Estudio comparativo de la articulación escapulo-humeral canina mediante artroscopia y resonancia magnética

espanolLa Imagen por Resonancia Magnetica (IRM) es una tecnica de reciente introduccion en medicina veterinaria con una creciente demanda, particularmente, en la articulacion escapulo-humeral del canino. El objetivo de este trabajo es estudiar la articulacion escapulo-humeral del canino mediante artroscopia e Imagen por Resonancia Magnetica. Para tal fin, se desarrollo un protocolo de RM para evaluar la articulacion en caninos sanos y enfermos, comparando los resultados obtenidos con los hallazgos encontrados en la artroscopia. El 91.67% de los animales afectados fueron perros de talla media a grande, entre 2 y 7 anos, incluyendo mestizos, Pastor Aleman, Labrador Retriever, Gran Danes, Boxer y perro de Aguas. Los diagnosticos mas frecuentes con IRM fueron: Tendinopatia del supraespinoso (TS) en el 45.83% de los casos, seguido por la Inestabilidad Articular Escapulo-humeral (IAEH) con 20.83%, Tendosinovitis Bicipital (TSB) y Osteocondritis Disecante (OCD) con 12.5%, en ultimo lugar la Osificacion Incompleta del centro caudal de Glenoide (OICCG) y la contractura Fibrotica del Musculo Infraespinoso (CFMI) con 4.16%. Los diagnosticos mas frecuentes con la artroscopia fueron: IAEH en el 41.66% de los casos, seguida de OCD y TSB con el 25% y en ultimo lugar la OICCG con 8,33%. El porcentaje de concordancia entre las dos tecnicas fue del 85,4%. En cuanto a las enfermedades como la OCD o la OICCG se obtuvo el 100% de concordancia. En cuanto a la IAEH se obtuvo un 80% y en la TSB un 66.66%. En el 14,6% de los casos se sobreestimo el grado de compromiso inflamatorio atribuido por IRM con respecto a lo observado en la artroscopia. La IRM permitio evaluar los componentes intra, y extra-articulares, la extension de la lesion en el hueso subcondral y valorar el derrame articular. La artroscopia permitio una valoracion mas detallada de la membrana sinovial, las erosiones superficiales del cartilago y realizar los test dinamicos, asi como, conocer la textura de los tejidos afectados mediante la palpacion con la instrumentacion artroscopica. Adicionalmente permitio la resolucion quirurgica de algunos casos en el mismo tiempo operatorio. En conclusion la IRM permitio una valoracion integral de la articulacion por lo que se considera que es la tecnica de eleccion en el estudio de la articulacion escapulo-humeral del canino. ARTHROSCOPY AND MAGNETIC RESONANCE OF CANINE SHOULDER JOINT. A COMPARATIVE STUDY. SUMMARY. Magnetic Resonance Image (MRI) is recently reasonable widespread in veterinary medicine and veterinarians are increasing its use in canine shoulder disease. The objective of this job is to study shoulder joint of dogs through arthroscopy and Magnetic Resonance Image. In order to screen canine shoulder disease a protocol of Magnetic resonance was performed and proved in healthy dogs and dogs with shoulder disease. Magnetic resonance image were compared with arthroscopic findings. The 91.67% of dogs were 2-7 years, medium and large breed including crossbreed, German Sheppard, Retrievers, Great Dane, Boxer and water dogs. More frequently RMI diagnostic were 45.83% Supraspinatus Tendinopathy (ST), 20.83% Instability joint disease (IJD), 12.5% Bicipital Tenosynovitis (TSB) and Osteochondrosis Dissecans (OCD) of humeral head, and 4.16% Incomplete ossifications or caudal center of Glenoid Cavity (IOCCGC) and Infraspinatus muscle contracture (FIMC). More frequently diseases by arthroscopy were 41.66% IJD, 25% TSB and OCD and 4.16% IOCCGC and FIMC. Concordance between both techniques was 85.4%. Regarding to disease like Osteochondritis Dissecans and Incomplete Ossification of Caudal Glenoid cavity concordance was 100%, with regard to Shoulder Joint Instability was an 80% and Tenosynovitis of Biceps Tendon was a 66.66%. Inflammatory degree was overestimate in 14.6% of cases compared with arthroscopic findings. IRM revealed intra and extra articular disease, subcondral bone lesions and joint effusion. Arthroscopy allowed best assessment of synovial membrane and joint cartilage and to perform dynamic functional test. The affected tissues consistence was determined by palpation with arthroscopy instrumentation. Moreover arthroscopy allowed surgery treatment at the same time. MRI is a noninvasive technique that allowed a comprehensive assessment of the shoulder joint and is the best choice to diagnose canine shoulder diseases. EnglishMagnetic Resonance Image (MRI) is recently reasonable widespread in veterinary medicine and veterinarians are increasing its use in canine shoulder disease. The objective of this job is to study shoulder joint of dogs through arthroscopy and Magnetic Resonance Image. In order to screen canine shoulder disease a protocol of Magnetic resonance was performed and proved in healthy dogs and dogs with shoulder disease. Magnetic resonance image were compared with arthroscopic findings. The 91.67% of dogs were 2-7 years, medium and large breed including crossbreed, German Sheppard, Retrievers, Great Dane, Boxer and water dogs. More frequently RMI diagnostic were 45.83% Supraspinatus Tendinopathy (ST), 20.83% Instability joint disease (IJD), 12.5% Bicipital Tenosynovitis (TSB) and Osteochondrosis Dissecans (OCD) of humeral head, and 4.16% Incomplete ossifications or caudal center of Glenoid Cavity (IOCCGC) and Infraspinatus muscle contracture (FIMC). More frequently diseases by arthroscopy were 41.66% IJD, 25% TSB and OCD and 4.16% IOCCGC and FIMC. Concordance between both techniques was 85.4%. Regarding to disease like Osteochondritis Dissecans and Incomplete Ossification of Caudal Glenoid cavity concordance was 100%, with regard to Shoulder Joint Instability was an 80% and Tenosynovitis of Biceps Tendon was a 66.66%. Inflammatory degree was overestimate in 14.6% of cases compared with arthroscopic findings. IRM revealed intra and extra articular disease, subcondral bone lesions and joint effusion. Arthroscopy allowed best assessment of synovial membrane and joint cartilage and to perform dynamic functional test. The affected tissues consistence was determined by palpation with arthroscopy instrumentation. Moreover arthroscopy allowed surgery treatment at the same time. MRI is a noninvasive technique that allowed a comprehensive assessment of the shoulder joint and is the best choice to diagnose canine shoulder diseases.

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