Achados radiográficos e artroscópicos em articulações do cotovelo de 12 cães com doença do coronóide medial
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2014
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A displasia do cotovelo ocorre geralmente em cães jovens de raças médias a grandes e compreende as seguintes formas: incongruência articular, não-união do processo ancóneo, osteocondrite dissecante do côndilo umeral e doença do coronóide medial.
A doença do coronóide medial é a forma mais frequente, sendo que o seu diagnóstico pode ser feito recorrendo a diferentes meios de diagnóstico, com mais ou menos fiabilidade dos mesmos. O método mais utilizado, pelo seu reduzido custo, maior acessibilidade e por ser menos invasivo é o raio-x, no entanto, este raramente permite a visualização direta do fragmento e, por conseguinte, o diagnóstico definitivo. A artroscopia é considerada o método gold standard de diagnóstico de displasia do cotovelo permitindo uma visualização direta da articulação e por conseguinte do fragmento na doença do coronóide medial. É no entanto um meio de diagnóstico mais custoso economicamente e que requer anestesia geral.
Neste estudo foram avaliados radiográfica e artroscopicamente 12 cães, num total de 18 cotovelos para a presença de doença do coronóide medial. A interpretação radiográfica consistiu na avaliação de presença de osteófitos periarticulares, esclerose, incongruência radio-ulnar, Kissing lesion, alteração da morfologia do processo coronóide medial e presença de fragmento livre. Artroscopicamente foi avaliada a presença de Kissing lesion e fragmento livre do coronóide medial.
A amostra foi composta por uma maioria de Labrador Retrievers (33.3%) machos (44.4%) com uma idade média de 2 anos. Os achados mais comuns na avaliação radiográfica foram a esclerose e a alteração da morfologia do coronóide (ambas 94.4%), tendo apenas sido possível identificar por meio de radiografia 50% dos fragmentos livres diagnosticados por via artroscópica.
São necessários estudos com uma amostra populacional maior e parâmetros mais pormenorizados para verificar quais os melhores indicadores de severidade da doença do coronóide medial.
Elbow dysplasia affects mainly young, medium to large breed dogs and can occur in four different presentations: articular incongruence, ununited anconeal process, osteochondritis dissecans and medial coronoid disease. Medial coronoid disease is the most frequent presentation and its diagnosis can be accomplished using different methods. The most used diagnostic method is radiography because it´s inexpensive, more accessible and less invasive, however, radiographs rarely allow direct visualization of the fragment and therefore, definitive diagnosis. Arthroscopy is considered the gold standard for elbow dysplasia diagnosis, allowing direct assessment of the joint and medial coronoid process fragments. This is however a more expensive method that requires general anesthesia. In this study, 12 dogs and 18 elbows were evaluated radiological and arthoscopically to diagnose medial coronoid disease. Radiographic interpretation included evaluation of the presence of periarticular osteophytes, sclerosis, radioulnar incongruence, Kissing lesion, morphology of the medial coronoid process and presence of free fragments of the medial coronoid process. Arthroscopic analysis was used to identify the presence of Kissing lesion and the presence of free fragments of the medial coronoid process. The population was mostly composed of male (44.4%) Labrador Retrievers (33.3%) with a mean age of 2 years old. The most common radiographic findings were sclerosis and abnormally shaped medial coronoid processes (94.4% each). A free fragment of the medial coronoid process was only identified in 50% of the free fragments diagnosed by arthroscopy. Further studies with a larger population sample and more detailed parameters are needed in order to assess the best predictors of severity of arthroscopic pathology for medial coronoid disease.
Elbow dysplasia affects mainly young, medium to large breed dogs and can occur in four different presentations: articular incongruence, ununited anconeal process, osteochondritis dissecans and medial coronoid disease. Medial coronoid disease is the most frequent presentation and its diagnosis can be accomplished using different methods. The most used diagnostic method is radiography because it´s inexpensive, more accessible and less invasive, however, radiographs rarely allow direct visualization of the fragment and therefore, definitive diagnosis. Arthroscopy is considered the gold standard for elbow dysplasia diagnosis, allowing direct assessment of the joint and medial coronoid process fragments. This is however a more expensive method that requires general anesthesia. In this study, 12 dogs and 18 elbows were evaluated radiological and arthoscopically to diagnose medial coronoid disease. Radiographic interpretation included evaluation of the presence of periarticular osteophytes, sclerosis, radioulnar incongruence, Kissing lesion, morphology of the medial coronoid process and presence of free fragments of the medial coronoid process. Arthroscopic analysis was used to identify the presence of Kissing lesion and the presence of free fragments of the medial coronoid process. The population was mostly composed of male (44.4%) Labrador Retrievers (33.3%) with a mean age of 2 years old. The most common radiographic findings were sclerosis and abnormally shaped medial coronoid processes (94.4% each). A free fragment of the medial coronoid process was only identified in 50% of the free fragments diagnosed by arthroscopy. Further studies with a larger population sample and more detailed parameters are needed in order to assess the best predictors of severity of arthroscopic pathology for medial coronoid disease.
Descrição
Orientação: Nuno Cardoso
; co-orientação. Pedro Faísca ; responsabilidade externa: Martinho Capelão, Isabel Grou e Alfred Legendre
Palavras-chave
VETERINÁRIA, CANÍDEOS, DISPLASIA, DISPLASIA DO COTOVELO, DOENÇA DO CORONÓIDE MEDIAL, FRAGMENTAÇÃO DO PROCESSO CORONÓIDE, RADIOGRAFIA, ARTROSCOPIA, MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, CANIDS, DYSPLASIA, ELBOW DYSPLASIA, MEDIAL CORONOID DISEASE, FRAGMENTED MEDIAL CORONOID PROCESS, RADIOGRAPHY, ARTHROSCOPY, CÃES, DOGS, MEDICINA VETERINÁRIA, VETERINARY MEDICINE