Reliability of ultrasonography and radiography for the diagnosis of diaphragmatic hernia in bovine

The study was aimed to evaluate the reliability of ultrasonography vis-a-vis radiography in the diagnosis of diaphragmatic hernia (DH), and to compare the left and right side ultrasonographic approaches for the diagnosis of DH in cows and buffaloes. 50 clinical cases of bovines (46 buffaloes and 4 cows) suspected for DH on the basis of history and clinical signs were used. Ultrasonography (USG) was done in all the animals restrained in a crate without any sedation, using 3.5–5.0 MHz convex probe, from the right side and left side of thoraco-abdominal wall (4^th ICS to 8^th ICS), which was followed by radiography (RAD). The USG and RAD findings were confirmed upon laparorumenotomy. Reliability of USG (based on combined right and left lateral approaches; and at 4^th ICS right vs. left lateral approach) and RAD were calculated and compared. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the techniques were worked out and compared. The sensitivity and specificity of USG in the diagnosis of DH was 100% and 83.3%, respectively. PPV and NPV of USG were 95.0% and 100%, respectively. The sensitivity of USG at 4^th ICS from right lateral approach was more (89.4%) than left lateral approach (68.4%). Specificity and PPV of USG at 4^th ICS from right lateral and left lateral approaches were 100%. The NPVs of USG at 4^th ICS from right lateral approach and left lateral approach was 75.0% and 50.0%, respectively. The sensitivity and specificity of RAD in the diagnosis of DH were 81.5% and 58.3%, respectively. PPV and NPV of RAD were 96.8% and 100%, respectively. The results indicate that USG is more sensitive and specific for diagnosis of DH in bovine as compared to RAD. And right 4^th ICS was found to be the most effective site for USG for confirmatory diagnosis of DH in cattle and buffaloes.