背景:马运动员近端指骨(P1)矢状槽的损伤被认为主要是由于慢性骨应力超负荷而发生的。
目的:描述低场MRI诊断为矢状沟病(SGD)的一大群马的矢状沟中存在的异常范围。
方法:回顾性,横截面。
方法:检索医疗记录以确定诊断为SGD的马的初始MRI图像,并使用半定量分级方案和新型SGDMRI分类系统对这些图像进行盲目评估,以反映病理进展的潜在途径和压力损伤的严重程度。
结果:研究中包括来自111匹马的132条肢体;主要是在跳马(n=83)和盛装舞步(n=18)中竞争的热血液。SGDMRI分类为:0(正常,n=0),1(小软骨下缺损,n=2),2(骨致密化,n=28),3(软骨下微裂隙骨致密化,n=7),4(软骨下±骨小梁和±软骨下微裂隙或去矿质内的骨水肿样信号,n=72),5(不完全大裂缝/骨折,n=23)和6(完全骨折,n=0)。分类4c(骨水肿样信号与脱矿质)和5在后肢足底三分之一的比例较高(3%和10%,分别)与前肢(0%和0%,分别)。腿(n=116)和非腿(n=16)之间的SGD分类和骨水肿样信号的程度没有显着差异(均p>0.05)。在25%和39%的肢体中,在P1的近端背侧发现了骨膜新骨和水肿样信号(确定或怀疑),分别。
结论:通过诊断纳入原始MRI报告,可变的临床病史,一些分类组的规模较小。
结论:有无跛行并不是SGD严重程度的可靠指标。先前尚未在SGD的MRI中描述P1的骨膜水肿样信号,并进一步支持骨应力损伤的概念。
BACKGROUND: Injuries of the sagittal groove of the proximal phalanx (P1) in equine athletes are considered to predominantly occur due to chronic bone stress overload.
OBJECTIVE: To describe the range of abnormalities that is present in the sagittal groove in a large group of horses diagnosed with sagittal groove disease (SGD) on low-field MRI.
METHODS: Retrospective, cross-sectional.
METHODS: Medical records were searched to identify initial MRI images of horses diagnosed with SGD and these were blindly evaluated using a semi-quantitative grading scheme and novel SGD MRI classification system reflecting potential pathways of pathological progression and severity of stress injury.
RESULTS: A total of 132 limbs from 111 horses were included in the study; predominantly warmbloods competing in showjumping (n = 83) and dressage (n = 18). SGD MRI classifications were: 0 (normal, n = 0), 1 (small subchondral defect, n = 2), 2 (osseous densification, n = 28), 3 (subchondral microfissure with osseous densification, n = 7), 4 (bone oedema-like signal within the subchondral ± trabecular bone and ± subchondral microfissure or demineralisation, n = 72), 5 (incomplete macrofissure/fracture, n = 23) and 6 (complete fracture, n = 0). Classification 4c (bone oedema-like signal with demineralisation) and 5 had higher proportions in the plantar third of hindlimbs (3% and 10%, respectively) compared with forelimbs (0% and 0%, respectively). SGD classification and extent of bone oedema-like signal were not significantly different between lame (n = 116) and non-lame limbs (n = 16) (both p > 0.05). Periosteal new bone and oedema-like signal were identified (either confidently or suspected) at the dorsoproximal aspect of P1 in 25% and 39% of limbs, respectively.
CONCLUSIONS: Inclusion via diagnoses in original MRI reports, variable clinical history, small size of some classification groups.
CONCLUSIONS: The presence or absence of lameness is not a dependable measure of the severity of SGD. The periosteal oedema-like signal of P1 has not previously been described in MRI of SGD and further supports the concept of bone stress injury.