Assessment of stifle effusion-synovitis as a predictor for canine cruciate disease

Abstract

Objective: To objectively quantify stifle effusion-synovitis in dogs with confirmed cranial cruciate ligament (CrCL) disease, with or without meniscal pathology, through radiographic assessment by investigating an association between severity of effusion-synovitis and cruciate and meniscal disease, and to establish a standardised quantitative radiographic measurement screening tool to predict severity of cruciate and meniscal injury. Methods: A total of 100 diseased stifles met the inclusion criteria and were assigned to either partial CrCL tear (PT), complete CrCL tear (CT), partial CrCL tear with meniscal pathology (PTM) or complete CrCL tear with meniscal pathology (CTM) groups. Quantitative measurement assessment was then performed to evaluate the percentage of cranial effusion-synovitis (CrES), caudal effusion-synovitis (CdES) and cranial fat pad compression. Three surgeons conducted a blinded review of 15 mediolateral stifle radiographs and were instructed to subjectively and quantitatively predict the degree of cruciate and meniscal pathology. Results: A significant difference of CrES between CT and PT groups (P=0.0173) and CTM and PT (P=0.0169) groups was identified. A significant difference in CdES between PT and CT groups (P=0.0015), PT and CTM groups (P=0.0041) and CTM and CT (P=0.0005) groups was identified. Quantitative measurement demonstrated improved sensitivity, specificity and agreement when compared to subjective assessment. Clinical significance: The results of this study propose that a quantitative radiographic measuring tool for predicting the severity of cruciate and meniscal disease may improve diagnosis of stifle pathology in a clinical setting and aid in pre-operative clinician decision making compared to subjective classification schemes.