1910

Köpeklerde diz ekleminin klinik, radyolojik ve bilgisayarlı tomografi sonuçlarının teşhis yönünden karşılaştırılması

Amaç: Diz eklemi lezyonlarının klinik, radyolojik ve bilgisayarlı tomografibulgularının teşhis açısından karşılaştırılması amaçlanmıştır.Ayrıca ön çapraz bağ kopuklarının erken teşhisinde bilgisayarlı tomografininetkinliğine bakıldı.Gereç ve Yöntem: 12 adet orta/büyük farklı ırk, cins, yaş ve ağırlıktaköpek çalışma materyali olarak kullanıldı. Klinik muayeneleri ardındanyürüyüş ve ağrı derecelendirme testleri (HVAS-Hudson VisualAnalog Scale, CBPI-Canine Brief Pain Inventory) yapıldı. Köpeklerdeekstremitelerdeki eşit olmayan ağırlık dağılımını ölçmek için basışanalizatörü kullanıldı. Üç yönlü radyografik muayene (ayakta cranio-caudal (CrCa), medio-lateral (ML), tibial kompreste mediolateral(ML)) yapıldı. Bu amaçla seyyar röntgen cihazı ve sabit röntgen cihazıkullanıldı. Tomografi uygulamasında bilgisayarlı tomografi yararlanıldı.Elde edilen verilerin istatiksel analizleri % olarak ifade edildi.Yürüyüş, ağrı ve basış analizlerinin aritmetik ortalamaları hesaplandı.Bulgular: Olguların klinik muayene ve basış analiz sonuçlarına göreproblemli ekstremite belirlendi. Bazı olgularda lig. collaterale medialedüzeyinden uygulanan basınç ve ekstremiteye yaptırılan ekstensiyondabelirgin bir eklem efuzyonu gözlendi. Tibial kompresyon testindetuberositas tibia’nın cranial yer değişimi fark edildi. Radyografik olarakcondylus medialis ve lateraliste belirgin derecelerde daralmalartespit edildi. 2 olgu’nun art. genu’sunda osteofitik üremeler belirlendi.Olguların çoğunda tibianın craniale rotasyonu görüldü. Bilgisayarlı tomografikmuayenede 1 olguda osteofitik üremeler belirlendi.Öneri: Art. genu problemlerini teşhisinde röntgen kullanımı özellikleosteofitik değişimlerin ortaya konması, tuberositas tibia’nın cranialeyer değişimi, patellar luksasyon’un teşhisinde yararlı tanısal bir yöntemdir.BT muayenesi ise direk çekim yapılırsa patella luksasyonu,tibia’nın craniale yer değişimi teşhislerinde yararlı olduğu gözlenmiştir.Art. genu eklemi problemlerinin ortaya konmasında BT yararlıdır.Fakat, kesitlerin alınması, kullanılan aletin modernize oluşu görselliğiher zaman etkilemektedir.

Comparison on diagnostic results of clinical, radiological and computed tomography of stifle joint in dogs

Aim: It is aimed to compare clinical, radiological and computed tomography findings of knee joint lesions in terms of diagnosis. In addition, early diagnosis of cranial cruciate ligament defects were assessed for effectiveness of computed tomography. Materials and Methods: 12 medium / large dogs with different breed, sex, age and breed were used as study materials. After the clinical examinations, Hudson Visual Analogue Scale and Canine Brief Pain Inventory were performed. In dogs, a force platform was used to measure unequal weight distribution in the extremities. Three positions of radiographic examination (standing cranio-caudal (CrCa), medio-lateral (ML), tibial compression mediolateral (ML)) was performed. For this purpose, mobile x-ray machine and fixed x-ray equipment were used. Computed tomography was used for tomographic examinations. Statistical analysis of the obtained data was expressed as %. Walking, pain and force platform results of arithemtic averages were used. Results: The problematic extremity was determined for according to the results of clinical examination and force platform of the cases. In some cases, pressure over the ligamentum collaterale mediale level showed that joint effusion on the extremity. Cranial displacement of tuberositas tibia was noted with the tibial compression test. Condylus medialis and lateral femoris were markedly narrowed with radiographically, art. genu of two cases were detected osteophytic production. In most of the cases, cranial rotation of the tibia was seen. Osteophyte production were identified in 1 case with computed tomographic examination. Conclusion: Especially for the identification of osteophytic production, cranial displacement of tuberosity tibia, diagnosis of patellar luxation in in Art. genu could be diagnosed by x-ray. Diagnosis of patellar luxation and cranial displacement of tibia is also observed with CT scan directly. But, CT is useful in revealed for knee joint problems. However, the taking of the sections, the modernization of the instrument should always affects the visuality.

PDF

___

Alkan Z, Bumin A, Temizsoylu D, Sarıerler M, 2001. Köpeklerde Diz Eklemi Lezyonlarının Direkt Radyografik, Artrografik ve Artroskopik Tanısı Üzerine Klinik ve Deneysel Uygulamaların Karşılaştırılması. Turk J. Vet. Anim. Sci. 25,57-64.
Arıcan M, 1995. Bone and cartilage metabolism in canine arthropathies. PhD Thesis, Liverpool Üniversitesi, Liverpool. Arıcan M, Yavru N, 1997. Köpeklerdeki eklem hastalıklarının teşhisinde kullanılan biyokimyasal, immunolojik ve enzim parametreleri, Vet Cer Der, 3 (1), 54-57.
Arıcan M, 2014. Köpeklerde Dejeneratif Eklem Hastalıklarında (Osteoartritis) Güncel Teşhis ve Tedavi Yöntemleri. Türkiye Klinikleri Veteriner Bilimleri Dergisi 5, 2, 1-9.
Arıcan M, Parlak K, Satılmış F, 2015. Köpeklerde articulatio genu lezyonlarının tanısında artroskopi uygulamaları. Eurasian J Vet Sci, 31,1,20-26).
Bland D, 2015. Canine Osteoarthritis and Treatmens: a review. Veterinary Science Development, 5,5931.
Bonath KH, Prieur WD, 1998. Kleintierkrankheiten Band 3, Orthopadische Chirurgie und Travmatologie, Stuttgart: Ulmer.
Brinker WO, Piermattei DL, FLO GL, 1993. Diagnosis and treatment of orthopedic conditions of the hindlimb. In: Brinker WO, Piermattei DL, Flo GL, eds. Handbook of small animal orthopedics and fraCTure treatment. Philadelphia, WB Saunders, 341-470.
Brown DC, Boston RC, Coyne JC, Farrar JT, 2007. ‘’Development and psychometric testing of an instrument designed to measure chronic pain in dogs with osteoarthritis’’. AJVR, 68, 631–37.
Budsberg SC, Johnston SA, Schwarz PD, DeCamp CE, Claxton R, 1999. ‘’Efficacy of etodolac for the treatment of osteoarthritis of the hip joints in dogs’’. JAVMA, 214, 206–10.
DeCamp CE, Soutas-Little RW, Hauptman J, Olivier B, Braden T, Walton A, 1993. ‘’Kinematic gait analysis of the trot in healthy Greyhounds’’. AJVR, 54, 627–34.
de Rooster H, Van Ryssen B, van Bree H, 1998. Diagnosis of cranial cruciate ligament injuries in dogs by tibial compression radiography. Vet Rec, 142, 366 – 68.
De Rycke LM, Gielen IM, van Bree H, et al 2002. Computed tomography of the elbow joint in clinically normal dogs. Am J Vet Res, 63,1400–07.
Faby S, Flohr T, 2017. Multidetector-Row CT Basics, Technological Evoluation and Current Technology. Edit: Giovanna Bertolini, Body MDCT in Small Animalls Basic Principles, Technology and Clinical Applications. Springer. 3-35.
Fitch RB, Hathcock JT, Montgomery RD, 1996. Radiographic and computed tomographic evaluation of the canine intercondylar fossa in normal stifles and after notchplasty in stable and unstable stifles. Vet Radiol Ultrasound, 37, 266-74.
Fitch RB, Beale BS, 1998. Osteochondrosis of the canine tibiotarsal joint. Vet Clin North Am Small Anim PraCT 28, 95-113.
Gielen I, van Bree H, Van Ryssen B, De Clercq T, De Rooster H, 2002. Radiographic, computed tomographic and arthroscopic findings in 23 dogs with osteochondrosis of the tarsocrural joint. Vet Rec, 150, 442-47.
Grassi W, Cervini C, 1998. Ultrasonography in rheumatology: an evolving technique. Ann Rheum Dis. 57, 268-271.
Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, Fainsinger R, Aass N, Kaasa S, 2011. ‘’European Palliative Care Research Collaborative (EPCRC). Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: a systematic literature review’’. Journal of Pain and Symptom Management, 41, 1073–93.
Hudson JT, Slater MR, Taylor L, Scott HM, Kerwin SC, 2004. ‘’Assessing repeatability and validity of a visual analogue scale questionnaire for use in assessing pain and lameness in dogs’’. Am J Vet Res, 65, 1634–43.
Innes JF, Costello M, Barr FJ, Rudorf H, Barr AR, 2004. ‘’Radiographic progression of osteoarthritis of the canine stifle joint: a prospeCTive study’’. Veterinary Radiology & Ultrasound, 45,143–48.
Innes F, Tobias M, Johnston (ed.), 2012. Veterinary surgery: Small animal. Elsevier Saunders, St. Louis; 1078-111.
Johnson MJ, Johnson AL, 1993. Cranial cruciate ligament rupture: Pathogenesisi, diagnosis and postoperative rehabilitation. Vet Clin North Am. Small Anim Pract. 23, 717-32.
Lohmander LS, 1994. Articular cartilage and osteoarthrosis. The role of molecular markers to monitor breakdown, repair and disease, J Anat, 184, 477-92.
McEntee MC, Thrall DE, 2001. Computed tomographic imaging of infiltrative lipoma in 22 dogs. Vet Radiol Ultrasound. 42, 221-25.
Mele E, 2007. Epidemiology of Osteoarthritis. Veterinary Focus, 17, 3.
Muzzi L, Rezende C, Muzzi R, 2009. Physiotherapy after arthroscopic repair of the cranial cruciate ligament in dogs. I- clinical, radiographic, ultrasonographic evaluation. Arq Bras Med Vet Zootec, 61(4), 805-14.
Ohlerth S, Scharf G, 2007. Computed tomography in small animal-basic principles and state of the art applications. Vet J, 173, 254-71.
Plesman R, Gilbert P, Campbell J, 2013. Detection of meniscal tears by arthroscopy and arthrotomy in dogs with cranial cruciate ligament rupture. A retrospective, cohort study. Vet Comp Orthop Traumatol, 26(1), 42-46.
Reed AL, Payne JT, Constantinescu GM, 1995. Ultrasonographic anatomy of the normal canine stifle. Vet Radiol Ultrasoun, 36, 315–21.
Schulz K, 2007. ‘’Diseases of the joints’’. In Fossum TW (ed.). Small animal surgery. 3rd ed. Mosby Elsevier, St. Louis, 1143-1315.
Sharma L, 2016. Osteoarthritis year in review 2015:clinical. Osteoarthr Cartilage, 24, 36-48).
Soler M, Murciano J, Latorre R, Belda E, Rodrıguez MJ, Agut A, 2007. Ultrasonographic, computed tomographic and magnetic resonance imaging anatomy of the normal canine stifle joint. Vet J,174,351 – 361.
Slocum B, Slocum TD, 1998. ‘’Diagnostic Tests’’ In: Current Techniques in Small Animal Surgery; Knee, 4th ed., Ed.: M.J. Bojrab, G.W. Ellison, B. Slocum. Williams & Wilkins, Baltimore.
Vasseur PM, 2003. Stifle joint. In: Texbook of Small Animal Surgery, Vol: II. Ed.: D. Slatter, W.B. Saunders: Philadelphia, USA, p.:2090-2143.