Morphology of distal border synovial invaginations of the equine distal sesamoid bone

Objectives: To compare the difference and agreement of the morphology of distal border synovial invaginations on a dorsoproximal-palmarodistal oblique (DPr-PaDiO) projection with hoof-specific angle versus computed tomography. Methods: Computed tomography (CT) images and a DPr-PaDiO radiographic projection with hoof-specific angle were obtained on 50 cadaveric forefeet from 25 Warmblood horses. Computed tomography was assumed to be the gold standard. The number, shape and depth of penetration of distal border synovial invaginations into the distal sesamoid bone were evaluated with both methods, and the comparison of their measurements was statistically described. Results: Significantly more invaginations were seen on CT compared to radiography, with an observed average difference of 1.2. In none of the cases did radiography have a higher number than that observed with CT. No statistically significant difference for depth between CT and the DPr-PaDiO projection was seen, however, there was quite a large variation of the actual difference of measurements against their mean found. Radiography was underestimated when high mean values applied. The agreement between both modalities for shape was moderate to good. A very high specificity of the specific DPr-PaDiO projection for shape was found (97%). Clinical significance: The radiographic projection with hoof-specific angle differs significantly from CT concerning the number and depth of the distal border synovial invaginations. Therefore, this specific view may not be considered useful in the evaluation of these invaginations.