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Faulkner JE, Joostens Z, Broeckx BJG, Hauspie S, Mariën T, Vanderperren K. Low-field magnetic resonance imaging of sagittal groove disease of the proximal phalanx in non-racing sport horses. Equine Vet J 2024. [PMID: 38566459 DOI: 10.1111/evj.14088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Injuries of the sagittal groove of the proximal phalanx (P1) in equine athletes are considered to predominantly occur due to chronic bone stress overload. OBJECTIVES To describe the range of abnormalities that is present in the sagittal groove in a large group of horses diagnosed with sagittal groove disease (SGD) on low-field MRI. STUDY DESIGN Retrospective, cross-sectional. METHODS Medical records were searched to identify initial MRI images of horses diagnosed with SGD and these were blindly evaluated using a semi-quantitative grading scheme and novel SGD MRI classification system reflecting potential pathways of pathological progression and severity of stress injury. RESULTS A total of 132 limbs from 111 horses were included in the study; predominantly warmbloods competing in showjumping (n = 83) and dressage (n = 18). SGD MRI classifications were: 0 (normal, n = 0), 1 (small subchondral defect, n = 2), 2 (osseous densification, n = 28), 3 (subchondral microfissure with osseous densification, n = 7), 4 (bone oedema-like signal within the subchondral ± trabecular bone and ± subchondral microfissure or demineralisation, n = 72), 5 (incomplete macrofissure/fracture, n = 23) and 6 (complete fracture, n = 0). Classification 4c (bone oedema-like signal with demineralisation) and 5 had higher proportions in the plantar third of hindlimbs (3% and 10%, respectively) compared with forelimbs (0% and 0%, respectively). SGD classification and extent of bone oedema-like signal were not significantly different between lame (n = 116) and non-lame limbs (n = 16) (both p > 0.05). Periosteal new bone and oedema-like signal were identified (either confidently or suspected) at the dorsoproximal aspect of P1 in 25% and 39% of limbs, respectively. MAIN LIMITATIONS Inclusion via diagnoses in original MRI reports, variable clinical history, small size of some classification groups. CONCLUSIONS The presence or absence of lameness is not a dependable measure of the severity of SGD. The periosteal oedema-like signal of P1 has not previously been described in MRI of SGD and further supports the concept of bone stress injury.
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Affiliation(s)
- Josephine E Faulkner
- Department of Morphology, Imaging, Orthopaedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | - Bart J G Broeckx
- Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | | | - Katrien Vanderperren
- Department of Morphology, Imaging, Orthopaedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Cartilage Degeneration of the Metacarpal Condyle and Enthesopaties of The Collateral Ligaments of Equine Metacarpophalangeal Joint. J Equine Vet Sci 2021; 106:103754. [PMID: 34670704 DOI: 10.1016/j.jevs.2021.103754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 11/22/2022]
Abstract
Articular degeneration can be characterized by fibrillation and eburnation of the articular layers of the metacarpophalangeal (MP) joint. Structural changes within the articular joint predispose the development of osteophytes, enthesophytes and, in many cases is associated with changes the collateral ligaments of the MP joint. The aim of the present study was to investigate the relationship between degenerative processes of the articular cartilage and the enthesopathies of collateral ligaments (superficial or deep portion) of the equine MP joint, using radiographic, ultrasonographic and anatomopathological exam, as well as establishing their sensitivity. Thirty equine forelimbs were selected from animals that died due to various clinical conditions with an average age of 5.7 years which came from a private clinic or sent to the Laboratory of Veterinary Pathology of UFSM. The specimens were placed in a hydraulic press and submitted to radiographic evaluation of the MP joint (lateromedial, flexed lateromedial, dorsopalmar, dorsolateral-palmaromedial oblique 450 and dorsomedial-palmarolateral oblique 450 projections). Transversal and longitudinal ultrasound images of the dorsal and collateral aspect of the MP joint were obtained using a Sonosite Edge machine with a 5 to 10 MHz linear transducer. Subsequently, the specimens were sent for gross and histopathological examination. A highly positive correlation (P value <.001) was observed between ultrasonographic and macroscopic techniques, showing a relationship between the cartilaginous degenerations of the MP joint and the medial and lateral LC enthesopathies.
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Ramzan PHL. Mind the gaps: The science of POD and the racehorse fetlock. Equine Vet J 2020; 53:217-220. [PMID: 33210760 DOI: 10.1111/evj.13369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/02/2020] [Accepted: 10/18/2020] [Indexed: 11/28/2022]
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Quiney LE, Ireland JL, Dyson SJ. Evaluation of the diagnostic accuracy of skeletal scintigraphy in lame and poorly performing sports horses. Vet Radiol Ultrasound 2018; 59:477-489. [DOI: 10.1111/vru.12626] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 02/01/2018] [Accepted: 03/08/2018] [Indexed: 11/27/2022] Open
Affiliation(s)
- Laura E. Quiney
- Centre for Equine Studies; Animal Health Trust; Newmarket Suffolk CB8 7UU UK
| | - Joanne L. Ireland
- Centre for Equine Studies; Animal Health Trust; Newmarket Suffolk CB8 7UU UK
| | - Sue J. Dyson
- Centre for Equine Studies; Animal Health Trust; Newmarket Suffolk CB8 7UU UK
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Davis AM, Fan X, Shen L, Robinson P, Riggs CM. Improved radiological diagnosis of palmar osteochondral disease in the Thoroughbred racehorse. Equine Vet J 2016; 49:454-460. [DOI: 10.1111/evj.12636] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 08/25/2016] [Indexed: 12/19/2022]
Affiliation(s)
- A. M. Davis
- Veterinary Clinical Services; The Hong Kong Jockey Club; Sha Tin Hong Kong
| | - X. Fan
- Department of Statistics; The Chinese University of Hong Kong; Sha Tin Hong Kong
| | - L. Shen
- Department of Information Engineering; The Chinese University of Hong Kong; Sha Tin Hong Kong
| | - P. Robinson
- Veterinary Clinical Services; The Hong Kong Jockey Club; Sha Tin Hong Kong
| | - C. M. Riggs
- Veterinary Clinical Services; The Hong Kong Jockey Club; Sha Tin Hong Kong
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Trope GD, Ghasem-Zadeh A, Anderson GA, Mackie EJ, Whitton RC. Can high-resolution peripheral quantitative computed tomography imaging of subchondral and cortical bone predict condylar fracture in Thoroughbred racehorses? Equine Vet J 2014; 47:428-32. [DOI: 10.1111/evj.12312] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 06/19/2014] [Indexed: 11/26/2022]
Affiliation(s)
- G. D. Trope
- Faculty of Veterinary Science; University of Melbourne; Werribee Victoria Australia
| | - A. Ghasem-Zadeh
- Department of Endocrinology and Medicine, Austin Health; University of Melbourne; Parkville Victoria Australia
| | - G. A. Anderson
- Faculty of Veterinary Science; University of Melbourne; Werribee Victoria Australia
| | - E. J. Mackie
- Faculty of Veterinary Science; University of Melbourne; Werribee Victoria Australia
| | - R. C. Whitton
- Faculty of Veterinary Science; University of Melbourne; Werribee Victoria Australia
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8
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Rickey EJ, Cruz AM, Trout DR, McEwen BJ, Hurtig MB. Evaluation of experimental impact injury for inducing post-traumatic osteoarthritis in the metacarpophalangeal joints of horses. Am J Vet Res 2013; 73:1540-52. [PMID: 23013179 DOI: 10.2460/ajvr.73.10.1540] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether a single contusive impact injury to the palmar aspect of the metacarpus would progress to post-traumatic osteoarthritis or palmar osteochondral disease in horses. ANIMALS 12 horses. PROCEDURES In each horse, an impact injury was created on the palmar aspect of the medial metacarpal condyle of 1 randomly chosen limb with an impactor device under arthroscopic and fluoroscopic guidance. The opposite limb was sham operated as a control. A low to moderate amount of forced exercise was instituted, and horses were evaluated clinically via lameness examinations weekly for 5 months, then biweekly until endpoint, with synovial fluid analysis performed at 0, 1, 2, 3, 4, 6, 8, and 10 months and radiography at baseline and endpoint. Macroscopic examination, micro-CT, and sample collection for cartilage viability and sulfated glycosaminoglycan content, histologic evaluation, immunohistochemical analysis, and fluorochrome analysis were performed following euthanasia at 1 (3 horses), 4 (4), and 8 to 10 (5) months after surgery. RESULTS There was variability in impact lesion location, depth, and area on macroscopic inspection, but on histologic evaluation, cartilage defects were less variable. Mean sulfated glycosaminoglycan concentration from cartilage at the impact site was significantly lower than that at a similar site in control limbs. Higher concentrations of cartilage oligomeric matrix protein were observed in synovial fluid from impact-injured joints. CONCLUSIONS AND CLINICAL RELEVANCE The impact injury method caused mild focal osteoarthritic lesions in the metacarpophalangeal joint, but did not progress to palmar osteochondral disease at this site. Repeated injury is probably required for the development of palmar osteochondral disease.
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Affiliation(s)
- Ellen J Rickey
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
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Peremans K, Duchateau L, Vermeire S, Vandermeulen E, Dobbeleir A, Gielen I, Polis I, Van Rijssen B, De Bakker E, Saunders J, De Spiegeleer B, Dik K. The use of the HiSPECT bone scan in canine flexor enthesopathy and coronoid pathology. Res Vet Sci 2013; 94:628-33. [PMID: 23375664 DOI: 10.1016/j.rvsc.2012.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 11/26/2012] [Accepted: 12/08/2012] [Indexed: 10/27/2022]
Abstract
In this study the use of the high resolution Micro-Single Photon Emission Tomography (HiSPECT) system with a radioactive bonemarker, (99m)Tc-oxidronate, was evaluated in dogs with coronoid pathology and/or flexor enthesopathy. Sixty-five elbows of 34 dogs were included. CT and HiSPECT were performed on all elbows, arthroscopy on 59. Tracer uptake in 8 anatomical regions was graded according to two models. Increased activity in the medial epicondylar region was associated with flexor pathology on CT (P=0.0002) and arthroscopy (P<0.0001) and increased uptake in the medial coronoid (P<0.0001) and the medial condylar area (P<0.013) with coronoid pathology. Uptake in the remaining areas was not associated with both pathologies. In conclusion, the improved resolution of the HiSPECT system allows identification of increased tracer uptake in the anatomical regions involved in coronoid pathology and flexor enthesopathy. This modality may improve the diagnostic potential of the bone scan in canine elbow disease.
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Affiliation(s)
- K Peremans
- Department of Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
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Dyson S, Nagy A, Murray R. Clinical and diagnostic imaging findings in horses with subchondral bone trauma of the sagittal groove of the proximal phalanx. Vet Radiol Ultrasound 2012; 52:596-604. [PMID: 21831247 DOI: 10.1111/j.1740-8261.2011.01852.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Eight sports horses with unilateral (4) or bilateral (3) forelimb or unilateral hindlimb (1) lameness had subtle radiologic abnormalities of the subchondral bone of the sagittal groove of the proximal phalanx associated with moderate or intense increased radiopharmaceutical uptake. High-field or low-field magnetic resonance (MR) imaging confirmed the presence of a fissure fracture or subchondral and trabecular bone trauma. Seven of eight lesions were located approximately midway between the dorsal and palmar cortices of the proximal phalanx; the eighth was sited more dorsally. Two horses underwent follow-up MR imaging and abnormal signal intensity persisted, with little change.
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Affiliation(s)
- Sue Dyson
- Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK.
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12
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O'Brien T, Baker TA, Brounts SH, Sample SJ, Markel MD, Scollay MC, Marquis P, Muir P. Detection of Articular Pathology of the Distal Aspect of the Third Metacarpal Bone in Thoroughbred Racehorses: Comparison of Radiography, Computed Tomography and Magnetic Resonance Imaging. Vet Surg 2011; 40:942-51. [DOI: 10.1111/j.1532-950x.2011.00881.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Thomas O'Brien
- Comparative Orthopaedic Research Laboratory and the Department of Surgical Sciences; School of Veterinary Medicine; University of Wisconsin-Madison; Madison; WI
| | - Theresa A. Baker
- Comparative Orthopaedic Research Laboratory and the Department of Surgical Sciences; School of Veterinary Medicine; University of Wisconsin-Madison; Madison; WI
| | - Sabrina H. Brounts
- Comparative Orthopaedic Research Laboratory and the Department of Surgical Sciences; School of Veterinary Medicine; University of Wisconsin-Madison; Madison; WI
| | - Susannah J. Sample
- Comparative Orthopaedic Research Laboratory and the Department of Surgical Sciences; School of Veterinary Medicine; University of Wisconsin-Madison; Madison; WI
| | - Mark D. Markel
- Comparative Orthopaedic Research Laboratory and the Department of Surgical Sciences; School of Veterinary Medicine; University of Wisconsin-Madison; Madison; WI
| | | | | | - Peter Muir
- Comparative Orthopaedic Research Laboratory and the Department of Surgical Sciences; School of Veterinary Medicine; University of Wisconsin-Madison; Madison; WI
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Tull TM, Bramlage LR. Racing prognosis after cumulative stress-induced injury of the distal portion of the third metacarpal and third metatarsal bones in Thoroughbred racehorses: 55 cases (2000–2009). J Am Vet Med Assoc 2011; 238:1316-22. [DOI: 10.2460/javma.238.10.1316] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Trope GD, Anderson GA, Whitton RC. Patterns of scintigraphic uptake in the fetlock joint of Thoroughbred racehorses and the effect of increased radiopharmaceutical uptake in the distal metacarpal/tarsal condyle on performance. Equine Vet J 2011; 43:509-15. [PMID: 21545647 DOI: 10.1111/j.2042-3306.2010.00316.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
REASONS FOR PERFORMING STUDY The effect of palmar osteochondral disease lesions on performance of Thoroughbred (TB) racehorses is unclear. There is a need to describe patterns of radiopharmaceutical uptake (IRU) in fetlock joints of TB racehorses and to evaluate post scintigraphy performance. HYPOTHESES IRU in the metacarpal (MC) and metatarsal (MT) condyles is more common than IRU in the parasagittal grooves and is associated with poorer post diagnosis performance than controls. METHODS Location of IRU within the fetlock region was identified and graded subjectively in TB racehorses. Performance variables were determined from race records for horses with moderate/marked MC/MT condylar IRU (cases), other horses undergoing scintigraphy (scintigraphy controls) and age/sex matched controls from the last race in which a case participated (controls). Statistical analyses included quantile regression, Fisher's exact test, Kaplan-Meier survival curves, log-rank test and Cox regression. RESULTS Metacarpal/MT condylar IRU was identified in 103/220 horses with only 3/220 having parasagittal IRU. Moderate/marked IRU was identified in the MC and MT condylar regions in 62 and 39 horses, respectively, with palmaromedial and plantarolateral IRU most common. Fore- and hindlimb cases had fewer starts, reduced earnings (P<0.001) and reduced earnings/start than controls respectively. Cases were more likely to return to racing later than controls following a rest period. Cases were older than scintigraphy controls. CONCLUSIONS In TB racehorses presenting for lameness MC/MT condylar IRU is the most common abnormality identified within the fetlock joint. Racehorses with moderate/marked condylar IRU have a shortened racing career, are less successful than age/sex matched controls and are older than other racehorses presented for scintigraphy. POTENTIAL RELEVANCE Overload of the MC/MT condyles is a common and significant problem in TB racehorses that is readily identified with scintigraphy. Scintigraphy of horses that are lame or performing poorly is less useful for screening for potential condylar fractures.
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Affiliation(s)
- G D Trope
- Faculty of Veterinary Science, University of Melbourne, Victoria, Australia.
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PARKER RA, BLADON BM, PARKIN TDH, FRASER BSL. Quantitative evaluation of subchondral bone injury of the plantaro-lateral condyles of the third metatarsal bone in Thoroughbred horses identified using nuclear scintigraphy: 48 cases. Equine Vet J 2010; 42:552-7. [DOI: 10.1111/j.2042-3306.2010.00088.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Steel CM, Hopper BJ, Richardson JL, Alexander GR, Robertson ID. Clinical findings, diagnosis, prevalence and predisposing factors for lameness localised to the middle carpal joint in young Standardbred racehorses. Equine Vet J 2010; 38:152-7. [PMID: 16536385 DOI: 10.2746/042516406776563332] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY Lameness related to the middle carpal joint (MCJ) occurs in up to 30% of young Standardbred horses in race training and the incidence increase with radiographic severity of third carpal bone (C3) sclerosis on DPr-DDIO (skyline) view of the carpus. Factors predisposing horses to carpal injury have not been well investigated. OBJECTIVES To determine the importance of MCJ lameness as a cause of wastage in young Standardbred racehorses, stage of training at which it occurs and predisposing factors, and to describe clinical findings and diagnosis. METHODS Standardbred horses (n = 114) entering their first year of race training were examined at approximately 3-month intervals over 12-18 months. For 87 of the horses, a training diary was available and these horses were trained at 3 different stables, each using a different exercise regime. At each examination, forelimb conformation, MCJ effusion, MCJ lameness and radiographic findings were graded, and training history and reasons for lost training days recorded. Nuclear scintigraphy and exploratory arthroscopy were performed on a limited selection of horses. Results for horses that developed MCJ lameness during the study period were compared statistically with results for horses that did not. RESULTS Carpal lameness occurred in 28% of horses and was present in 56% with forelimb lameness. In most cases lameness was mild, bilateral and with little or no MCJ effusion and was attributed to subchondral bone pain associated with radiographic evidence of C3 sclerosis. Carpal lameness was the most common reason for >1 month's rest during the study period. It occurred at any stage of training but, in most cases, some speed training had begun. Of the variables studied, poor forelimb conformation and more intense speed training were predisposing factors. CONCLUSIONS AND POTENTIAL RELEVANCE The information gained should assist in making recommendations regarding training young Standardbreds to reduce the incidence of MCJ lameness. However, further investigations to determine the optimal training regime are warranted.
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Affiliation(s)
- C M Steel
- Division of Veterinary and Biomedical Sciences, School of Veterinary Clinical Science, Murdoch University, Murdoch, Western Australia, Australia
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BIGGI MARIANNA, DYSON SUEJ, MURRAY RACHELC. SCINTIGRAPHIC ASSESSMENT OF THE METACARPOPHALANGEAL AND METATARSOPHALANGEAL JOINTS OF HORSES WITH JOINT PAIN. Vet Radiol Ultrasound 2009; 50:536-44. [DOI: 10.1111/j.1740-8261.2009.01579.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Archer DC, Boswell JC, Voute LC, Clegg PD. Skeletal scintigraphy in the horse: Current indications and validity as a diagnostic test. Vet J 2007; 173:31-44. [PMID: 16359891 DOI: 10.1016/j.tvjl.2005.10.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Gamma scintigraphy is a well established imaging modality, which in equine practice is predominantly used in the investigation of lameness and suspected musculoskeletal problems. Whilst there is a growing literature on the indications for scintigraphy in the horse, there has been little emphasis so far on identifying the validity of scintigraphy as a diagnostic test. In particular, to what extent can the results of a scintigraphic examination be trusted? In this opinionated review the current indications for skeletal scintigraphy in the horse are considered and its validity as a diagnostic test reviewed. It is concluded that in the majority of published studies, inherent biases in study design make it difficult to assess accurately the validity of skeletal scintigraphy in the horse. Further well designed, prospective studies are required to assess the validity of skeletal scintigraphy as a diagnostic tool, particularly in horses with subtle alterations in radiopharmaceutical uptake.
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Affiliation(s)
- D C Archer
- Department of Clinical Studies, Philip Leverhulme Large Animal Hospital, University of Liverpool, Leahurst, Neston, The Wirral CH64 7TE, UK.
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Kraus BM, Ross MW, Boswell RP. STRESS REMODELING AND STRESS FRACTURE OF THE HUMERUS IN FOUR STANDARDBRED RACEHORSES. Vet Radiol Ultrasound 2005; 46:524-8. [PMID: 16396273 DOI: 10.1111/j.1740-8261.2005.00096.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Two 2-year-old pacers, a 3-year-old pacer and a 2-year-old-trotter with acute forelimb lameness were admitted for nuclear scintigraphic examination. Horses were grade 3-4/5 lame. There was increased radiopharmaceutical uptake (IRU) in the distal cranial medial aspect of the humerus in one horse and along the caudal humeral cortex in the other three horses. Two of the four horses were affected bilaterally. Radiographic abnormalities consisted of thickening of the caudal cortex of the mid-diaphysis of the humerus but radiographic changes were not present in all horses. All horses were managed with stall rest initially then stall rest with hand-walking followed by limited turn out for a total of four months. None of the horses had raced before injury. One horse has returned to race training and the other three horses have returned to racing. Average time to return to racing was 329 days. Humeral stress fractures in Standardbred horses are rare. Diffuse patterns of IRU have not been reported in the humerus and are likely indicative of severe stress remodeling. Standardbred racehorses with stress fractures or stress remodeling of the humerus appear to have a good prognosis for return to racing.
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Affiliation(s)
- Beth M Kraus
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, 382 West Street Road, Kennett Square, PA 19348, USA.
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Davidson EJ, Ross MW, Parente EJ. Incomplete sagittal fracture of the talus in 11 racehorses: outcome. Equine Vet J 2005; 37:457-61. [PMID: 16163949 DOI: 10.2746/042516405774480030] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY Little information exists regarding talus fractures in the horse and there have been no previously published case series of racehorses diagnosed with incomplete sagittal fracture of the talus. OBJECTIVE To describe the diagnosis, treatment and post injury performance of horses with incomplete sagittal fracture of the talus. METHODS Medical records of 11 racehorses (8 Standardbreds and 3 Thoroughbreds) admitted between January 1992 and January 1999 were reviewed. Subject details, anamnesis, results of lameness examination, radiographs and nuclear scintigraphic findings were evaluated. Racing performance was assessed by comparing pre- and post injury race records. RESULTS Nuclear scintigraphic examination, performed in 8 of the 11 horses, revealed focal increased radiopharmaceutical uptake in the proximal aspect of the affected talus. Fractures could best be seen on dorsal 10-20 degrees lateral-plantaromedial oblique radiographs; all had raced pre-injury. All horses were treated conservatively and follow-up information was available for 8 horses, of which 7 raced after injury. Performance in 3 horses was improved, in 1 it was unchanged and in 3 horses performance declined. CONCLUSIONS Horses with incomplete fracture of the talus have a good prognosis for return to racing after conservative management. POTENTIAL RELEVANCE Incomplete sagittal fracture of the talus should be considered as a cause of hindlimb lameness in racehorses. Further research is necessary to determine the pathophysiology of these fractures.
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Affiliation(s)
- E J Davidson
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, 382 West Street Road, Kennett Square, Pennsylvania 19348-1692, USA
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Weekes JS, Murray RC, Dyson SJ. Scintigraphic evaluation of metacarpophalangeal and metatarsophalangeal joints in clinically sound horses. Vet Radiol Ultrasound 2004; 45:85-90. [PMID: 15005367 DOI: 10.1111/j.1740-8261.2004.04014.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The purpose of this study was to describe the pattern of radiopharmaceutical uptake in the metacarpophalangeal (MCP) and metatarsophalangeal (MTP) (fetlock) joints in clinically sound horses. Scintigraphic images from 29 clinically normal horses were evaluated. All the images were assessed subjectively. The lateral views were assessed quantitatively using vertical line profiles through the center of the joint, and mean ratios of radiopharmaceutical uptake were calculated from regions of interest around the third metacarpal or metatarsal bones, and the proximal phalanx and proximal sesamoid bones. From the vertical line profiles, in the majority of forelimbs (65%) the peak activity of radiopharmaceutical distribution was at the proximal region of the proximal phalanx, with a significantly lower activity within the condyles of the third metacarpal bone. However, in 84% of hindlimbs there was a broader profile peak incorporating the condyles of the third metatarsal bone and the proximal aspect of the proximal phalanx, indicating a more generalized even uptake of radiopharmaceutical across the MTP joint. When the regions of interest were compared between front and hindlimbs, there was no significant difference between proximal phalanx and proximal sesamoid bones, but the distal condyles of the third metacarpal bone of the forelimb had significantly lower radiopharmaceutical activity than hindlimbs (P < 0.04). In lateral images, the mean forelimb ratios tended to be higher in the left MCP joint compared with the right (P = 0.069). In hindlimbs, the mean ratios tended to be higher in the right MTP joint than the left (P = 0.052). There was no significant effect of age.
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Affiliation(s)
- Jo S Weekes
- Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK
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Davidson EJ, Ross MW. Clinical recognition of stress-related bone injury in racehorses. ACTA ACUST UNITED AC 2003. [DOI: 10.1053/j.ctep.2004.04.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Foreman JH, Kneller SK, Twardock AR, Chambers MD, Inoue OJ. Forelimb skeletal scintigraphy responses in previously untrained Thoroughbreds undergoing initial treadmill training. Equine Vet J 2002:230-5. [PMID: 12405692 DOI: 10.1111/j.2042-3306.2002.tb05424.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Scintigraphy has been used in numerous clinical settings to examine horses to determine the origin of lameness problems, but it has not been used previously to monitor prospectively the skeletal responses of a group of similarly-trained racehorses. Our hypothesis was that in naïve Thoroughbred (TB) racehorses, initial treadmill training induces increased radiopharmaceutical uptake in high-motion joints and in the dorsal third metacarpal bone (MC3). Eight previously-untrained TB racehorses underwent sequential skeletal scintigraphic examinations as they exercised daily for 9 weeks on an inclined treadmill. At the end of Weeks 0 (pre-training), 3 (trotting at 4.2 m/s and initial galloping), 6 (galloping at 7.5 m/s), and 9 (sprinting 600 m at 12.5 m/s), horses received 140 mCi 99m Technetium-methylene diphosphonate i.v. followed by a standard skeletal scintigraphic forelimb examination 2 h later. Views were graded for increased radiopharmaceutical uptake by 3 co-investigators who were blinded to horse identification, breed, sex, date, and clinical findings. Results were compared before and after training for each skeletal location using the Mann-Whitney Rank Sum Test with the level of significance set at P<0.05. Initial treadmill training resulted in increased radiopharmaceutical uptake in the carpus (P = 0.031), metacarpophalangeal joint (P = 0.021), proximal phalanx (P = 0.035), and distal phalanx (P = 0.003). Training did not affect dorsal MC3 radiopharmaceutical uptake (P>0.05).
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Affiliation(s)
- J H Foreman
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana 61802, USA
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Van Harreveld PD, Lillich JD, Kawcak CE, Gaughan EM, Mclaughlin RM, Debowes RM. Clinical evaluation of the effects of immobilization followed by remobilization and exercise on the metacarpophalangeal joint in horses. Am J Vet Res 2002; 63:282-8. [PMID: 11843131 DOI: 10.2460/ajvr.2002.63.282] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To evaluate clinical effects of immobilization followed by remobilization and exercise on the metacarpophalangeal joint (MPJ) in horses. ANIMALS 5 healthy horses. PROCEDURE After lameness, radiographic, and force plate examinations to determine musculoskeletal health, 1 forelimb of each horse was immobilized in a fiberglass cast for 7 weeks, followed by cast removal and increasing amounts of exercise, beginning with hand-walking and ending with treadmill exercise. Lameness examination, arthrocentesis of both MPJ, single-emulsion radiographic examination, nuclear scintigraphic examination, ground-reaction force-plate analysis, and computed tomographic examination were done at various times during the study. RESULTS All horses were lame in the immobilized MPJ after cast removal; lameness improved slightly with exercise. Force plate analysis revealed a significant difference in peak forces between immobilized and contralateral limbs 2 weeks after cast removal. Range of motion of the immobilized MPJ was significantly decreased, and joint circumference was significantly increased, compared with baseline values, during the exercise period. Osteopenia was subjectively detected in the immobilized limbs. Significant increase in the uptake of radionucleotide within bones of the immobilized MPJ after cast removal and at the end of the study were detected. Loss of mineral opacity, increased vascular channels in the subchondral bone, and thickening within the soft tissues of the immobilized MPJ were detected. CONCLUSIONS AND CLINICAL RELEVANCE Results indicate that 8 weeks of enforced exercise after 7 weeks of joint immobilization did not restore joint function or values for various joint measurements determined prior to immobilization.
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Affiliation(s)
- Philip D Van Harreveld
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan 66506-5606, USA
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Twardock AR. Equine bone scintigraphic uptake patterns related to age, breed, and occupation. Vet Clin North Am Equine Pract 2001; 17:75-94. [PMID: 11488047 DOI: 10.1016/s0749-0739(17)30076-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
It is well known that skeletal scintigraphy is an imaging modality with high sensitivity but low specificity. Sites of IRU provide good evidence of increased bone turnover but not its specific cause. Results of lameness workups, blocks, and other imaging techniques are required to determine specific causes. Overinterpretation of causes of IRU is tempting, especially in assigning diagnoses to EIBR--adaptive or non-adaptive. Nevertheless, a quarter of a century's experience with equine skeletal scintigraphy has shown that certain patterns and locations can be fairly predictive of certain pathologic findings. It behooves the equine scintigrapher to know those patterns and how they are affected by the patient's age, breed, and occupation so that he or she can indicate how to best focus other diagnostic procedures toward a definitive diagnosis. Those who are conducting research involving equine skeletal scintigraphy are challenged to help sharpen that focus, especially in evaluating the significance of relatively mild IRUs. Equine clinicians who use scintigraphy in their lameness workups are especially challenged. Working in concert with nuclear medicine imagers, they are in the best position to garner, collate, and analyze the information that is needed to correlate IRUs and the clinical picture. As difficult as they are to design and conduct, such studies are most productive if done prospectively and are most rewarding for those who carry them through.
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Affiliation(s)
- A R Twardock
- Departments of Veterinary Biosciences and Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
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