Hip Dysplasia Radiograph Procedures
Radiographs submitted to the OFA must follow the
American Veterinary Medical Association guidelines
for positioning. This view is accepted world wide
for detection and assessment of hip joint
irregularities and secondary arthritic hip joint
changes. To obtain this view, the animal must be
placed on its back in dorsal recumbency with the
rear limbs extended and parallel to each other. The
knees (stifles) are rotated internally and the
pelvis is symmetric. Chemical restraint (anesthesia)
to the point of relaxation is recommended. For
elbows, the animal is placed on its side and the
respective elbow is placed in an extreme flexed
position.
The radiograph film must be permanently
identified with the animal's registration number or
name, date the radiograph was taken, and the
veterinarian's name or hospital name. If this
required information is illegible or missing, the
OFA cannot accept the film for registration
purposes. The owner should complete and sign the OFA
application. It is important to record on the OFA
application the animal's tattoo or microchip number
in order for the OFA to submit results to the AKC.
Sire and dam information should also be present.
Radiography of pregnant or estrus females
should be avoided due to possible increased joint
laxity (subluxation) from hormonal variations.
OFA recommends radiographs be taken one month after
weaning pups and one month before or after a heat
cycle. Physical inactivity because of illness,
weather, or the owner's management practices may
also result in some degree of joint laxity. The OFA
recommends evaluation when the dog is in good
physical condition.
Chemical restraint (anesthesia) is not
required by OFA but chemical restraint to the point
of muscle relaxation is recommended. With
chemical restraint optimum patient positioning is
easier with minimal repeat radiographs (less
radiation exposure) and a truer representation of
the hip status is obtained.
For large and giant breed dogs, 14" x 17" film
size is recommended. Small film sizes can be used
for smaller breeds if the area between the sacrum
and the stifles can be included.
If a copy is necessary ask your veterinarian to
insert 2 films in the cassette prior to making the
exposure. This will require about a 15% increase in
the kVp to make an exact duplicate of the radiograph
sent to OFA. Films may be returned if a $5.00 fee
and request for return are both included at time of
submission.
Good contrast is desirable (high mAs, low kVp).
Grid techniques are recommended for all large dogs.
When a radiograph arrives at the OFA, the
information on the radiograph is checked against
information on the application. The age of the dog
is calculated, and the submitted fee is recorded.
The board-certified veterinary radiologist on staff
at the OFA screens the radiographs for diagnostic
quality. If it is not suitable for diagnostic
quality (poor positioning, too light, too dark or
image blurring from motion), it is returned to the
referring veterinarian with a written request that
it be repeated. An application number is assigned.
Radiographs of animals 24 months of age or older are
independently evaluated by three randomly selected,
board-certified veterinary radiologists from a pool
of 20 to 25 consulting radiologists throughout the
USA in private practice and academia. Each
radiologist evaluates the animal's hip status
considering the breed, sex, and age. There are
approximately 9 different anatomic areas of the hip
that are evaluated (Figure 1).
-
Craniolateral acetabular rim
-
Cranial acetabular margin
-
Femoral head (hip ball)
-
Fovea capitus (normal flattened area on hip
ball)
-
Acetabular notch
-
Caudal acetabular rim
-
Dorsal acetabular margin
-
Junction of femoral head and neck
-
Trochanteric fossa
The radiologist is concerned with deviations in
these structures from the breed normal. Congruency
and confluence of the hip joint (degree of fit) are
also considered which dictate the conformation
differences within normal when there is an absence
of radiographic findings consistent with HD. The
radiologist will grade the hips with one of seven
different physical (phenotypic) hip conformations:
normal which includes excellent, good, or fair
classifications, borderline or dysplastic which
includes mild, moderate, or severe classifications.
Seven classifications are needed in order to
establish heritability information (indexes) for a
given breed of dog. Definition of these phenotypic
classifications are as follows:
-
Excellent
-
Good
-
Fair
-
Borderline
-
Mild
-
Moderate
-
Severe
(See
What Do Hip Grades Mean for more detail on the
classifications)
The hip grades of excellent, good and fair are
within normal limits and are given OFA numbers. This
information is accepted by AKC on dogs with
permanent identification and is in the public
domain. Radiographs of borderline, mild, moderate
and severely dysplastic hip grades are reviewed by
the OFA radiologist and a radiographic report is
generated documenting the abnormal radiographic
findings. Unless the owner has chosen the open
database, dysplastic hip grades are closed to public
information.
When results of 1.8 million radiographic evaluations
by 45 radiologists were analyzed, it was found that
all three radiologists agreed as to whether the dog
should be classified as having a normal phenotype,
borderline phenotype, or HD 94.9% of the time. In
addition, 73.5% of the time, all three radiologists
agreed on the same hip phenotype (excellent, fair,
good, borderline, mild, moderate or severe).
Twenty-one percent of the time, two radiologists
agreed on the same hip grade and the third
radiologist was within one hip grade of the other
two. Two radiologists agreed on the same hip grade
and the third radiologist was within two hip grades
of the other two 5.4% of the time. This percentage
of agreement is high considering the subjective
nature of the evaluation.
In addition to assessing the dog's hip conformation,
the veterinary radiologist reports other
radiographic findings that could have familial,
inherited causes such as transitional vertebrae
or spondylosis.
Transitional vertebrae are a congenital
malformation of the spine that occur at the
junctions of major divisions of the spine (usually
between the thoracic and lumbar vertebral junction
and the lumbar and sacral vertebral junction).
Transitional vertebrae take on anatomic
characteristics of both divisions of the spine it
occurs between. The most common type of transitional
vertebrae in dogs is in the lumbo-sacral area where
the last lumbar vertebral body takes on anatomic
characteristics of the sacrum. Transitional
vertebrae are usually not associated with clinical
signs and the dog can be used in a breeding program.
The OFA recommends breeding the dog to another dog
that does not have transitional vertebrae.
Spondylosis is another incidental radiographic
finding where smooth new bone production is
visualized between vertebral bodies at the
intervertebral disc spaces. The new bone production
can vary in extent from formation of small bone
spurs to complete bridging of adjacent vertebral
bodies. Spondylosis may occur secondary to spinal
instability but often it is of unknown cause and
clinically insignificant. A familial basis for its
development has been reported. Like transitional
vertebrae, dogs with spondylosis can be used in a
breeding program.
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