RADIOULNAR INCONGRUENCE IN DOGS WITH ELBOW DYSPLASIA

摘要

3D-renderings of the radio-ulnar joint surface allow accurate diagnosis of radio-ulnar incongruence (RUI).1 Using this technique in 63 elbows with arthroscopically confirmed fragmented medial coronoid process (FCP) and no other obvious cartilage pathologies, positive RUI was documented at time of FPC diagnosis in 62% and negative RUI in 3%. Evaluating elbows for RUI in addition to arthroscopic treatment of FPC, may allow for better patient selection. In young dogs with RUI, re-establishing joint congruence may prevent accelerated cartilage wear and development of medical compartment syndrome. Detection of RUI is problematic as plain radiography is not precise enough. Arthroscopy on the other hand is invasive and operator dependent, but arthroscopicdetection of RUI has been shown to be highly accurate, at least in vitro. 3D-renderings of the radioulnar joint surface allow for unobstructed inspection of the radio-ulnar transition. However, with a sensitivity of 0.86 and a specificity of 0.77, clinical application of this technique would still result in a significant number of false positive and false negative diagnoses. By fitting a sphere to the trochlea notch, negative (Fig. 1) as well as positive (Fig. 2) RUI become more easily distinguishable from a congruent joint (Fig. 3). When evaluated using an in vitro model of RUI, this improved technique reaches values of sensitivity and specificity of 0.92 and 0.94, with an inter observer reliability of R~2 = 0.88.