Elastografia arfi na avaliação da articulação coxofemoral e musculaturas do quadril em cães com displasia coxofemoral
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Data
2022-12-09
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Universidade Estadual Paulista (Unesp)
Resumo
A displasia coxofemoral é caracterizada por proporcionar instabilidade do quadril em animais jovens e doença articular degenerativa nos adultos. Desde a primeira descrição em 1935, a radiologia tem sido o principal método diagnóstico em cães. As diferentes projeções do quadril, além de diagnosticar a doença articular, auxiliam na escolha adequada do tratamento e na triagem do paciente, mas não possibilita avaliar características capsulares e musculares, atributos esses que podem ser examinados no exame de ultrassonografia. O objetivo deste estudo foi avaliar a acurácia da ultrassonografia modo-B e elastografia ARFI na avaliação da cápsula articular e musculaturas periarticulares de cães associadas a avaliação Fundação Ortopédica dos animais (OFA) e índice de distração (ID) para o diagnóstico tardio e precoce da displasia coxofemoral. Além disso, objetivou-se propor um protocolo de avaliação ultrassonográfica das estruturas do quadril. Verificou-se que o aumento da rigidez do pectíneo (valor de corte >2,77 m/s) pela elastografia e a espessura da cápsula (valor de corte >0,9mm), ao modo-B, foram associados à animais jovens com índice de distração >0,5 e ambos possuindo correlação positiva. Na avaliação ultrassonográfica modo-B, a presença de sinais de doença articular degenerativa como irregularidades da borda cranial do acetábulo e cabeça femoral foram associados a animais com índice de distração >0,5 com especificidade de 94%. Nos adultos, os achados de doença articular degenerativa pela ultrassonografia foram associados com pacientes classificados como doentes pela OFA (P<0,05). A mensuração da cápsula articular >1,10mm foi diagnóstica para displasia em cães não saudáveis pela OFA. Concluiu-se que os métodos ultrassonográficos podem ser utilizados como adjuvante no diagnóstico da displasia coxofemoral em associação com a avaliação radiográfica em animais jovens e adultos.
Hip dysplasia is characterized by hip instability in young animals and degenerative joint disease in adults. Since the first description in 1935, radiology has been the main diagnostic method in dogs. The different projections of the hip, in addition to diagnosing joint disease, help in choosing the right treatment and screening the patient, but it does not make it possible to evaluate capsular and muscular characteristics, attributes that can be examined in the ultrasound examination. The objective of this study was to evaluate the accuracy of B-mode ultrasonography and ARFI elastography in the evaluation of the joint capsule and periarticular musculature of dogs associated with the evaluation of the Orthopedic Foundation of the animals (OFA) and index of distraction (DI) for the late and early diagnosis of hip dysplasia. In addition, the objective was to propose a protocol for ultrasonographic evaluation of hip structures. It was verified that the increase in pectinate stiffness (cut-off value >2.77 m/s) by elastography and capsule thickness (cut-off value >0.9 mm), in B-mode, were associated with young animals with distraction index >0.5 and both having a positive correlation. In the B-mode ultrasonographic evaluation, the presence of signs of degenerative joint disease such as irregularities of the cranial edge of the acetabulum and femoral head were associated with animals with a distraction index >0.5 with a specificity of 94%. In adults, findings of degenerative joint disease on ultrasound were associated with patients classified as diseased by OFA (P<0.05). The measurement of the joint capsule >1.10mm was diagnostic for dysplasia in unhealthy dogs by OFA. It was concluded that the ultrasonographic methods can be used as an adjuvant in the diagnosis of hip dysplasia in association with radiographic evaluation in young and adult animals.
Hip dysplasia is characterized by hip instability in young animals and degenerative joint disease in adults. Since the first description in 1935, radiology has been the main diagnostic method in dogs. The different projections of the hip, in addition to diagnosing joint disease, help in choosing the right treatment and screening the patient, but it does not make it possible to evaluate capsular and muscular characteristics, attributes that can be examined in the ultrasound examination. The objective of this study was to evaluate the accuracy of B-mode ultrasonography and ARFI elastography in the evaluation of the joint capsule and periarticular musculature of dogs associated with the evaluation of the Orthopedic Foundation of the animals (OFA) and index of distraction (DI) for the late and early diagnosis of hip dysplasia. In addition, the objective was to propose a protocol for ultrasonographic evaluation of hip structures. It was verified that the increase in pectinate stiffness (cut-off value >2.77 m/s) by elastography and capsule thickness (cut-off value >0.9 mm), in B-mode, were associated with young animals with distraction index >0.5 and both having a positive correlation. In the B-mode ultrasonographic evaluation, the presence of signs of degenerative joint disease such as irregularities of the cranial edge of the acetabulum and femoral head were associated with animals with a distraction index >0.5 with a specificity of 94%. In adults, findings of degenerative joint disease on ultrasound were associated with patients classified as diseased by OFA (P<0.05). The measurement of the joint capsule >1.10mm was diagnostic for dysplasia in unhealthy dogs by OFA. It was concluded that the ultrasonographic methods can be used as an adjuvant in the diagnosis of hip dysplasia in association with radiographic evaluation in young and adult animals.
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Articulação, Canino, Ortopedia, Ultrassonografia