The Prevalence of Feline Hip Dysplasia, Patellar Luxation and Lumbosacral Transitional Vertebrae in Pedigree Cats in The Czech Republic

(1) Background: The aim of this study was to find the prevalence of feline hip dysplasia (HD), patellar luxation and lumbosacral transitional vertebra (LTV) in pedigree cats in the Czech Republic. (2) Methods: 107 pedigree cats at least 10 months old were recruited prospectively at the Small Animal Clinic at the University of Veterinary and Pharmaceutical Sciences Brno, CZ, between April 2019 and July 2020. (3) Results: The prevalence of hip joint dysplasia in all pedigree cats was 46.7%, of which 78% of cats had bilateral dysplasia. The HD was mainly from mild (grade 1) to moderate (grade 2); however, 6.1% of hip joints showed signs of severe HD (grade 3) in Maine Coon and Siberian cats. Patellar luxation was noted in 32.7% of the pedigree cats, was present bilaterally in 91.4% and was grade 1 or 2 in most cats. The presence of LTV was noted in 7.5% of pedigree cats. (4) Conclusions: The high prevalence of HD in pedigree cats should be considered and screening pedigree cats for HD is recommended before they are used in breeding programs.

Lumbosacral transitional vertebra in military aviation candidates: A cross-sectional study

Introduction: Lumbosacral transitional vertebra (LSTV) is a common anomaly of the lumbosacral junction with a prevalence of 4–35.9% in various studies. Plain radiography of the spine in anteroposterior and lateral projections is done for the evaluation of the spine in candidates coming for medical evaluation for flying duties in the armed forces. Material and Methods: An observational study was conducted on the whole spine series of radiographs done at a medical selection establishment. The study population included candidates reporting to the establishment for medical examination to ascertain fitness for flying duties. In a small subset of this study population having LSTV, the Ferguson’s view was done to better delineate the lumbosacral junction. Results: The analysis revealed a total 148 cases of LSTV with a prevalence of 13.9%. Ferguson’s view, undertaken among 30 doubtful cases, confirmed the presence of LSTV in 27 cases. Type IIa was observed to be the most common pattern of LSTV followed by Type IIIb. As per the existing policy, 63.8% of candidates with LSTV were considered unfit for flying duties. Conclusion: Flying duties in the armed forces require the highest standard of physical fitness. LSTV is a very common finding during the evaluation of candidates and it is appropriate that the cases of LSTV be evaluated thoroughly. In doubtful cases of LSTV, the Ferguson’s view is a useful supplementary view as it clearly delineates the lumbosacral junction.

The association of lumbosacral transitional vertebral anomalies with acetabular dysplasia in adult patients with hip-spine syndrome

Aims Some patients presenting with hip pain and instability and underlying acetabular dysplasia (AD) do not experience resolution of symptoms after surgical management. Hip-spine syndrome is a possible underlying cause. We hypothesized that there is a higher frequency of radiological spine anomalies in patients with AD. We also assessed the relationship between radiological severity of AD and frequency of spine anomalies. Methods In a retrospective analysis of registry data, 122 hips in 122 patients who presented with hip pain and and a final diagnosis of AD were studied. Two observers analyzed hip and spine variables using standard radiographs to assess AD. The frequency of lumbosacral transitional vertebra (LSTV), along with associated Castellvi grade, pars interarticularis defect, and spinal morphological measurements were recorded and correlated with radiological severity of AD. Results Out of 122 patients, 110 (90.2%) were female and 12 (9.8%) were male. We analyzed the radiographs of 122 hips (59 (48.4%) symptomatic left hips, and 63 (51.6%) symptomatic right hips). Average age at time of presentation was 34.2 years (SD 11.2). Frequency of LSTV was high (39% to 43%), compared to historic records from the general population, with Castellvi type 3b being the most common (60% to 63%). Patients with AD have increased L4 and L5 interpedicular distance compared to published values. Frequency of pars interarticularis defect was 4%. Intraclass correlation coefficient for hip and spine variables assessed ranged from good (0.60 to 0.75) to excellent (0.75 to 1.00). Severity of AD did not demonstrate significant correlation with frequency of radiological spine anomalies. Conclusion Patients with AD have increased frequency of spinal anomalies seen on standard hip radiographs. However, there exists no correlation between radiological severity of AD and frequency of spine anomalies. In managing AD patients, clinicians should also assess spinal anomalies that are easily found on standard hip radiographs. Cite this article: Bone Joint J 2021;103-B(8):1351–1357.

Vertebral Formulae and Congenital Vertebral Anomalies in Guinea Pigs: A Retrospective Radiographic Study

The objectives of this retrospective study of 240 guinea pigs (148 females and 92 males) were to determine the prevalence of different vertebral formulae and the type and anatomical localization of congenital vertebral anomalies (CVA). Radiographs of the cervical (C), thoracic (Th), lumbar (L), sacral (S), and caudal (Cd) part of the vertebral column were reviewed. Morphology and number of vertebrae in each segment of the vertebral column and type and localization of CVA were recorded. In 210/240 guinea pigs (87.50%) with normal vertebral morphology, nine vertebral formulae were found with constant number of C but variable number of Th, L, and S vertebrae: C7/Th13/L6/S4/Cd5-7 (75%), C7/Th13/L6/S3/Cd6-7 (4.17%), C7/Th13/L5/S4/Cd6-7 (2.50%), C7/Th13/L6/S5/Cd5-6 (1.67%), C7/Th12/L6/S4/Cd6 (1.25%), C7/Th13/L7/S4/Cd6 (1.25%), C7/Th13/L7/S3/Cd6-7 (0.83%), C7/Th12/L7/S4/Cd5 (0.42%), C7/Th13/L5/S5/Cd7 (0.42%). CVA were found in 30/240 (12.5%) of guinea pigs, mostly as a transitional vertebra (28/30), which represents 100% of single CVA localised in cervicothoracic (n = 1), thoracolumbar (n = 22) and lumbosacral segments (n = 5). Five morphological variants of thoracolumbar transitional vertebrae (TTV) were identified. Two (2/30) guinea pigs had a combination of CVA: cervical block vertebra and TTV (n = 1) and TTV and lumbosacral transitional vertebra (LTV) (n = 1). These findings suggest that guinea pigs’ vertebral column displays more morphological variants with occasional CVA predominantly transitional vertebrae.

RETROSPECTIVE DATA REVIEW TO FIND THE ASSOCIATION OF LUMBOSACRAL TRANSITIONAL VERTEBRA AND DEGENERATIVE DISC DISEASE IN YOUNG PATIENTS

Objective: To find out the frequency of lumbar disc degeneration among the patients having lumbosacraltransitional vertebra between 20-40 years. Study Design: Retrospective cross sectional study. Place and Duration of Study: Radiology department POF Wah Cantt, from Jan 2018 to Dec 2019. Methodology: Six Hundred patients between 20-40 years having lumbosacral transitional vertebra and historyof low back pain >1 year were studied. X ray and MRI lumbar spine of these patients was studied retrospectivelyon PACS. Two hundred patients having history of traumatic or other non-traumatic etiologies, in addition toLumbosacral transitional vertebra were excluded. Four hundred patients with only lumbosacral transitionalvertebra were included. Data analysis was done by SPSS-22. Castellvi types of transitional vertebra was calculated among patients with degenerative lumbar disc. Results: One hundred and four (26.6%) were having degenerative disc disease while 296 (74.4%) patients werenot having degenerative disc disease. Patients having degenerative disc disease were between 24-40 years withthe mean age 29.96 ± 0.417 years. Among the patients having degenerative disc disease were 59 women and45 males but no statistical significance association was found between gender and degenerative disc disease with p-value = 0.55. Castellvi type III had significant association with degenerative disc disease, p-value = 0.006. Conclusion: Age related disc degeneration is commonly seen in middle age people but in younger age group in2nd and 3rd decade it is observed frequently in those patients having lumbosacral transitional vertebra especially in the setting of no other associated traumatic or non-traumatic etiology, which leads to early degenerative disc disease.

Congenital anomalies of the lumbosacral spine

The aim of the study is to compare the structure of the lumbosacral transitional vertebra, which were detected by computed tomography (CT) and identified on dried human sacral, and to discuss possible pathogenetic mechanisms of this congenital malformation. The article presents 9 cases of lumbosacral transitional vertebra, including 6 cases of L5 sacralization and 3 cases of S1 lumbarization. The formation of the transitional lumbosacral vertebra is genetically determined. All types of such developmental anomaly can be detected only on CT. L5 sacralization repeats the process of fusion of the sacral vertebra into a single bone. A lack of the costotransverse bars of the first sacral vertebrae fusion results in the S1 lumbarization.

Frequency of potential causes of lower back pain and incidental findings in patients with suspected sacroiliitis: retrospective analysis of 886 patients with negative sacroiliac MRI examination for sacroiliitis

Background In a majority of patients with suspected sacroiliitis (SI) who underwent sacroiliac magnetic resonance imaging (MRI), imaging studies may be normal, may depict other causes for pain, or may show clinically irrelevant incidental findings. Purpose To determine the prevalence of possible etiologies other than SI and frequency of incidental findings demonstrated on sacroiliac MRI examinations in a cohort of patients with lower back pain and suspected SI. Material and Methods Sacroiliac MRI examinations of 1421 patients with suspected SI were retrospectively reviewed. In patients without SI findings, other potential causes for lower back pain and incidental findings were documented. Results SI was present in 535 of 1421 patients (37.6%). In 886 of the patients whose MRI studies were negative for SI, other possible causes for lower back pain or incidental findings were seen in 386 (43.5%). The most common musculoskeletal (MSK) finding was lumbosacral transitional vertebra (8.6%) followed by findings suggesting piriformis syndrome (4.2%), spondylosis (3.7%), and sacral insufficiency fractures (1.8%). The most common non-MSK findings were follicular cysts (15.3%) and uterine fibroids (4.9%). Conclusion In patients with suspected SI but negative MRI examinations for SI, some other possible causes for lower back pain and several incidental findings can be seen on imaging. The presence of these findings may explain the patient’s symptoms, and awareness of these conditions may be helpful in patient management and individualizing treatment.

Segmented lordotic angles to assess lumbosacral transitional vertebra on EOS

Purpose To test the vertical posterior vertebral angles (VPVA) of the most caudal lumbar segments measured on EOS to identify and classify the lumbosacral transitional vertebra (LSTV). Methods We reviewed the EOS examinations of 906 patients to measure the VPVA at the most caudal lumbar segment (cVPVA) and at the immediately proximal segment (pVPVA), with dVPVA being the result of their difference. Mann–Whitney, Chi-square, and ROC curve statistics were used. Results 172/906 patients (19%) had LSTV (112 females, mean age: 43 ± 21 years), and 89/172 had type I LSTV (52%), 42/172 type II (24%), 33/172 type III (19%), and 8/172 type IV (5%). The cVPVA and dVPVA in non-articulated patients were significantly higher than those of patients with LSTV, patients with only accessory articulations, and patients with only bony fusion (all p < .001). The cVPVA and dVPVA in L5 sacralization were significantly higher than in S1 lumbarization (p < .001). The following optimal cutoff was found: cVPVA of 28.2° (AUC = 0.797) and dVPVA of 11.1° (AUC = 0.782) to identify LSTV; cVPVA of 28.2° (AUC = 0.665) and dVPVA of 8° (AUC = 0.718) to identify type II LSTV; cVPVA of 25.5° (AUC = 0.797) and dVPVA of − 7.5° (AUC = 0.831) to identify type III–IV LSTV; cVPVA of 20.4° (AUC = 0.693) and dVPVA of − 1.8° (AUC = 0.665) to differentiate type II from III–IV LSTV; cVPVA of 17.9° (AUC = 0.741) and dVPVA of − 4.5° (AUC = 0.774) to differentiate L5 sacralization from S1 lumbarization. Conclusion The cVPVA and dVPVA measured on EOS showed good diagnostic performance to identify LSTV, to correctly classify it, and to differentiate L5 sacralization from S1 lumbarization.