Radiological Methods for the Imaging of Congenital Malformations of C6-T1, the First and Second Sternal Ribs and Development of a Classification System, Demonstrated in Warmblood Horses

Simple Summary Congenital malformations of the equine cervicothoracic junction have recently been recognized as a finding in performance riding horses. Their clinical relevance is not yet fully understood. To promote better precision in the description of radiological findings among researchers and clinicians, our objective in this study was to identify and grade the equine congenital malformations of C6, C7 and the cranial rib malformations of the first and second sternal ribs using radiographs. Equine cranial rib malformations (ECRMs) refer to cranial rib malformations of the first and second sternal ribs. The radiographic methods described here can help veterinarians to produce radiographs of high diagnostic quality and to assess the severity of malformations according to a uniform system. Future studies will investigate the clinical relevance of different grades of malformations of C6, C7 and the first and second ribs. This knowledge may facilitate improved treatment and management options and more strategic breeding decisions.Abstract There are conflicting data in studies on malformations of the cervicothoracic (C-T) junction (C6 to T2, including the first and second ribs), but evidence is mounting that they can be of clinical significance for horses. The objectives of this study were to establish a radiographic protocol for imaging the C-T junction in the field and to classify the radiographic variations found in 39 warmblood horses presented for clinical evaluation due to behavioral or performance issues. Malformations of the ventral lamina of C6 and transposition onto the ventral aspect of C7 were seen in 37/39 (94.9%) horses for both conditions. Rib anomalies were found among the horses with C6 and C7 malformations. A missing first rib, unilateral or bilateral, was found in 3/35 (11.4%) horses, a unilateral shortening of the rib in 17/35 (48.6%) horses, a bilateral shortening of the ribs in 12/35 (34.3%) horses, bifid ribs in 3/35 (8.6%) horses, and only 4/35 (11.4%) horses had a normal length of the first rib on both sides. There was a moderately to highly significant association between the grades of left and right malformations of C6 and C7 and first ribs as well as between C6 and C7. A large number of malformations were visualized radiographically at the C-T junction using the newly described methods of latero-lateral and oblique radiographic projections, which allows for these features to be identified in living horses.