Comparison of radiography and computed tomography to evaluate metacarpo/metatarsophalangeal joint pathology of paired limbs of thoroughbred racehorses with severe condylar fracture.
Authors: Morgan Joseph W, Santschi Elizabeth M, Zekas Lisa J, Scollay-Ward Mary C, Markel Mark D, Radtke Catherine L, Sample Susannah J, Keuler Nicholas S, Muir Peter
Journal: Veterinary surgery : VS
Summary
# Editorial Summary This cadaveric study compared conventional radiography and computed tomography for detecting joint pathology in the fetlock region of eleven pairs of Thoroughbred limbs affected by severe condylar fractures, aiming to establish which imaging modality provides more comprehensive diagnostic information in this common racing injury. Four independent raters evaluated standard orthogonal radiographs and multiple transverse CT images of both fractured and contralateral limbs, with findings validated against gross anatomical dissection. Computed tomography demonstrated significant advantages for identifying proximal metacarpal/metatarsal fissures, articular comminution, small condylar cracks and lucencies, and proximal sesamoid fractures, whilst offering equivalent detection to radiography for main fracture lines and diaphyseal involvement; radiography retained superiority only for proximal first phalangeal dorsal fractures. Notably, both modalities performed poorly at detecting palmar/plantar first phalangeal fractures and subchondral coalescing cracks—lesions that may have important prognostic implications for return to racing. For practitioners managing Thoroughbreds with suspected or confirmed condylar fractures, CT should be considered the imaging modality of choice when available, though awareness of its limitations regarding certain subchondral and plantar lesions remains clinically important for prognosis and rehabilitation planning.
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Practical Takeaways
- •Use CT imaging when evaluating condylar fractures in racehorses, as it detects significantly more pathology than radiography alone, particularly proximal fissures and comminution
- •Radiography alone is insufficient for complete fracture assessment and may miss critical findings that affect prognosis and treatment decisions
- •Be aware that neither imaging modality reliably detects all pathology—palmar/plantar P1 fractures and subchondral cracks may be missed, requiring clinical correlation and sometimes second-look surgical evaluation
Key Findings
- •CT was superior to radiography for detecting MC/MT3 proximal fissures, articular comminution, condylar small cracks and lucencies, and proximal sesamoid fractures
- •Radiography was superior to CT for detecting proximal P1 dorsal fractures
- •Both imaging modalities showed good to excellent interobserver agreement for most pathologic features
- •Both radiography and CT were poor at detecting palmar/plantar proximal P1 fractures and subchondral bone coalescing cracks