132 Clinical Features
(A)abab(B)Figure 18.5 Positional changes of lateral (A) and medial
(B) femoral condyles in a cranial cruciate
ligament-deficient stifle using stress-MRI. The
superimposed outlines of the caudal femoral condyle
(solid line=neutral; dotted line=stressed) demonstrate
that stress-MRI is able to induce femorotibial subluxation.
Source: Tremoladaet al. 2014. Reproduced with
permission from the American Veterinary Medical
Association.
MRI-compatible jig was used for either the tib-
ial compression test or the cranial drawer test.
Both methods were equally effective in caus-
ing cranial tibial subluxation in CrCL-deficient
stifles. With cross-sectional imaging, translation
in both the lateral and medial compartments
could be quantified (Figure 18.5) (Tremolada
et al. 2014). The magnitude of cranial tibial trans-
lation was shown to be greater in the lateral
compartment. The main goal of the study was
to demonstrate the feasibility of a stress-MRI
technique to potentially improve the ability to
identify meniscal tears using advanced imag-
ing. While stress-MRI of the knee is a useful
clinical test for assessing menisci in humans,
further studies are required to determine if the
technique has a superior diagnostic accuracy
to standard MRI for characterizing meniscal
pathology in dogs.Conclusions
In summary, stress imaging techniques aim-
ing to induce cranial tibial subluxation in joints
with suspected CR are well described. They
have potential clinical utility, as the ability to
detect instability with stress radiography is
superior to physical maneuvers such as the
cranial drawer test. Thus, stress imaging may
be particularly valuable for clinicians with less
experience and confidence with stifle palpation
alone. Stress imaging is also a useful tool for
providing an ability to assess stifle stability in
both clinical and experimental studies.References
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