ULTRASONOGRAPHY IN HEMATOGENEOUS, SEPTIC ARTHRITIS, POLYARTHRITIS ANDOSTEOMYELITIS IN CALVES

A retrospective comparison of clinical, radiographic, arthrocentesis f indings and/or intraoperative or post-mortem findings with the ultraso nographic features was performed in 18 calves aged one week to nine mo nths with hematogeneous septic monarthritis or polyarthritis with or w ithout concurrent osteomyelitis. The ultrasonographic examination was carried out by means of a real-time B-mode unit equipped with a 7.5 MH z-linear transducer. Size, appearance of the borders of the joint pouc hes, echogenicity of synovial effusion, flow-phenomena, acoustic enhan cement and periarticular affections were evaluated. In these 18 calves a total of 38 joints showed septic arthritis: a monarthritis was diag nosed in 3 calves, a monarthritis with concurrent osteomyelitis in 5 c alves, a polyarthritis in 6 calves (with 14 joints involved), and a se ptic polyarthritis with a concurrent osteomyelitis in 4 calves (with 1 6 joints involved). In 29% of the affected joints soft tissue swelling was the only radiographic sign. The distension of the joint pouches c ould be determined in all 38 joints ultrasonographically. The echogeni city of synovial effusion varied, depending on the presence of a serou s, sero-fibrinous, fibrinous or purulent exudate. The joint pouches we re distinctly demarcated from the periarticular soft tissue in most ca ses. Flow-phenomena were assessed in all cases with liquid effusion. L ack of flow-phenomena indicated a semisolid effusion (clotted fibrinou s masses). The sonographic signs of osteomyelitis were subperiosteal f luid accumulation and elevation of the periosteum. The sonographic ass essment of synovial effusion with distension of the joint pouches was a sensitive indicator; a clear diagnosis could be stated already in th e initial phase. of septic arthritis. Diagnostic ultrasound revealed i mportant additional findings, especially in cases where no synovial sa mples could be aspirated or where radiography showed no significant si gns. These ultrasonographic findings were helpful for choosing adequat e treatment (lavage or arthrotomy), depending an the presence of liqui d or semisolid joint effusion.