Zur Anatomie und Diagnostik von Erkrankungen des caninen Carpus unter besonderer Berücksichtigung des Ultraschalls

Klußmann, Sven (2024): Zur Anatomie und Diagnostik von Erkrankungen des caninen Carpus unter besonderer Berücksichtigung des Ultraschalls. Dissertation, LMU München: Tierärztliche Fakultät

Abstract

The canine carpus with its seven carpal bones, arranged in two rows and held together by a multitude of carpal ligaments, is a complex joint. These structures can be damaged by many causes. The canine carpus is a challenging region to examine and requires a thorough knowledge of the anatomy to make a diagnosis. Carpal effusion and the physiologic appearance of the carpal cavity and recess have received little attention in imaging studies. The purpose of this study was to examine the carpal joint cavity and its recesses in healthy dogs using radiography (Siemens Axiom Luminos dRF; Siemens Healthcare GmbH, Erlangen, Germany), ultrasonography (GE LOGIQ E9; L8-L18i-D Hockey Stick Probe, GE Healthcare, Solingen, Germany), CT, CT- arthrography, and 3D-VRT (SOMATOM Definition AS, CT070/13/S, Siemens Healthcare GmbH, Erlangen, Germany), to describe the morphologic appearance, and to prove the applicability of musculoskeletal US for the detection of artificial carpal joint effusion in dogs. Twenty-eight clinically and radiologically unremarkable canine carpal cadavers of different breeds were examined. The novel results of this study provide the first morphological description of the ultrasonographic, radiographic and computed tomographic arthrographic appearance of the canine carpal joint cavities and recesses with different injection volumes. The canine carpal joint cavities, and particularly its recesses had a complex appearance with a basic structure found in all dogs: Antebrachiocarpal joint: dorsoproximal antebrachiocarpal recess, dorsodistal antebrachiocarpal recess, medial antebrachiocarpal recess, lateral antebrachiocarpal recess and five palmar antebrachiocarpal recesses. Middle carpal joint: two dorsal middle carpal recesses, medial common middle carpal and carpometacarpal recess, lateral common middle carpal, and carpometacarpal recess, four palmar middle carpal recesses. The carpometacarpal joint had dorsal and palmar funnel-shaped and irregular, finely tubular extensions, the most prominent ran dorsal to metacarpal III, the maximum distal end represented the proximal metacarpal diaphysis. All recesses presented ultrasonographically as a generalized anechogenic to hypoechoic filled continuation of the articular capsule with an indistinct peripheral hypoechogenic to isoechogenic fine capsule, the synovial-connective tissue interface was difficult to identify. The applicability of musculoskeletal US to visualize an artificial carpal effusion has been demonstrated. A further and subsequent aim of this study was to transfer and apply the results obtained to disordered canine carpal joints and to evaluate the sensitivity and specificity of musculoskeletal US for the diagnosis of various canine carpal disorders, using a final confirmed diagnosis, based on arthrocentesis, microbiologic, histopathologic, CT, MRI, or surgical findings, and a clinical course of at least one year, as the gold standard for comparison. A further aim was to investigate and characterize these US findings of individual canine carpal disorders to provide ultrasonographic reference data for evaluating dogs with suspected carpal disorder. The new results of the present study demonstrate that US is a reliable modality for the diagnosis of various canine carpal disorders (sensitivity: 100%; specificity: 40%; accuracy: 78.6%) and is superior to radiography (sensitivity: 100%; specificity: 23%; accuracy: 51%). Another result of this work is an ultrasonographic case collection of different canine carpal disorders, which provides reference data for the ultrasonographic evaluation of dogs with possible carpal disease. Another finding of this study is that US is useful in the diagnosis of pathologic joint effusion and that dorsal displacement of the dorsal antebrachiocarpal fat pad is an easy ultrasound finding for the diagnosis of joint filling of the antebrachiocarpal joint.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Keywords: arthrography, canine, carpus, computed tomography, ultrasound
• Themengebiete: 500 Naturwissenschaften und Mathematik ; 500 Naturwissenschaften und Mathematik > 590 Tiere (Zoologie)
• Fakultäten: Tierärztliche Fakultät
• Sprache der Hochschulschrift: Deutsch
• Datum der mündlichen Prüfung: 6. Juli 2024
• 1. Bericht­erstatter:in: Meyer-Lindenberg, Andrea