Abstract

Master student: Ken Lindeblad
Specialisation: Surgery
Project: Clinical and ultrasound diagnostic examination of the meniscus in dogs and systematic review of meniscus diagnostics in dogs

Objective

To answer the key question: Is it possible to diagnose meniscal injuries in the canine knee by non-invasive techniques?

In addition it was the objective, based on a systematic review, to create a clinical guideline for non-invasive diagnosis of canine meniscal injuries.

Methods

A systematic review was conducted based on a literature search in the databases CAB and PubMed (Medline). After an initial relevance screening, articles in peer- reviewed journals were selected with a main focus on diagnostic accuracy of non-invasive methods to diagnose canine meniscal injuries. The articles were appraised including the use of methodology checklist from SIGN (Scottish Intercollegiate Guidelines Network). Included in the literature was a new surgical textbook, and a recent Danish study investigating ultrasonographic examination of the canine menisci (veterinary student master project) partly carried out at Faxe Dyrehospital.

Results

The search resulted in a total of 147 references. A large proportion of the references were case series, and descriptive studies; only few of these were selected for this review. A total of twenty-three references from the search were included in the study. The literature on the subject was limited and mainly based on studies with a relatively small amount of dogs or menisci. Neither reviews nor meta-analyses of non-invasive techniques for meniscus diagnosis in the canine knee were found in the search. Among the included references, 14 focused on non-invasive methods to diagnose canine meniscal injuries. There were twelve studies of diagnostic accuracy (cross –sectional), six articles were on Magnetic Resonance Imaging (MRI), two on Computed Tomography (CT) and four on ultrasonography. Two studies investigated clinical risk factors for meniscal injuries, one cohort and one case-control study.

Conclusion

Ultrasonography is a useful, but user dependent, tool for diagnosing meniscal damage in the canine knee. The technique has an acceptable sensitivity and specificity for detection of meniscal damage in the cruciate ligament deficient canine knee.

MRI and CT are currently methods of questionable value for diagnosing meniscal damage in the canine knee.

Based on the results of the systematic review, a guideline was created for clinical examination and ultrasonographic diagnosis of meniscal injuries in dogs.