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CT of CMO
Frontiers of Veterinary Science 2024
L. A. Pérez López, C. Almansa Ruiz, C. Almansa Ruiz. G. Steenkamp,A. Holdsworth
Background
Craniomandibular osteopathy (CMO) is a non-neoplastic, proliferative bone disorder affecting young dogs, particularly terrier breeds. While radiographic features of CMO are well documented, limited data exist on its computed tomographic (CT) characteristics. This study aims to describe the CT findings of CMO, highlighting the extent and severity of the disease and its secondary effects.
Methods
A retrospective multicenter case series reviewed CT scans and medical records of 20 dogs diagnosed with CMO. CT imaging evaluated osteoproliferation, osteolysis, and secondary changes, such as nasopharyngeal narrowing, ear canal stenosis, and temporomandibular joint (TMJ) impingement. Severity was categorized, and statistical correlations with age and breed were analyzed.
Results
-CT Findings:
-All dogs exhibited mandibular osteoproliferation (80% marked severity).
-Osteoproliferation of the tympanic bullae was present in 60% of dogs, all graded as marked.
-Cranial osteoproliferation was observed in 85% of cases, with 35% classified as marked.
-Osteolysis was identified in the mandible (50%), cranium (25%), and maxilla (5%), often with a moth-eaten appearance.
-Secondary effects included nasopharyngeal narrowing (67% marked) and TMJ impingement (83% of affected dogs).
-Demographics:
-Scottish terriers (65%) showed the most severe disease.
-Age correlated positively with disease severity (p = 0.032).
-Clinical Outcomes:
-Pain and difficulty opening the mouth were the most common complaints.
-Surgical intervention improved symptoms in select cases.
Limitations
The study's retrospective design, small sample size, and variability in imaging protocols between centers limited uniformity. Additionally, incomplete histopathological confirmation restricted diagnostic validation.
Conclusions
CT imaging provides a comprehensive characterization of CMO, including subtle changes undetectable by radiography. Findings suggest that CT can enhance diagnostic accuracy, guide surgical planning, and identify secondary complications. Further studies are recommended to explore disease progression and refine diagnostic criteria.
Figure 2. Transverse images showing examples of periosteal new bone formation affecting the mandibles. Images A–C show examples of osteoproliferation affecting the body of the mandible, and images D–F show osteoproliferation affecting the mandibular ramus. The severity of the osteoproliferation was graded as mild in images (A,D), moderate in images (B,E), and marked in images (C,F). Image A is from a 5-month-old Scottish terrier, B,E are from a 4-month-old Jack Russell terrier, C,F are from a 5-month-old akita, and D is from a 5-month-old Slovakian rough-haired pointer.
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