Radiographic evaluation of elbow joints before and after surgery in dogs with possible fragmented medial coronoid process.

摘要

The usefulness of 5 radiographic projections of the elbow joint was assessed for identification of fragmented coronoid process (FCP) and associated secondary degenerative changes in dogs. 19 dogs suspected of having FCP (7 dogs, 1 elbow joint; 12 dogs, both elbow joints) were used in the study. Five radiographic projections were obtained before and after surgery for all elbow joints on which exploratory arthrotomy was performed because of suspected FCP. Radiographs obtained before surgery were compared with radiographs obtained after surgery and radiographs taken of the excised fragments. Each projection was evaluated for its use in identifying FCP and 7 specific degenerative changes. The craniolateral-caudomedial oblique (Cr15L-CdMO) projection had a significantly higher sensitivity for definitively identifying FCP, compared with the other 4 projections. Inter-evaluator and kappa agreement for the 5 projections did not differ significantly among the 7 degenerative changes evaluated. The radiographic projection with the highest sensitivity and specificity for detecting a particular degenerative change varied by feature. It is concluded that of the 5 radiographic projections evaluated, the Cr15L-CdMO projection provided the highest sensitivity and was the best projection to use for definitively identifying FCP. Also, the craniocaudal, Cr15L-CdMO and mediolateral projections most reliably allowed for identification of secondary degenerative changes.