Efetividade da análise ultrassonográfica das articulações na leishmaniose canina naturalmente adquirida

Abstract

Canine leishmaniasis (CanL), caused by Leishmania infantum, is a chronic zoonotic parasitic disease with multisystemic involvement. The osteoarticular lesions described in CanL have been attributed to immune complex–mediated disease associated with inflammation of the synovial membrane microvasculature and/or the presence of the parasite within the synovium. The aim of this study was to establish and describe the findings identified through joint ultrasonography (USG) in dogs naturally infected with L. infantum, in order to evaluate the diagnostic effectiveness of this technique in the clinical characterization of dogs with CanL. A total of 43 L. infantum PCR-positive dogs, examined between February 2023 and January 2025 at the Zoonotic Leishmaniasis Outpatient Clinic of the Veterinary Hospital at UFBA, were included. The dogs underwent general clinical examination, locomotor physical assessment, laboratory tests, and imaging by radiography and/or USG. Ultrasonographic examinations were performed on the tarsal joints of all dogs, while other joints were evaluated by USG when alterations were identified during the locomotor physical exam. The dogs were divided into two groups: G1 (n=23), composed of dogs assessed only by USG, and G2 (n=20), composed of dogs evaluated by both USG and radiography. Most dogs were females (51.2%), adults (67.4%), and purebred (65.1%). Articular lesions were identified by ultrasonography in 86% (37/43) of the evaluated dogs, with osteophytes (83.8%), joint effusion (64.9%), and capsular thickening (56.7%) being the most frequent findings. Among dogs with articular alterations detected by ultrasonography, 29.7% (11/37) did not show clinical orthopedic abnormalities. Radiography detected tarsal joint lesions in 40% (8/20) of the dogs evaluated. Considering the physical examination as the reference, ultrasonography showed a sensitivity of 89.7% in identifying articular changes, whereas radiography showed a sensitivity of 66.7%. Overall, 88.4% (38/43) of the dogs with CanL presented articular alterations detectable by imaging methods, consistent with degenerative processes, even in the absence of clinical locomotor signs. We conclude that ultrasonography demonstrated superiority over radiography in detecting joint alterations in dogs with CanL, including cases of subclinical arthropathy. These findings support the recommendation of joint ultrasonography as a first-line tool in the early diagnosis of osteoarticular lesions associated with L. infantum infection.