Abstract
Objectives The aim of this study was to determine the radiographic sensitivity in detecting
medial coronoid disease (MCD), using computed tomography (CT) as reference in dogs
presented for an official second opinion, and to compare the medial coronoid process
(MCP) in fragmented and fissured MCP as well as those unaffected by MCD.
Materials and Methods The data of dogs, presented for official second opinion radiographs and CT, were
reviewed by three board-certified observers and in accordance with the International
Elbow Working Group guidelines regarding MCD. Radiographic delineation, radiopacity
and Hounsfield Units (HU) of the MCP were recorded additionally and the correlation
between radiography and CT was investigated.
Results Sensitivity and specificity of radiography compared with CT yielded values of 83.6%
for the former and 83.5% for the latter. False-negative grading in radiography correlated
significantly (p = 0.0001) with a present fissure line in CT. The mean delineation (p = 0.03) and mean HU of fragmented MCP (p = 0.0045) were significantly reduced compared with fissured MCP and no significant
differences in measured HU for fissured MCP were detected in comparison to elbows
unaffected by MCD.
Conclusion The results of the present study show substantial agreement between radiography and
CT in second opinion cases. However, sensitivity is reduced compared with not preselected
cases. A present fissure line in CT was significantly associated with a false-negative
grading in radiography. Therefore, CT imaging of the elbows is strongly recommended
in cases of appeal.
Keywords
canine - elbow dysplasia - medial coronoid disease - CT - fissures
