Osteochondrosis Research Articles

PHYSICAL REHABILITATION FOR YOUNG MEN WITH GRADE I AND II OBESITY

The goal of this study is to study the role of exercise and dietary modification in the treatment of obesity in young men. Materials and methods. A study was conducted with 10 young men aged 25 to 30 who had a body mass index (BMI) exceeding 30 kg/m², indicative of obesity. The primary intervention combined diet therapy with increased physical activity. Most participants also had obesity-related comorbidities, including arterial hypertension, autonomic-vascular dystonia, type II diabetes, and spinal osteochondrosis. Patient motivation was considered crucial in program development, and thus only individuals with a high motivation level were selected for participation. Results and discussion. Based on data from dynamic observations, we can state that the physical therapy program studied has a positive effect on body weight reduction in cases of mild forms of alimentary obesity. After three months of participation, an average weight loss of 8.5% was observed, which represents a very favorable outcome. The results indicate that physical exercises combined with dietary adjustments positively influence weight loss dynamics in young men with grade 1 alimentary obesity. Weight loss occurred most rapidly during the first month of the program. Conclusion. The physical therapy program for grade 1 obesity involves a comprehensive approach, combining physical exercises conducted in a medical rehabilitation department with a specially designed dietary plan. This program is recommended for individuals with mild forms of alimentary obesity and a body mass index (BMI) up to 35 kg/m². After three months of implementing this approach, participants showed an average reduction in excess body weight of 8.5%. This physical therapy program may be effectively used for managing grade I obesity.

Regarding the assessment of the influence of thoracic spine manual therapy on the women 's cardiovascular system in the course of sanatorium treatment

Purpose: The purpose of this study was to evaluate the reaction of the cardiovascular system of women to manual therapy procedures on the chest during the course of sanatorium-resort treatment of osteochondrosis of the spine. Material and methods Under supervision were 29 women aged 37.8 (31.3; 45.8) years who underwent a course of sanatorium-resort treatment for osteochondrosis of the thoracic spine in the clinical sanatorium named after V.P. Chkalov (Odesa, Ukraine) in 2010-2011. The treatment complex included of 4 thoracic spine manual therapy (TSMT) procedures, which were performed every 5-7 days of sanatorium-resort treatment. The indicators of the cardiovascular system were recorded using the Omron M1 Classic device (Japan) in a supine position before and after every procedure TSMT. Results In general, the same type of significant changes is noted for most of the hemodynamic indicators under the influence of TSMT procedures. This applies to parameters DBP (mmHg), which increase, HR (min-1), which decrease, and integral indicators – Double product (cu.) and Index Kerdo (cu.), which also decrease. Changes in MBP (mmHg) and PBP (mmHg) are not always significant. Taking into account distribution of types Δ Double product and Δ Kerdo`s Index, it can be stated that the optimal reaction to the TSMT procedure was observed most often after the 2nd procedure - in 62.1% of patients for heart`s contractile function and in 65.5% for autonomic regulation of hemodynamics. It is also informative that from procedure to procedure the number of cases falling into the extreme limits of the distribution and being assigned to excessively pronounced and inadequate types of response significantly decreases. According to the indicator Δ Double product their number from the first to the fourth procedure decreases from 17.2% to 3.4%, and according to the indicator Δ Kerdo`s Index from 17.2% to 6.8%. Conclusions. Determination of changes in indicators of the cardiovascular system activity under the influence of the thoracic spine manual therapy procedure made it possible to characterize the types of reactions of the cardiovascular system.

Methodological approaches to assessing the genetic predisposition of osteochondrosis of the tarsocrural joint in the Pura Raza Española horses

Osteochondrosis (OC) is a developmental orthopaedic disease of significant concern in numerous sport horse breeds, with significant international relevance. Using digital radiographs, we assessed the occurrence of hock (tarsocrural joint) OC in 3 048 Pura Raza Española (PRE) horses which took part in a morpho-functional test, in three specific locations in the tarsus limbs: the Distal Intermediate Ridge of the Tibia (DIRT), the lateral trochlear ridges of the talus (LTT), and the medial trochlear ridges of the talus (MTT). An incidence rate of 13.3% was found for hock OC in the analysed sample, with the highest incidence rate observed in DIRT (10.0%) and the lowest in MTT (0.2%). Estimates of genetic predisposition to hock OC were carried out using three genetic approaches: 1a) a binomial threshold model based on the presence or absence of OC, 1b) a multinomial threshold model, on a scale from 0 (absence) to 3 (maximum), and 2) a linear model. The effects considered in the models included sex, genetic origin and stud class. All the analyses were based on the Bayesian inference methodology, using the THRGIBBS3F90 software. The binomial threshold model yielded the most suitable results, with an estimated heritability for Overall hock OC of 0.71 ± 0.055 on the underlying scale (0.53 on the observed scale), ranging in different locations from 0.48 ± 0.087 (LTT) to 0.66 ± 0.063 (DIRT) on the underlying scale (0.10 and 0.38 on the observed scale, respectively). The highest significative genetic correlation was observed between Overall and DIRT (0.97) for approach 1a, and the lowest significant genetic correlation was between Overall and LTT (0.49), for approach 2. This study contributes valuable insights into the genetic predisposition towards, as well as for the potential for selective breeding against, hock OC in PRE horses, and provides a basis for future research and breeding programmes aimed at minimising the occurrence of hock OC and promoting the overall health of this breed.

Determinants of joint effusion in tarsocrural osteochondrosis of yearling Standardbred horses.

Tarsocrural osteochondrosis (OCD) is a developmental orthopedic disease commonly affecting young Standardbreds, with different fragment localization and size. Clinically, it is characterized by variable synovial effusion in the absence of lameness, whose determinants are ill-defined. We hypothesized that localization and physical characteristics of the osteochondral fragments like dimensions, multifragmentation, and instability influence joint effusion and correlate with synovial markers of cartilage degradation and inflammation. Clinical data, synovial fluid and intact osteochondral fragments were collected from 79 Standardbred horses, aged between 12 and 18 months, operated for tarsocrural OCD. The severity of tarsocrural joint effusion was assessed semi-quantitatively. The osteochondral fragment site was defined radiographically at the distal intermediate ridge of the tibia (DIRT), medial malleolus (MM) of the tibia, and/or lateral trochlear ridge (LTR) of the talus. Size, stability, and arthroscopic appearance (unique or multi-fragmented aspect) of the fragments were determined intra-operatively. Synovial concentrations of C-terminal cross-linked telopeptides of type II collagen (CTX-II), leukotriene B4 (LTB4), and prostaglandin E2 (PGE2) were quantified. Tarsocrural synovial effusion was significantly affected by localization and stability of the fragments, with MM-located and unstable fragments being associated with highest joint effusion. Concentrations of CTX-II, LTB4, and PGE2 positively correlated with the severity of synovial effusion. This study underlines characteristics of the osteochondral fragments determining higher synovial effusion in OCD-affected tarsocrural joints and suggests both inflammation and extra-cellular matrix degradation are active processes in OCD pathology.

The epidemiology of osteochondrosis in an insured Swedish dog population

Osteochondrosis (OC) is a focal disturbance of endochondral ossification due to a failure of blood supply to the epiphyseal growth cartilage. In dogs, OC most commonly affects the shoulder joint, followed by the elbow, tarsal, and stifle joints. The condition is associated with clinical signs such as lameness and pain and the prognosis varies depending on the affected joint. Most epidemiologic studies of OC in dogs were performed over 20 years ago, and updated estimates of disease incidence are lacking. Therefore, the objectives of this study were to provide population-based estimates of the incidence rate, cause-specific mortality rate, and age at diagnosis of appendicular OC (AOC, including OC of the shoulder, elbow, stifle, and tarsal joints) and stifle and tarsal OC separately, using data from Agria Djurförsäkring in Sweden (2011–2016). Further, the study aimed to evaluate the risk of OC in subgroups divided by breed and sex and describe previous, concurrent, and subsequent diagnoses of the affected joint in dogs with stifle or tarsal joint OC. The study population included just over 600,000 dogs, of which 685 were affected by AOC. Stifle joint OC (n = 113) was more common than tarsal joint OC (n = 80). The incidence rate of AOC was 3.77 (95% confidence interval (CI): 3.49–4.07) cases per 10,000 dog-years at risk, while the incidence rate of stifle and joint tarsal OC was 0.64 (95% CI: 0.53–0.77) and 0.43 (95% CI: 0.34–0.54) cases per 10,000 dog-years at risk, respectively. All breeds at increased risk of AOC were large or giant, and male dogs had an increased risk of AOC compared to female dogs (RR 1.76, 95% CI: 1.50–2.07, p < 0.001). The median age at first diagnosis during the study period was 0.74 (0.32–11.5) years for AOC, 2.62 (0.45–8.82) years for stifle joint OC, and 0.73 (0.35–7.35) years for tarsal joint OC. Of the dogs with stifle or tarsal joint OC, 30.2% and 15.0% had a previous diagnosis of stifle/tarsal joint pain or other unspecific clinical signs, respectively, and 13.8% of the dogs with stifle joint OC suffered subsequent cruciate ligament rupture. Osteochondrosis was the most common reason for euthanasia in the affected dogs. In total, 77 dogs were euthanised due to AOC during the study period.

82 Relationships between performance traits and osteochondrosis of the hock in Standardbred racehorses

Abstract Equine osteochondrosis (OC) is a developmental orthopedic disease that results in abnormal articular cartilage and often the formation of osteochondral bone chips (osteochondrosis dissecans). Standardbreds, a breed predominately used in harness racing, are prone to the development of OC. This study aimed to quantify the relationship between OC and key performance traits, fastest mile time, annual earnings, and consistency in race times over career, using a cohort of 347 North American Standardbred horses. Radiographic examination of the tarsi was previously performed to identify horses as OC-affected (n = 155) or healthy (n = 192). Performance data was acquired from the United States Trotting Association (USTA) detailing horse identification, performance, and lifetime race record. Linear mixed multiple regression models were constructed to evaluate the relationship between OC and performance. A total of 24 performance related variables (e.g., age, gait, track) were evaluated for inclusion in the model through subset variable selection and goodness of fit as determined by Schwarz’s Bayesian Information Criterion (SBC). Preliminary results indicate that healthy horses exhibit significantly faster mile times (P &amp;lt; 0.001) compared with their OC-affected counterparts. However, no significant association was detected between OC status and annual earnings (P &amp;gt; 0.2) or consistency in race times over career (P &amp;gt; 0.2). Ongoing analyses are currently being conducted to assess additional predictors and performance variables for a potential association with osteochondrosis. This study emphasizes the importance of implementing effective strategies for OC management and improving breeding selection practices when producing offspring with desired performance characteristics.

FEATURES OF CHILDREN'S PHYSICAL THERAPY WITH LEGG-CALVE-PERTES DISEASE

Introduction. The article analyzes modern domestic and foreign publications related to the study of the effectiveness of physical therapy (PT) in Legg-Calve-Perthes disease (or juvenile osteochondrosis of the femoral head). Since today there is no certainty about the superiority of different FT agents in the treatment and rehabilitation of patients with Legg-Calve-Perthes disease of LKP), there is no unanimous opinion regarding the choice of the optimal time for the use of FT agents during the development of the disease, therefore, a review of rehabilitation programs with the features of the use of FT is relevant children with juvenile osteochondrosis of the femoral head.&#x0D; The aim of the study - study of physical therapy features in children with Legg-Calve-Perthes disease with analysis of existing physical rehabilitation programs.&#x0D; Conclusions. Legg-Calve-Perthes disease is characterized by unilateral or bilateral necrosis of the femoral head, which affects the range of motion of the hip. Despite the low incidence, LCP is a serious global health problem, as it affects a significant proportion of children under 15 years of age and is characterized by lameness, pain, and limitation of hip mobility.&#x0D; The causes of LKP disease are unknown. This disease is believed to be multifactorial, caused by a combination of environmental, metabolic, and genetic factors.&#x0D; The pathogenesis of LKP disease is complex, therefore, taking into account the multifactorial etiology, treatment and recovery, the prognosis of the disease is determined according to the characteristics of each patient, such as age, sex, type and size of the affected part of the femur.&#x0D; The analysis of the scientific and methodical literature indicated the need to observe the staged application of FT in the rehabilitation of this disease. The result of treatment and rehabilitation of patients with LKP depends to a large extent on the child's age, weight, gender, size of the femoral head necrososis, and the timeliness of medical and rehabilitation assistance. At the same time, the effectiveness and the choice of the optimal time for the use of FT agents in the course of the development of the disease of LCP have not been fully clarified.

Bilateral juvenile osteochondrosis dissecans in monozygotic twins: a case report

IntroductionThe etiology of osteochondrosis dissecans (OCD), a chondropathy associated with detachment of the subchondral bone and the overlaying cartilage, is not yet fully understood. While repetitive physical exercise-related stress is usually assumed to be the main risk factor for the occurrence of OCD, genetic predisposition could have an underestimated influence on the development of the disease.Case reportWe report a case of monozygotic twins with almost identical stages of bilateral osteochondrosis dissecans of the knee joint. In both patients, initially, a unilateral lesion occurred; despite restricted physical exercise, in the further course of the disease a lesion also developed on the contralateral side. While the lesion found most recently demonstrated an ongoing healing process at a 6-month follow-up, the other three lesions showed a natural course of healing under conservative treatment with significant clinical as well as radiological improvements after one year and complete consolidation in magnetic resonance imaging (MRI) after 2 years.ConclusionThere could be a genetic component to the development of OCD, although this has not yet been proven. Based on a two-year MRI follow-up, we were able to show the self-limiting characteristics of juvenile osteochondrosis dissecans.

Differential Diagnosis of Chest Pain Syndrome: Thoracalgia and Cardialgia

Summary. The objective of the study was to conduct a differential diagnosis of chest pain and to identify the percentage of patients with a cardiac component. Material and Methods. 147 patients were examined; mean age was 43.2±1.9 years. Patients' complaints and risk factors were carefully analyzed. MRI examination, radiography of the thoracic spine, electrocardiography, echocardiography, and bicycle ergometry were performed. Exclusion criteria were as follows: acute isolated pathology of the cardiovascular system (myocardial infarction, angina pectoris), deforming and traumatic changes in the spine (grade 3-4 scoliosis, compression fractures of the vertebral bodies, chest deformities). Results. The patients were divided into 3 groups: patients with spinal degenerative disc disease, patients with cardiac symptoms and spinal variables, and a group that mainly suffered from cardiovascular disease. Electrocardiography, echocardiography, and bicycle ergometry were performed to objectively confirm the obtained data. Electrocardiography changes were observed in 29.2% of patients. Among patients with degenerative disc disease, electrocardiography changes occurred in 4%, while they were noted in 21.4% of cases in the group with mixed pathology and 100% in the group of patients with signs of cardiovascular disease. According to echocardiography, 28.6% had cardiac changes. The most common cause was atherosclerosis (50%) and hypertension (21.4%). By observation groups, the level of changes and their severity significantly increased from group 1 to group 3. Bicycle ergometry gave a “positive” test in 20% of cases. Diagnostic procedures revealed a tendency to establish the causes of pain. MRI and electrocardiography play the most important role. The data obtained allow us to conclude that the cause of pain syndrome in group 3 of patients is based on heart and vascular disease. This group is transferred to the supervision of a cardiologist, so in the further study, we paid attention to the groups with spinal osteochondrosis (75) and the mixed group (42). The degree of severity of changes, both quantitatively and in terms of the severity of concomitant pathology, is noteworthy. Thus, in patients with spinal degenerative disc disease, the level of comorbidities reached 18.7%; in patients with cardiac symptoms and changes in the spine, it was 50%, which significantly aggravates their course. The high level of anxiety in the group as a whole is noteworthy, which creates a negative background for treatment and requires mandatory correction. A program of appropriate treatment in the group with combined pathology should be created taking into account its cardiological component. Conclusions. A careful analysis of the results indicates the presence of a group of patients with concomitant cardiac pathology that requires additional correction in the complex of generally accepted therapeutic measures.

Outcomes of laparoscopic pyeloplasty and impact of an enhanced recovery protocol

&lt;b&gt;Purpose:&lt;/b&gt; The study aims to analyze the enhanced recovery protocol’s (ERP) effectiveness in a comparative study of elective surgeries for ureteropelvic junction obstruction (UPJO).&lt;br /&gt; &lt;b&gt;Methods:&lt;/b&gt; The prospective study included 30 patients with UPJO who underwent laparoscopic pyeloplasty in 2018-2021.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; Postoperative complications developed rarely, and their frequency and severity were comparable. Independent predictors of UPJO recurrence were the spine osteochondrosis &amp;gt;II period (HR 13.97; 95% CI 1.26; 154.8; p=0.032), the concretions self-discharge (HR 28.49; 95% CI 1.78; 455.62; p=0.018), surgical operation duration &amp;gt; 110 minutes (HR 44.7; 95% CI 3.95; 505.4; p=0.002) and previous nephrostomy (HR 1.07; 95% CI 1.02; 1.13; p=0.002).&lt;br /&gt; &lt;b&gt;Conclusions:&lt;/b&gt; In the surgical treatment of UPJO, it is advisable to use ERPs, as this allows achieving a better treatment quality with comparable results.

Endoscopic and morphological features of chronic gastritis in patients with lumbar spine osteochondrosis.

Aim: of the study is to determine the endoscopic and morphological features of chronic gastritis (CG) in patients with lumbar spinal OC. Materials and Methods: 102 patients with lumbar spine OC and CG were examined. The patients were diagnosed with Helicobacter pylori (HP) infection, according to which the patients were divided into two groups: the first group included 92 HP-positive patients, the second group consisted of 10 HP-negative patients. Results: Among HP infected patients with lumbar spine OC, erosive gastropathy was most often diagnosed (in 40 (43.5%) of the examined), as well as erosive-papular and erosive-hemorrhagic gastropathy (in 14 (15.2%) and in 16 (17, 4 %) of patients, respectively), while erythematous gastropathy was more often diagnosed among HP-negative patients (in 7 (70.0 %) cases, respectively). Conclusions: 1. 90.2% of patients with lumbar spine OC and CG have been diagnosed with HP infection. 2. Endoscopically, the lesion of the stomach MM in patients with lumbar spine OC corresponds mainly to erosive and erosive-hemorrhagic forms of gastropathy. 3. During histological examination of stomach MM, mainly 2nd and 3rd degrees of inflammation were established, especially in patients with erosive, erosive-papular and erosive-hemorrhagic forms of gastropathy.

Efficacy of manual correction of cervical spine osteochondrosis in the treatment of arterial hypertension syndrome and prediabetes

To evaluate the therapeutic effect of non-pharmacological methods of restoring brainstem blood supply in patients with AH and prediabetes. The number of patients equal 125 (57 men and 68 women, mean age 63.3±11.5 and 65.4±11.8 y.o., respectively) with prediabetes and 1st degree of AH without target organs damage, among whom 102 patients with prehypertension or 1st degree of hypertension and 24 ones with 2nd degree of hypertension, were examined. The original method of manually restoring brainstem blood supply developed in the Shishonin's Clinic was applied to all patients. The control group included patients with the same disorder, who did not receive manipulations. Blood pressure (BP) measurement, ultrasound and triplex ultrasonography of vertebral arteries, biochemical blood test, and estimation of glycemia and glycated hemoglobin were performed. All patients of the study group had decreased levels of systolic BP (by 23.8±10.7 mm Hg for men and 32.8±11.9 mm Hg for women), an increase of flow velocity in vertebral arteries (by 20.6±7.5 and 21.5±7.2 cm/s, respectively), a decrease of glycated hemoglobin concentration (by 0.32±0.51 and 0.34±0.41%, respectively). In the comparison group, there were no patients with improvement in these indicators. The effectiveness of the author's manual method of cervical spine osteochondrosis correction in the reduction of BP and glycemia levels in the early stages of the disease is shown.

Study of polymorbidity in patients with musculoskeletal diseases at the stage of medical and ­physical rehabilitation

Background. The study of multimorbidity is an urgent task for assessing individual clinical risks and prognosis, developing a treatment and rehabilitation plan.&#x0D; Aim. To study multimorbidity in patients with chronic musculoskeletal diseases.&#x0D; Material and methods. The study was conducted in 20222023 on the basis of the medical center for the treatment of spine and joints DEMA and the Peoples' Friendship University of Russia named after Patrice Lumumba. Study subjects were patients with musculoskeletal diseases (n=212) who sought medical and physical rehabilitation. Men n=75 (average age 40.26.65 years, proportion of patients 60 years 20%), women n=137 (average age 47.26.84 years, proportion of patients 60 years 18%). The subject of the study was polymorbidity in patients with musculoskeletal diseases. The following methods were used: content analysis, analytical, statistical, mathematical, comparative analysis method.&#x0D; Results. Spinal diseases were detected in 79.2% of patients, and various dysfunctions of the musculoskeletal system were detected in 19.36%. 43 (20.28%) patients were diagnosed with two diseases of the musculoskeletal system. Women were more likely than men to be diagnosed with spinal osteochondrosis (p=0.015), cervicalgia (p=0.015), degenerative diseases of the hip and knee joints (p=0.022) and consequences of skeletal injuries (p=0.015). Of the concomitant diseases in all patients, eye (23.1%) and cardiovascular diseases (25.5%) were common. Women were more often diagnosed with endocrine (p=0.025), ophthalmic (p=0.001), gynecological (p=0.001) diseases, urolithiasis (p=0.025) and cholelithiasis (p=0.025); men with consequences of injuries/surgeries (p=0.025). Polymorbidity was established in 50.33% of patients 42 men and 72 women. Two and three concomitant chronic diseases were predominantly diagnosed in women, and six or more were diagnosed in men. All patients 60 years of age (25%) had three or more chronic diseases.&#x0D; Conclusion. Most patients with musculoskeletal pathology suffer from several chronic diseases.

MISTAKES AND COMPLICATIONS AFTER SURGICAL TREATMENT OF LUMBAR SPONDYLOLISTHESIS. CLINICAL CASE

Spondylolisthesis is a pathology of the musculoskeletal system that causes a vertebra to move forward, sideways or backward. Most often, it is treated surgically using transpedicular structures. Objective. To present a clinical case of re-treatment for degenerative lumbar spondylolysis of the LV vertebral body using transpedicular and posterior autografting techniques. Methods. The clinical case of lumbar spine osteochondrosis, spondyloarthritis,posterior transpedicular fusion LV–SI, fracture of the screw in the body of the SI vertebra on the right, and spinal canal stenosis at the level of LV–SI is described. Lower paraparesis. Results. The patient underwent metal removal, decompression of the spinal canal at the level of LV–SI, open reduction of the LV vertebral body, posterior transpedicular fusion of LIV–SI and posterior autografting fusion. The surgical intervention was successful, despite the technical difficulties associated with removing the threaded part of the broken screw. According to the visual analogue scale, the patient had 8 points beforethe operation, which indicates acute pain syndrome, and after that the pain intensity decreased to 4 points. Muscle strength of the right and left lower extremities before surgery was 2 and 2.5 points, respectively, 5 days after surgery, improvement was recorded — 3 points for each limb. From the second day after repeated surgical treatment, the patient showed a significant improvement in muscle sensitivity and strength in both lower extremities.Conclusions. The clinical example of repeated surgery due to the failure of the metal structure and the deterioration of the patient's neurological status highlights the need for postoperative follow-up. Taking into account the percentage of complications after transpedicular spondylodesis, it is necessary tocontinue scientific research to improve the results of surgical treatment of patients with degenerative diseases of the spine.

Automatic classification of the vertebral endplate lesions in magnetic resonance imaging by deep learning model.

A novel classification scheme for endplate lesions, based on T2-weighted images from magnetic resonance imaging (MRI) scan, has been recently introduced and validated. The scheme categorizes intervertebral spaces as "normal," "wavy/irregular," "notched," and "Schmorl's node." These lesions have been associated with spinal pathologies, including disc degeneration and low back pain. The exploitation of an automatic tool for the detection of the lesions would facilitate clinical practice by reducing the workload and the diagnosis time. The present work exploits a deep learning application based on convolutional neural networks to automatically classify the type of lesion. T2-weighted MRI scans of the sagittal lumbosacral spine of consecutive patients were retrospectively collected. The middle slice of each scan was manually processed to identify the intervertebral spaces from L1L2 to L5S1, and the corresponding lesion type was labeled. A total of 1,559 gradable discs were obtained, with the following types of distribution: "normal" (567 discs), "wavy/irregular" (485), "notched" (362), and "Schmorl's node" (145). The dataset was divided randomly into a training set and a validation set while preserving the original distribution of lesion types in each set. A pretrained network for image classification was utilized, and fine-tuning was performed using the training set. The retrained net was then applied to the validation set to evaluate the overall accuracy and accuracy for each specific lesion type. The overall rate of accuracy was found equal to 88%. The accuracy for the specific lesion type was found as follows: 91% (normal), 82% (wavy/irregular), 93% (notched), and 83% (Schmorl's node). The results indicate that the deep learning approach achieved high accuracy for both overall classification and individual lesion types. In clinical applications, this implementation could be employed as part of an automatic detection tool for pathological conditions characterized by the presence of endplate lesions, such as spinal osteochondrosis.

Evaluation of the appearance of osteochondrosis lesions by two radiographic examinations in sport horses aged from 12 to 36 months.

Osteochondrosis is a developmental orthopedic disease characterized by a defect of enchondral ossification. This pathological condition develops and evolves during growth and is influenced by various factors, in particular genetic and environmental. However, little research has been conducted on the dynamic of this condition in horses after the age of 12 months. The retrospective study presented here investigates changes in osteochondrosis lesions through two standardized radiographic examinations carried out on young Walloon sport horses after one year of age (mean age at first and second examination was 407 (±41) and 680 (±117) days respectively). Each examination, analyzed independently by three veterinarians, included latero-medial views of the fetlocks, hocks, stifles, plantarolateral-dorsomedial hocks view and additional radiograph if the operator deemed it necessary. Each joint site was graded as healthy, osteochondrosis (OC) or osteochondrosis dissecans (OCD) affected. A group of 58 horses was studied, among them 20 presented one or more osteochondrosis lesions for a total of 36 lesions present during at least one examination. In this population, 4 animals (6.9%) presented osteochondrosis during only one examination (2 at the first examination and 2 at the second one). Moreover, it was possible to demonstrate the appearance, disappearance and more generally the evolution of 9/36 lesions (25%) within the different joints. The results of the study suggest that, although substantial main limitations, osteochondrosis lesions can evolve after the age of 12 months in sport horses. Knowing this is useful in helping to decide the appropriate radiographic diagnosis timing and management.

Detection of fragment migration into the biceps tendon sheath originating from a humeral osteochondrosis lesion - A case report and review of the literature.

The purpose of this report is to demonstrate that radiographic evaluation of the canine shoulder joint alone is not sensitive enough to detect migrated osteochondral fragments within the biceps tendon sheath, as a sequela to osteochondrosis dissecans of the caudal humeral head. A 6-months-old, male, 35 kg Hovawart was referred due to chronic intermittent lameness on the left forelimb. Survey radiographs revealed a semilunar radiolucency surrounded by a moderately sclerotic rim at the caudal aspect of the left humeral head, referred to as osteochondrosis dissecans. However, only computed tomography combined with ultrasonography could clearly confirm a dislodged osteochondral fragment within the left biceps tendon sheath and a consequent tenosynovitis. Arthroscopic treatment on the clinically affected left forelimb followed by an additional approach over the left biceps tendon sheath to remove the migrated fragment resulted in a complete remission of the lameness until the last follow-up one year after surgery. In our opinion, computed tomography should be applied in the medical work up of canine shoulder osteochondrosis (OC) as standard. Combined with ultrasonography, it can further aid in complete evaluation of the shoulder joint and reliable exclusion of displaced osteochondral fragments, which might also be missed during arthroscopy when located too far distally.

Role of cartilage and bone matrix regulation in early equine osteochondrosis

The objective of this study is to better understand the pathogenesis of early equine osteochondrosis (OC) by identifying differences in gene and protein expression of extracellular matrix components and regulators in normal and diseased cartilage and bone, focusing on the osteochondral junction and cells surrounding the cartilage canals. We expected to find an upregulation of matrix metalloproteinases and a decrease in extracellular matrix constituent expression along the osteochondral junction and cells surrounding the cartilage canals in OC samples. Paraffin-embedded osteochondral samples (6 OC-affected, 8 normal controls) and cDNA from chondrocytes captured with laser capture microdissection from frozen sections (4 OC-affected, 5 normal controls) were used in this study. Quantitative real-time polymerase chain reaction was performed on 16 target genes. Immunohistochemistry was performed on osteochondral samples for Sox-9, lubricin, osteocalcin, and collagen type IIB. In OC-affected samples, there was significantly (P ≤ 0.05) decreased gene expression of collagen type IIB, aggrecan, and SOX-9 in chondrocytes surrounding the cartilage canals and decreased gene expression of PRG4 (Lubricin) and collagen type IIB in chondrocytes along the osteochondral junction. We found significantly lower collagen type IIB total matrix percentages in the middle and deep cartilage layers, lower lubricin total cellular percentage in the superficial layer, and higher Sox-9 total cellular percentage in bone of OC samples. No significant differences were found in matrix degradation molecules or HSCORE protein expression at any locations between normal and OC-affected samples in our study.

Эффективность рентгенологических методов диагностики нестабильности позвоночно-двигательного сегмента в шейном отделе

Introduction. Standard spine radiography is the basic method of radiodiagnosis, used for screening. X-ray imaging allows you to assess the anatomy of spinal motion segments in the cervical spine, determine the period of osteochondrosis and the tactics of further examination and treatment. Various types of dislocation of vertebrae are much more common than can be determined by spinal radiography in standard projections; as a result of dislocation, a pain syndrome occurs. Aim. To study the effectiveness of conventional methods for diagnosis of instability in the spinal motion segment (SMS) in the cervical spine. Materials and methods. We observed 50 patients (mean age 50.6 ± 2.19 years) who were admitted to the Clinic of the Irkutsk Scientific Center for Surgery and Traumatology (Neurosurgical Department) with a diagnosis Adult osteochondrosis of spine (ICD-10 code – M42.1). Conventional methods were used to diagnose SMS instability: plain radiography in anteroposterior and lateral projections, functional cervical spine radiography. Results. It was stated that the most common changes are characteristic of II and III periods of osteochondrosis: straightening of cervical lordosis – in 48 patients (96%), decrease in intervertebral disc height – in 46 patients (92%), anterior wedging of vertebral bodies – in 48 patients (96%), endplate sclerosis – in 37 patients (74%), presence of marginal osteophytes – in 45 patients (90%). In maximum flexion and extension, the CII–CVI vertebrae were involved in the formation of pathological mobility of the intervertebral segments, while the CI and CVII vertebrae remained stable. Instability in one cervical vertebra was revealed in 15 patients (30%). Most often, excessive mobility of 2 vertebrae was observed – in 22 people (44%), less often of 3 vertebrae – in 5 patients (10%). The dislocation of 4 vertebrae was quite rare – in 2 patients (4%). When analyzing the data of functional cervical spine radiography, we have found that the SMS instability in patients with intervertebral disc degeneration develops most often in the following segments: CII–CIII – 13 people (26%), СIII–СIV – 34 people (70%), CIV–CV – 29 people (58%), СV–СVI – 12 people (24%). Conclusion. The SMS instability still remains an urgent problem in neurology and neurosurgery. Plain radiography reveals only indirect signs of SMS instability. Diagnosis by functional spondylography made it possible to verify the SMS instability only in 36% of cases.

Long-term outcome of dogs treated by surgical debridement of proximal humeral osteochondrosis.

To evaluate long-term clinical outcomes of dogs surgically treated for proximal humeral osteochondrosis (OC). Cross-sectional study. Twenty dogs (n=26 shoulders). Dogs treated with surgical debridement of proximal humeral OC lesions >12 months prior were enrolled. Orthopedic examination (including limb circumference and shoulder goniometry), kinetic gait analysis, shoulder radiographs, shoulder computed tomography (CT), and shoulder arthroscopy were performed. All owners completed a dog mobility questionnaire. Brachial circumference (P=.003) and maximum shoulder extension (P=.013) were decreased and maximum shoulder flexion (P=.008) was increased (ie less flexion) in the OC limb versus the contralateral limb in unilaterally affected dogs. There were no differences in peak vertical force and vertical impulse between affected and unaffected limbs. Dogs demonstrated a 4.4% decrease in load distributed to the operated limb. Osteoarthritis was present in all shoulders treated for OC lesions. The degree of osteoarthritis in OC-affected shoulders was increased compared to the contralateral limb as evaluated on CT (P=.005) and radiography (P=.0001) in unilaterally affected cases. Moderate-to-severe synovitis was seen in all OC-affected joints. Arthroscopically, all lesions were noted to have patchy, incomplete cartilaginous infilling. Median of aggregate Liverpool Osteoarthritis in Dogs (LOAD) scores was 6. All dogs exhibited ipsilateral muscle atrophy and progressive osteoarthritis, with most dogs exhibiting subtle lameness on the subjective gait examination. Despite this, owner-perceived mobility was satisfactory. Progression of joint disease over time should be expected; however, the abnormalities detected on examination appear to be of questionable clinical relevance.