Radiographic characterization of ossification of the ungular cartilages in horses: 271 cases (2005–2012)

Jones LE, Dyson SJ. J Am Vet Med Assoc. 2015 Oct 1; 247 (7): 801-11.

OBJECTIVE: To describe in detail the radiographic appearance of ossified ungular cartilages in horses and to evaluate the usefulness of a flexed dorsolateral-palmaromedial oblique (flexed oblique) radiographic view in evaluating the ungular cartilages.

DESIGN: Retrospective case series.

SAMPLE: Radiographs of 1,255 front feet of horses.

PROCEDURES: Ossification of the ungular cartilages was graded during evaluation of radiographs on a scale from 0 to 5; feet with cartilages with an ossification grade ≥ 2 were included (386 feet [271 horses]). The shape (straight, curved outward or inward, and dorsopalmar extension of ossification) was determined. The view on which abnormalities were best identified was documented. Abnormalities of the compact bone, radiopacity, trabecular architecture, compactospongious demarcation, and presence of radiolucent lines were recorded; grouped as modeling, adaptive changes, or both; compared with ossification grade, separate centers of ossification, mediolateral symmetry of ossification, shape, cartilage (medial or lateral), and foot (left or right); and tested for significant associations.

RESULTS: Fractures (n = 35) were most common in feet with cartilages with an ossification grade of 4 (18) or 5 (17) and were best identified in flexed oblique images, compared with more commonly recommended images. Multivariable logistic regression showed a significant positive association of ossification grade with modeling or adaptive changes; feet with cartilages with an ossification grade of 4 (OR, 11.59; 95% CI, 6.52 to 20.60) or 5 (OR, 72.90; 95% CI, 25.32 to 209.90) were more likely than those with an ossification grade of 2 or 3 to have modeling or adaptive changes. Abnormally shaped cartilages were more likely to have modeling or adaptive changes, compared with normally shaped cartilages (OR, 4.90; 95% CI, 1.94 to 12.42).

CONCLUSIONS AND CLINICAL RELEVANCE: Extensive ossification and the presence of inward or outward curvature as well as palmar curvature or a bulbous shape were significant risk factors for modelling and adaptive changes. Flexed oblique images provided clinically useful information, including detection of abnormal shape and fractures, that may not be evident on other currently recommended images. Such images are recommended for complete radiographic appraisal of ossified ungular cartilages of the foot in horses.