Abstract
Osteoarthritis (OA) is the most common orthopedic condition in dogs, characterized as the chronic, painful end-point of a synovial joint with limited therapeutic options other than palliative pain control or surgical salvage. Since the 1970s, radiography has been the standard-of-care for the imaging diagnosis of OA, despite its known limitations. As newer technologies have been developed, the limits of detection have lowered, allowing for the identification of earlier stages of OA. Identification of OA at a stage where it is potentially reversible still remains elusive, however, yet there is hope that newer technologies may be able to close this gap. In this article, we review the changes in the imaging of canine OA over the past 50 years and give a speculative view on future innovations which may provide for earlier identification, with the ultimate goal of repositioning the limit of detection to cross the threshold of this potentially reversible disease.
Highlights
Osteoarthritis (OA) is the most common orthopedic condition observed in dogs [1], with estimated clinical prevalence of ∼2.5% [2, 3] that increases to 20% when evaluated post-mortem [4, 5]
Since Morgan’s publication in 1969 outlining the radiographic changes in the dog, the imaging of OA in dogs has advanced beyond recognition
Each advancement in imaging technology and development of resolution has driven back the point of identification of OA to an earlier stage of gross structural disease
Summary
Osteoarthritis (OA) is the most common orthopedic condition observed in dogs [1], with estimated clinical prevalence of ∼2.5% [2, 3] that increases to 20% when evaluated post-mortem [4, 5]. As a non-invasive modality which can directly assess bone and soft-tissue joint components and in particular articular cartilage, MRI is commonly used in human phase III clinical trials leading to the development of several semi-quantitative scoring systems, such as the Whole-Organ Magnetic Resonance Imaging Score (WORMS) [86] among others [31]. These scoring systems assess the whole organ, unlike the radiographic systems, making them well suited for both cross-sectional and longitudinal studies. This application of MRI allows mapping of collagen bundles within soft-tissues which could provide other indicators of the structural derangements occurring in the cartilage (Figure 11)
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