Radiographic evaluation of the width of the femorotibial joint space in horses

OBJECTIVE To measure the minimal joint space width (mJSW) in caudocranial radiographic views of orthopedically normal femorotibial joints of horses, to compare the accuracy of measurements with those of a software program designed for humans, and to identify the ideal caudocranial radiographic projection angle for mJSW measurement. ANIMALS 12 healthy mares (22 femorotibial joints) and 3 equine cadavers (6 stifle joints). PROCEDURES Caudocranial views of femorotibial joints were acquired in the proximodistal plane at 5 degrees, 10 degrees, and 15 degrees (caudo-5 degrees-proximal-craniodistal oblique, 10 degrees, and 15 degrees) and lateromedial plane (caudo-10 degrees-proximo-5 degrees-lateral-craniodistomedial oblique and caudo-10 degrees-proximo-5 degrees-medial-craniodistolateral oblique). The mJSWs of medial and lateral femorotibial joint compartments were measured manually by 2 evaluators and automatically by a digital analysis software program. Interevaluator reproducibility was assessed. Post hoc tests were used to identify the projection angle that provided the largest measurements. Validation of mJSW measurements was performed by evaluation of 6 stifle joints ex vivo. RESULTS Excellent agreement was achieved between the 2 evaluators and between the veterinary radiologist and the analysis software for the medial and lateral compartments of femorotibial joints. Angle of caudocranial view in the proximodistal but not lateromedial plane had a significant effect on the medial compartment mJSW measurements. Mean mJSW for the medial compartment was significantly higher for the caudoproximal-craniodistal oblique projection made at 10 degrees from the horizontal than for other angles. Angle had no significant effect on mean mJSW for the lateral compartment. Agreement between automated measurements of mJSW in the medial compartment and thickness of nonmineralized cartilage in histologic preparations of associated tissues was excellent. CONCLUSIONS AND CLINICAL RELEVANCE Measurements of mJSW in the medial compartment of femorotibial joints, the most common site of osteoarthritis in horses, were reproducible and optimal with a caudoproximal-craniodistal oblique radiographic projection made at 10 degrees from the horizontal.