CLINICAL APPLICATION AND PROGNOSTIC VALUE OF COMPUTED TOMOGRAPHY EXAMINATION IN FOALS DIAGNOSED WITH HEMATOGENOUS OSTEOMYELITIS

Bacterial sepsis in foals is associated with high morbidity and mortality. Bacteremia often arises from localized infections, with septic arthritis and osteomyelitis serving as potential gateways for bacterial spread or as sequelae of bacteremia. Computed tomography (CT) is increasingly utilized for the diagnosis and preoperative planning of osteomyelitis in foals. However, the association between CT findings and clinical prognosis is lacking in the literature. The objectives of this thesis were to; Provide a detailed resource of descriptive data of foals diagnosed with osteomyelitis, to compare findings obtained by conventional imaging methods and CT, and to investigate correlations between clinical and imaging findings and survival. Inclusion criteria were; 1. Foals under 9 months of age, 2. Presumptive clinical diagnosis of osteomyelitis, 3. CT examination used for further evaluation. Fifty-six foals were included in the final analysis. Thirty-six foals survived to discharge (36/56, 64%) and 26 foals survived long term (26/50, 52%). Variables with a significant negative effect on survival to discharge included articular involvement (p=0.04, OR 0.06 95%CI 0.04-0.89) and long transition zone (p=0.03, OR 0.133 95%CI 0.23-0.78). Variables with a significant negative effect on long-term survival included lesions in multiple locations p=0.03, OR 0.05 95%CI 0.04-0.77. In 93% of cases, CT examination modified the diagnosis, revealing improved lesion localization (72%), lesion size (76%), or detecting additional lesions (45%) These findings underscore the critical role of CT in identifying and localizing complex lesions ultimately improving prognostic assessments.