Radiological Methods for the Imaging of Congenital Malformations of C6-T1, the First and Second Sternal Ribs and Development of a Classification System, Demonstrated in Warmblood Horses.
Authors: Ros Katharina B, Doveren Aldo, Dreessen Christie, Pellmann Ralf, Beccati Francesca, Zimmermann Elisa, Distl Ottmar
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary: Cervicothoracic Malformations in Warmblood Horses Malformations at the cervicothoracic junction (C6–T1) have been increasingly linked to performance and behavioural problems in horses, yet imaging protocols and classification systems remain poorly standardised. Ros and colleagues developed a radiographic protocol using latero-lateral and oblique projections to systematically evaluate the cervicothoracic region in 39 warmblood horses presenting with performance or behavioural complaints, establishing a novel classification framework for anatomical variations. Nearly 95% of horses examined displayed malformations of the ventral lamina of C6 and its transposition onto C7, whilst rib anomalies were remarkably prevalent: only 11.4% of horses possessed bilaterally normal first ribs, with unilateral shortening (48.6%), bilateral shortening (34.3%), complete absence (11.4%), and bifid ribs (8.6%) observed across the cohort. Significant associations existed between left and right-sided severity grades, and between C6, C7 and first rib involvement, suggesting these malformations may represent part of a developmental syndrome rather than isolated anomalies. For equine practitioners, this work provides a practical radiographic approach applicable in field settings, enabling identification of previously under-diagnosed cervicothoracic pathology that could explain previously unexplained performance or behavioural issues—particularly relevant given the high prevalence of these variations in the warmblood population studied.
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Practical Takeaways
- •When evaluating warmblood horses with behavioral or performance issues, cervicothoracic malformations are a common radiographic finding and should be considered as a potential contributing factor
- •A standardized radiographic protocol using latero-lateral and oblique projections can reliably identify C6-T1 and rib malformations in practice, enabling better clinical assessment and owner communication
- •First rib shortening is more prevalent than complete absence; bilateral involvement is more common than unilateral, suggesting these may be developmentally related breed-specific variations rather than rare anomalies
Key Findings
- •Malformations of the ventral lamina of C6 and transposition onto C7 were present in 94.9% (37/39) of warmblood horses evaluated
- •First rib anomalies included missing ribs (11.4%), unilateral shortening (48.6%), bilateral shortening (34.3%), and bifid ribs (8.6%), with only 11.4% having normal length bilaterally
- •Moderate to highly significant associations were found between the severity of left and right malformations of C6, C7, and first ribs
- •Newly described latero-lateral and oblique radiographic projections successfully visualized cervicothoracic malformations in living horses