title: Diagnostic sensitivity of bone scintigraphy for equine stifle disorders.
abstract: Disorders of the stifle are a common cause of lameness in horses yet the accuracy of scintigraphy for diagnosis of stifle conditions is controversial. The aim of retrospective cross-sectional study was to determine the diagnostic sensitivity (Se) of bone scintigraphy in detecting stifle disease and to determine if two orthogonal scintigraphic images improve diagnostic Se. Horses that underwent scintigraphic examination during a two-year period were included. Horses were divided into two groups: group 1 (N = 23) had lameness that was localized to the stifle by intra-articular analgesia and group 2 (N = 182) had lameness that was localized to a different location. Scintigraphic studies (one image or two images) were independently and retrospectively analyzed by two radiologists (R1 and R2). Sensitivity, specificity (Sp) and predictive values (PV), and were calculated for each type of study (one image or two images) and for each radiologist (R1 or R2). The Se to detect stifle disorders varied between radiologists (29.2% and 20.8%). The Sp was 84.5% and 88.3%. When two images were evaluated a decrease in the positive PV for both readers occurred. The Cohen kappa coefficient (κ) between readers was poor when one image (0.084) or two images (0.117) were evaluated. Findings from this study indicated that bone-phase nuclear scintigraphy is reasonably specific but highly insensitive for detecting lameness originating from the stifle in a diverse population of both normal and affected horses. The addition of a caudal scintigraphic image acquisition did not improve diagnostic sensitivity.
authors: Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32608.
authors: Sarah
authors: S
authors: Graham
authors: Mauricio
authors: M
authors: Solano
authors: James
authors: J
authors: Sutherland-Smith
authors: Amy F
authors: AF
authors: Sato
authors: Louise
authors: L
authors: Maranda
mesh_terms: D000700:Analgesics / Q000008:administration & dosage; D000818:Animals; D001182:Arthroscopy / Q000662:veterinary; D003430:Cross-Sectional Studies; D005260:Female; D006734:Horse Diseases / Q000000981:diagnostic imaging*; D006736:Horses; D007091:Image Processing, Computer-Assisted / Q000706:statistics & numerical data; D007270:Injections, Intra-Articular / Q000662:veterinary; D007794:Lameness, Animal / Q000000981:diagnostic imaging*; D008297:Male; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000662:veterinary; D010808:Physical Examination; D011237:Predictive Value of Tests; D011859:Radiography; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013264:Stifle / Q000000981:diagnostic imaging*; D014463:Ultrasonography
chemical_list: D000700:Analgesics
keywords: equine lameness; equine stifle; nuclear scintigraphy