The Use Of Advanced Imaging Techniques In Diagnosing Equine Musculoskeletal Disorders

Abstract

This work aimed to compare the overall diagnostic capabilities of MRI, CT, ultrasound and DR in the diagnosis of different MSDs in horses. Radiographic changes were deemed as soft tissue, osseous, joint, or other pathology. MRI proved to be the most sensitive in identifying soft tissue injuries of which 4 were scored severe (n=12) while CT was the most sensitive in identifying bone pathology of which 5 were scored severe (n=11). For joint abnormalities, DR has produced the highest results as compared to other methods (n=6). Likelihood ratios were derived and diagnostic accuracy metrics such as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were computed. MRI was the most accurate technique of detection with overall accuracy of 95% sensitivity and 85% specificity. While assessing the accuracy of CT used in the evaluation of acute exacerbation, CT was found to be 88% sensitive and 80% specific. But for the US and DR, it was somewhat lower, though sufficient to be accurate. Specificity: statistical analysis showed that there was increased specificity of US over MRI of the knee for soft tissue injuries, at 88% as opposed to 68%. A comparison of the performance of CT and MRI demonstrated that the former yielded a higher sensitivity for detecting bone lesions, 88%. The accuracy of US in the musculoskeletal system was highest for joint abnormalities with an average of 90%. In summary, MRI seems to offer the highest diagnostic sensitivity for diagnosing several MSDs in horses. These differences in imaging modality should serve to frame the selection for the assessment of musculoskeletal disorders.