Clinical application and prognostic value of computed tomography examination in foals diagnosed with osteomyelitis: Forty-four cases.

Abstract

Computed tomography (CT) is increasingly recognized as superior to conventional imaging methods for diagnosing osteomyelitis in foals. However, comprehensive studies in this area are limited. This study aims to report on clinical cases of osteomyelitis in foals, establishing a relationship between CT findings and survival outcomes. Additionally, it compares CT imaging with conventional methods such as radiography and ultrasound. We hypothesized that CT variables would more accurately predict survival than other clinical factors and provide more detailed information about osteomyelitis lesions. This retrospective study included foals presenting at a single equine referral hospital between July 2019 and December 2022. Inclusion criteria were: (1) foals less than 9 months of age, (2) presumptive clinical diagnosis of osteomyelitis, and (3) CT examination for further evaluation. Forty-four foals met the criteria; 29 (66%) survived to discharge, and 23 (55%) had long-term survival. Key variables associated with survival included joint collapse (P = .011, OR, 0.054, 95% CI, 0.006-0.506) and lesions in multiple locations (P = .015, OR, 0.19, 95% CI, 0.05-0.7). In 93% of cases, CT examination modified the diagnosis, revealing improved lesion localization (72%), lesion size (76%), or detecting additional lesions (45%). Common lesions involved the axial and proximal appendicular skeletons, with 8 foals (18%) having only axial skeleton involvement and 5 (11%) presenting with both axial and appendicular lesions. Coxofemoral joint involvement was diagnosed in 12 foals (27%), while pelvic lesions were found in 8 (18%). These findings underscore the critical role of CT in identifying and localizing complex lesions, ultimately improving prognostic assessments.