital radiographs (DR) and standing computed tomography (sCT) are in assessing the risk of condylar stress fractures in Thoroughbred racehorses, which can lead to catastrophic injuries.
  • - Four observers analyzed images of 31 horses, focusing on bone structure changes, and found that while both imaging methods had high specificity, the sensitivity for detecting structural changes was relatively low.
  • - Results indicated that sCT provided better repeatability and reliability for risk assessments compared to DR, particularly for identifying horses at high risk of injury.

Article Abstract

Background: Catastrophic injury has a low incidence but leads to the death of many Thoroughbred racehorses.

Objectives: To determine sensitivity, specificity, and reliability for third metacarpal condylar stress fracture risk assessment from digital radiographs (DR) and standing computed tomography (sCT).

Study Design: Controlled ex vivo experiment.

Methods: A blinded set of metacarpophalangeal joint DR and sCT images were prepared from 31 Thoroughbreds. Four observers evaluated the condyles and parasagittal grooves (PSG) of the third metacarpal bone for the extent of dense bone and lucency/fissure and assigned a risk assessment grade for condylar stress fracture based on imaging features. Sensitivity and specificity for detection of subchondral structural changes in the condyles and PSG, and for risk assessment for condylar stress fracture were determined by comparison with a reference assessment based on sCT and joint surface examination. Agreement between observers and the reference assessment and reliability between observers were determined. Intra-observer repeatability was also assessed.

Results: Sensitivity for detection of structural change was lower than specificity for both imaging methods and all observers. For agreement with the reference assessment of structural change, correlation coefficients were generally below 0.5 for DR and 0.49-0.82 for sCT. For horses categorised as normal risk on reference assessment, observer assessment often agreed with the reference. Sensitivity for risk assessment was lower than specificity for all observers. For horses with a reference assessment of high risk of injury, observers generally underestimated risk. Diagnostic sensitivity of risk assessment was improved with sCT imaging, particularly for horses categorised as having elevated risk of injury from the reference assessment. Assessment repeatability and reliability was better with sCT than DR.

Main Limitations: The ex vivo study design influenced DR image sets.

Conclusions: Risk assessment through screening with diagnostic imaging is a promising approach to improve injury prevention in racing Thoroughbreds. Knowledge of sensitivity and specificity of fetlock lesion detection provides the critical guidance needed to improve racehorse screening programs. We found improved detection of MC3 subchondral structural change and risk assessment for condylar stress fracture with sCT ex vivo.

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Source
http://dx.doi.org/10.1111/evj.14131DOI Listing

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