Radiografi sebagai penunjang diagnosis dan penentu tingkat keparahan laminitis pada kuda

Abstract

Laminitis is an inflammation of the laminae, sensitive tissue that connects hoof wall to the coffin bone/3rd phalanx and other structures of the horse’s foot. Along with the clinical examination, radiographic examination also can be done as a supporting diagnosis for laminitis. In this study, radiographic examination of laminitis was done in order to determine the severity of laminitis. Six horses which were clinically and radiographically diagnosed with laminitis were used in this study. Nineteen radiographic images were obtained and analyzed by radiographic indicators as the parameters to determine the severity grade of laminitis. The radiographic indicators consists of palmar angle (rotation of 3rd phalanx), horn lamellar zone width (H-L Zone), extensor process-coronary band distance (EP–CB), SDT (sole depth at tip)/SDW (sole depth at wings), and soft tissue changes. The severity grade of laminitis was divided into grade I, II, III, and IV. The result showed Grade I laminitis was characterized by 5 degrees rotation of 3rd phalanx, H-L zone width approximately 16/20 mm, EP-CB distance within normal limits, SDT/SDW both within a few mm of normal, and soft tissue changes limited to a subtle lucent line dorsal to dorsal surface of 3rd phalanx. Grade IV laminitis was indicated by more than 15 degrees rotation of 3rd phalanx, H-L zone width and EP-CB distance increased but SDW/SDT greatly decreased equally and followed penetration of the 3rd phalanx through the sole. Soft tissue changes was marked lucency along dorsal surface of 3rd phalanx and sole was opened and 3rd phalanx was exposed.

Laminitis merupakan peradangan pada laminae, jaringan tipis yang menghubungkan dinding kuku dengan coffin bone/os phalanx III dan struktur lain pada kaki kuda. Selain pemeriksaan klinis dapat pula dilakukan pemeriksaan radiografi sebagai penunjang diagnosis. Radiografi terhadap kasus laminitis dilakukan untuk mendiagnosis tingkat keparahan kasus laminitis yang terjadi. Enam ekor kuda didiagnosis menderita lamintis pada satu atau keempat kakinya dan diambil gambar radiografinya. Sembilan belas gambar radiografi diperoleh dan dibaca, serta diukur berdasarkan indikator radiografi yang digunakan sebagai parameter penentuan tingkat keparahan laminitis. Indikator radiografi terdiri atas Palmar angle (rotasi dari os phalanx III), lebar zona H-L (horn lamellar zone), jarak extensor process-coronary band (EP–CB), SDT (sole depth at tip)/SDW (sole depth at wings), dan soft tissue changes. Tingkat keparahan laminitis terbagi atas tingkat I, II, III, dan IV. Berdasarkan hasil pada laminitis Tingkat I ditandai dengan rotasi os phalanx III sebesar 5 derajat, lebar zona H-L sekitar 16/20 mm, jarak EP-CB dan nilai SDT/SDW berada dalam kisaran normal, serta perubahan pada jaringan yang terbatas pada permukaan distal os phalanx III. Laminitis Tingkat IV biasanya ditandai dengan rotasi os phalanx III lebih dari 15 derajat, lebar zona H-L dan jarak EP-CB meningkat, tapi nilai SDT/SDW menurun dan disertai menembusnya os phalanx III ke bagian sole. Perubahan pada jaringan ditandai dengan sole yang terbuka dan os phalanx III yang terlihat