The use of CT and CT arthrography in diagnosing equine stifle injury in a Rheinlander gelding.
Authors: Crijns C P, Gielen I M V L, van Bree H J J, Bergman E H J
Journal: Equine veterinary journal
Summary
# Editorial Summary A 5-year-old Rheinlander gelding presented with lameness localised to the left stifle that remained diagnostically elusive following standard physical examination, radiography, and ultrasonography. Advanced imaging using computed tomography (CT) and CT arthrography successfully identified multiple concurrent pathologies: an osteochondrosis dissecans-like lesion of the medial femoral condyle, intra-articular bone fragments, cartilage trauma, and caudal cruciate ligament damage—findings subsequently confirmed at post-mortem examination. Whilst this case was ultimately euthanised due to poor prognosis for athletic function, the results underscore the diagnostic superiority of cross-sectional imaging over conventional modalities when investigating complex stifle lameness, particularly when subtle bone, cartilage and ligamentous lesions are suspected. For equine practitioners managing horses with stifle pathology unresolved by routine imaging, CT and CT arthrography offer significantly enhanced soft tissue and cartilage visualisation that can facilitate accurate diagnosis and more informed prognostic discussion with owners. The confirmation of all CT findings through gross pathology provides robust validation for these techniques as a valuable—albeit resource-intensive—diagnostic step in equine stifle injury assessment.
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Practical Takeaways
- •When stifle lameness cannot be diagnosed using conventional imaging (radiography and ultrasound), CT and CT arthrography should be considered as they provide superior visualization of bony, cartilage, and soft tissue structures
- •Multiple concurrent stifle lesions may be present in a single case; comprehensive imaging is essential for accurate diagnosis and prognosis determination
- •Some equine stifle injuries carry poor prognosis for return to athletic use even when diagnosed, emphasizing the importance of thorough diagnostic workup before committing to treatment
Key Findings
- •CT and CT arthrography identified multiple stifle lesions (OCD-like lesion, bony fragments, cartilage trauma, CCL injury) that were not diagnosed by physical examination, radiography, or ultrasonography
- •All CT findings were confirmed by gross pathology examination post-euthanasia
- •Advanced imaging techniques provided diagnostic capability beyond conventional imaging modalities for equine stifle pathology