Relationship of orthopedic examination, goniometric measurements, and radiographic signs of degenerative joint disease in cats

B Duncan X Lascelles, Yaa-Hui Dong, Denis J Marcellin-Little, Andrea Thomson, Simon Wheeler, Maria Correa, B Duncan X Lascelles, Yaa-Hui Dong, Denis J Marcellin-Little, Andrea Thomson, Simon Wheeler, Maria Correa

Abstract

Background: Available information suggests a mismatch between radiographic and orthopedic examination findings in cats with DJD. However, the extent of the discrepancy between clinical and radiographic signs of OA in companion animals has not been described in detail. This study aimed to evaluate the relationship between orthopedic examination findings, joint goniometry, and radiographic signs of DJD in 100 cats, in a prospective observational design. Cat temperament, pain response to palpation, joint crepitus, effusion and thickening were graded. Radiographs of appendicular joints and the axial skeleton were made under sedation. Joint motion was measured by use of a plastic goniometer before and after sedation. Associations between radiographic degenerative joint disease (DJD) and examination findings were assessed to determine sensitivity, specificity and likelihood estimations.

Results: Pain response to palpation was elicited in 0-67% of the joints with DJD, with a specificity ranging from 62-99%; crepitus was detected in 0-56% of the joints and its specificity varied between 87 and 99%; for effusion, values ranged between 6 and 38% (specificity, 82-100%), and thickening, 0-59% (specificity, 74-99%). Joints with DJD tended to have a decreased range of motion. The presence of pain increased the odds of having DJD in the elbow (right: 5.5; left: 4.5); the presence of pain in the lower back increased the odds of spinal DJD being present (2.97 for lumbar; 4.67 for lumbo-sacral).

Conclusions: Radiographic DJD cannot be diagnosed with certainty using palpation or goniometry. However, negative findings tend to predict radiographically normal joints. Palpation and goniometry may be used as a tool to help to screen cats, mostly to rule out DJD.

References

    1. Beadman R, Smith RN, King AS. Vertebral osteophytes in the cat. Vet Rec. 1964;76(37):1005–1007.
    1. Clarke SP, Bennett D. Feline osteoarthritis: a prospective study of 28 cases. J Small Anim Pract. 2006;47(8):439–445. doi: 10.1111/j.1748-5827.2006.00143.x.
    1. Clarke SP, Mellor D, Clements DN, Gemmill T, Farrell M, Carmichael S, Bennett D. Prevalence of radiographic signs of degenerative joint disease in a hospital population of cats. Vet Rec. 2005;157(25):793–799.
    1. Godfrey DR. Osteoarthritis in cats: a retrospective radiological study. J Small Anim Pract. 2005;46(9):425–429. doi: 10.1111/j.1748-5827.2005.tb00340.x.
    1. Hardie EM, Roe SC, Martin FR. Radiographic evidence of degenerative joint disease in geriatric cats: 100 cases (1994-1997) J Am Vet Med Assoc. 2002;220(5):628–632. doi: 10.2460/javma.2002.220.628.
    1. Keller GG, Reed AL, Lattimer JC, Corley EA. Hip dysplasia: a feline population study. Vet Radiol Ultrasound. 1999;40(5):460–464. doi: 10.1111/j.1740-8261.1999.tb00375.x.
    1. Koeppel E, Ebner J. Die Hueftgelenksdysplasie der Katze. Kleintierpraxis. 1990;35:281–298.
    1. Langenbach A, Green P, Giger U, Rhodes H, Gregor TP, LaFond E, Smith G. Relationship between degenerative joint disease and hip joint laxity by use of distraction index and Norberg angle measurement in a group of cats. J Am Vet Med Assoc. 1998;213(10):1439–1443.
    1. Lascelles BD, Hansen BD, Roe S, DePuy V, Thomson A, Pierce CC, Smith ES, Rowinski E. Evaluation of client-specific outcome measures and activity monitoring to measure pain relief in cats with osteoarthritis. J Vet Int Med. 2007;21(3):410–416. doi: 10.1111/j.1939-1676.2007.tb02983.x.
    1. Lascelles BD, Henry JB, Brown J, Robertson I, Sumrell AT, Simpson W, Wheeler S, Hansen BD, Zamprogno H, Freire M. et al.Cross-sectional study of the prevalence of radiographic degenerative joint disease in domesticated cats. Vet Surg. 2010;39(5):535–544. doi: 10.1111/j.1532-950X.2010.00708.x.
    1. Loughin CA, Kerwin SC, Hosgood G, Ringwood PB, Williams J, Stefanacci JD, McCarthy RJ. Clinical signs and results of treatment in cats with patellar luxation: 42 cases (1992-2002) J Am Vet Med Assoc. 2006;228(9):1370–1375. doi: 10.2460/javma.228.9.1370.
    1. Pacchiana PD, Gilley RS, Wallace LJ, Hayden DW, Feeney DA, Jessen CR, Aird B. Absolute and relative cell counts for synovial fluid from clinically normal shoulder and stifle joints in cats. J Am Vet Med Assoc. 2004;225(12):1866–1870. doi: 10.2460/javma.2004.225.1866.
    1. Slingerland LI, Hazewinkel HA, Meij BP, Picavet P, Voorhout G. Cross-sectional study of the prevalence and clinical features of osteoarthritis in 100 cats. Vet J. 2011;187(3):304–309. doi: 10.1016/j.tvjl.2009.12.014.
    1. Freire M, Brown J, Robertson ID, Pease AP, Hash J, Hunter S, Simpson W, Thomson Sumrell A, Lascelles BD. Meniscal mineralization in domestic cats. Vet Surg: VS. 2010;39(5):545–552. doi: 10.1111/j.1532-950X.2010.00648.x.
    1. Freire M, Robertson I, Bondell HD, Brown J, Hash J, Pease AP, Lascelles BD. Radiographic evaluation of feline appendicular degenerative joint disease vs. macroscopic appearance of articular cartilage. Vet Radiol Ultrasound. 2011;52(3):239–247. doi: 10.1111/j.1740-8261.2011.01803.x.
    1. Creamer P. Current perspectives on the clinical presentation of joint pain in human OA. Novartis Found Symp. 2004;260:64–74. discussion 74-68, 100-104, 277-109.
    1. Hadler NM. Knee pain is the malady-not osteoarthritis. Ann Intern Med. 1992;116(7):598–599.
    1. Suter E, Herzog W, Leonard TR, Nguyen H. One-year changes in hind limb kinematics, ground reaction forces and knee stability in an experimental model of osteoarthritis. J Biomech. 1998;31(6):511–517. doi: 10.1016/S0021-9290(98)00041-4.
    1. Herzog W, Clark A, Longino D. Joint mechanics in osteoarthritis. Novartis Found Symp. 2004;260:79–95. discussion 95-79, 100-104, 277-109.
    1. Lascelles BD, Henderson AJ, Hackett IJ. Evaluation of the clinical efficacy of meloxicam in cats with painful locomotor disorders. J Small Anim Pract. 2001;42(12):587–593. doi: 10.1111/j.1748-5827.2001.tb06034.x.
    1. Dieppe PA. Relationship between symptoms and structural change in osteoarthritis: what are the important targets for therapy? J Rheumatol. 2005;32(6):1147–1149.
    1. Dieppe PA, Cushnaghan J, Shepstone L. The Bristol 'OA500' study: progression of osteoarthritis (OA) over 3 years and the relationship between clinical and radiographic changes at the knee joint. Osteoarthritis Cartilage. 1997;5(2):87–97. doi: 10.1016/S1063-4584(97)80002-7.
    1. Neogi T, Felson D, Niu J, Nevitt M, Lewis CE, Aliabadi P, Sack B, Torner J, Bradley L, Zhang Y. Association between radiographic features of knee osteoarthritis and pain: results from two cohort studies. British Med J. 2009;339:b2844. doi: 10.1136/bmj.b2844.
    1. Bedson J, Croft PR. The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC Musculoskelet Disord. 2008;9:116. doi: 10.1186/1471-2474-9-116.
    1. Peat G, Thomas E, Duncan R, Wood L, Wilkie R, Hill J, Hay EM, Croft P. Estimating the probability of radiographic osteoarthritis in the older patient with knee pain. Arthritis Rheum. 2007;57(5):794–802. doi: 10.1002/art.22785.
    1. Birrell F, Lunt M, Macfarlane G, Silman A. Association between pain in the hip region and radiographic changes of osteoarthritis: results from a population-based study. Rheumatology (Oxford) 2005;44(3):337–341. doi: 10.1093/rheumatology/keh458.
    1. Zamprogno H, Hansen BD, Bondell HD, Sumrell AT, Simpson W, Robertson ID, Brown J, Pease AP, Roe SC, Hardie EM, Wheeler SJ, Lascelles BDX. Item generation and design testing of a questionnaire to assess degenerative joint disease-associated pain in cats. Am J Vet Res. 2010;71(12):1417–1424. doi: 10.2460/ajvr.71.12.1417.
    1. Siegford JM, Walshaw SO, Brunner P, Zanella AJ. Validation of a temperament test for domestic cats. Anthrozoos. 2003;16(4):332–351. doi: 10.2752/089279303786991982.
    1. Pancheri P, Teodori S, Aparo UL. Psychological aspects of rheumatoid arthritis vis-a-vis osteoarthrosis. Scand J Rheumatol. 1978;7(1):42–48.
    1. Borstlap M, Zant JL, Van-Soesbergen M, Van der-Korst JK. Effects of total hip replacement on quality of life in patients with osteoarthritis and in patients with rheumatoid arthritis. Clin Rheumatol. 1994;13(1):45–50. doi: 10.1007/BF02229864.
    1. Hawker GA. Experiencing painful osteoarthritis: what have we learned from listening? Curr Opin Rheumatol. 2009;21(5):507–512. doi: 10.1097/BOR.0b013e32832e99d7.
    1. Davis MA, Ettinger WH, Neuhaus JM, Barclay JD, Segal MR. Correlates of knee pain among US adults with and without radiographic knee osteoarthritis. J Rheumatol. 1992;19(12):1943–1949.
    1. Jaeger GH, Marcellin-Little DJ, Depuy V, Lascelles BD. Validity of goniometric joint measurements in cats. Am J Vet Res. 2007;68(8):822–826. doi: 10.2460/ajvr.68.8.822.

Source: PubMed

Sponsor e collaboratori

Condizioni mediche

Interventi farmacologici

3
Sottoscrivi