Topic:Scintigraphy
Scintigraphy, also known as nuclear scintigraphy, is a diagnostic imaging technique used in equine medicine to assess bone and soft tissue abnormalities. This procedure involves the administration of a radiopharmaceutical agent that emits gamma rays, which are detected by a gamma camera to create detailed images of the horse's body. Scintigraphy is particularly useful for identifying areas of increased metabolic activity, often indicative of inflammation, infection, or injury. It is commonly employed in cases where lameness or other musculoskeletal issues are present, but the precise location or cause is not easily determined through other diagnostic methods. This page compiles peer-reviewed research studies and scholarly articles that explore the applications, methodology, and diagnostic value of scintigraphy in equine veterinary practice.
Scintigraphic and radiographic appearance of the sacroiliac region in horses with gait abnormalities or poor performance. Nuclear bone scintigraphy is commonly used in the diagnosis of sacroiliac disease in horses. The aim of the present retrospective study was to determine if there was an association between radiopharmaceutical uptake pattern and radiographic appearance of the sacroiliac region in horses. Seventy-nine horses undergoing bone scintigraphy with Tc-99 m-HDP and radiography of the pelvis because of lameness or poor performance were studied. Subjective and semiquantitative methods were used to characterize and compare radiopharmaceutical uptake between horses. Ventrodorsal radiographs of the region we...
Effects of radial extracorporeal shock wave therapy on radiographic and scintigraphic outcomes in horses with palmar heel pain. To investigate the effects of radial extracorporeal shock wave therapy (RESWT) on radiographic and scintigraphic variables in horses with clinical pain referable to the palmar heel. Methods: Eight client-owner horses with palmar heel pain were treated with RESWT for a total of three treatments. Nuclear scintigraphy and radiography were repeated at the beginning and completion of the study. Scintigram region of interest (ROI) density ratios were calculated and compared between treated limbs, untreated limbs, and a population of comparison limbs from eight horses free of lameness. Radiographs we...
Quantitative analysis of scintigraphic findings in tibial stress fractures in Thoroughbred racehorses. To develop a quantitative method of interpreting tibial scintigrams of Thoroughbred racehorses with tibial stress fractures that may facilitate diagnosis of fractures and to provide prognostic information regarding future performance of affected horses. Methods: 35 Thoroughbred racehorses. Methods: Static bone-phase scintigrams of tibial stress fractures were quantitatively analyzed by use of ratios of the mean radionuclide counts per pixel in a region of interest (ROI) drawn around the area of increased uptake of radiopharmaceutical to mean counts per pixel in a second ROI drawn around an app...
Clinical and scintigraphic findings in horses with a bone fragility disorder: 16 cases (1980-2006). To describe clinical and scintigraphic abnormalities in horses with a bone fragility disorder. Methods: Retrospective case series. Methods: 16 horses with scintigraphic evidence of multiple sites of increased radiopharmaceutical uptake (IRU). Procedures-Medical records were reviewed for information on signalment; history; clinical, clinicopathologic, and diagnostic imaging findings; and treatment. Follow-up information was obtained through telephone interviews with owners. Results: Horses ranged from 4 to 22 years old; there were 8 castrated males and 8 females. Foci of IRU most commonly invol...
Effects of exercise vs experimental osteoarthritis on imaging outcomes. To identify changes in imaging outcomes in a controlled model of osteoarthritis (OA) vs exercise. Methods: Sixteen 2-year-old horses were randomly assigned to an exercise control (n=8) or an exercise OA (n=8) group. All horses had middle carpal joints arthroscopically explored and an osteochondral fragment was induced in one middle carpal joint of the OA group. All horses were treadmill exercised for the duration of the study (91 days). Clinical, radiographic, nuclear scintigraphic, computed tomographic and magnetic resonance imaging (MRI) examinations were performed and outcomes of these were...
Evaluation of technetium Tc 99m-labeled biotin for scintigraphic detection of soft tissue inflammation in horses. To evaluate the use of technetium Tc 99m-labeled EDTA-biotin monomer ((99m)Tc-EB1) as a scintigraphic imaging agent for soft tissue inflammatory lesions in horses. Methods: 6 healthy adult horses. Methods: First (phase 1), the agent's safety and blood-tissue clearance and an appropriate imaging protocol were determined in 6 horses. Each horse was injected with (99m)Tc-EB1 (1.1 GBq, IV, once); images were acquired at intervals during the following 24-hour period. Subsequently (phase 2), inflammation was induced via injection of 200 mg (10 mL) of mepivacaine (0.4 mg/kg) into the right neck muscu...
Radiographic, scintigraphic and magnetic resonance imaging findings in the palmar processes of the distal phalanx. Increased radiopharmaceutical uptake (IRU) in the palmar processes of the distal phalanx is recognised but its clinical significance has not been established. Objective: To investigate the relationship between radiographic, scintigraphic and MRI findings in the palmar processes of the distal phalanx. Objective: Increased radiopharmaceutical uptake in the palmar processes of the distal phalanx is associated with MRI abnormalities; IRU and MRI abnormalities are over-represented in lame limbs. Methods: Clinical data, radiographic, scintigraphic and MRI findings of 258 horses with unilateral or bi...
Retrospective study of the effect of intra-articular treatment of osteoarthritis of the distal tarsal joints in 51 horses. Osteoarthritis of the distal tarsal joints, affecting the centrodistal and tarsometatarsal joints, is a common cause of hindlimb lameness in horses. This paper describes the outcome of the intra-articular treatment of 51 horses with the condition with either methylprednisolone acetate (mpa) or triamcinolone acetonide (tr), either with or without hyaluronic acid (ha). The outcome was assessed in terms of the changes in the horses' grade of lameness. Follow-up information was obtained from the owners by means of a telephone questionnaire. Horses treated once with mpa or tr, either with or withou...
Diagnostic imaging of the equine tarsal region using radiography and ultrasonography. Part 1: the soft tissues. The equine tarsus is the most commonly affected hindlimb region associated with lameness. Diagnostic imaging is routinely applied but because of its complexity, being composed of 10 multifaceted bones and different joints, multiple ligaments, tendons and bursae, imaging this region can be a challenge. This is the first part of a two-part review of the structures and disorders of the equine tarsus. It describes the principal disorders affecting the soft tissues of the tarsal region and addresses some of the technical aspects in taking radiographic, ultrasonographic and scintigraphic images of t...
Diagnostic imaging of the equine tarsal region using radiography and ultrasonography. Part 2: bony disorders. This is the second part of a two-part review of the structures and disorders of the equine tarsus. In this part the bones of the tarsal region are considered and the technical aspects of taking radiographic, ultrasonographic and scintigraphic images of the different lesions are addressed. The diagnostic use of arthroscopy, computed tomography and magnetic resonance are discussed. In current clinical practice the most frequently used combination to arrive at a diagnosis is still radiography and ultrasonography.
Decreased radiopharmaceutical uptake (photopenia) in delayed phase scintigraphic images in three horses. Decreased radiopharmaceutical uptake, photopenia, in delayed phase scintigraphic images is recognized in people but has only been reported rarely in horses. We describe three horses with septic osteitis, bone sequestrum formation, or distal limb thrombosis that had photopenia of the affected extremity. Photopenia may indicate the presence of ischemia and can be used to facilitate clinical decision making and prognosis assessment
Focal increased radiopharmaceutical uptake in the dorsoproximal diaphyseal region of the equine proximal phalanx. The aims of this study were to establish the frequency of occurrence, intensity and symmetry of focal increased radiopharmaceutical uptake in the dorsoproximal aspect of the diaphysis of the proximal phalanx; to determine if this focal increased radiopharmaceutical uptake was related to age, height, gender, breed, bodyweight, or discipline of the horse, and if there was any relationship with lameness. Scintigraphic images from 690 horses were analyzed subjectively and objectively. Age, breed, discipline, height, weight, gender, and lame limb(s) or reasons for presentation were recorded for all...
Verification of scintigraphic imaging for injury diagnosis in 264 horses with foot pain. Nuclear scintigraphy is commonly used as a diagnostic aid for foot pain, but there is limited information about different patterns of radiopharmaceutical uptake (RU) and their correlation with the results of other imaging modalities. Objective: To describe patterns of RU in horses with foot pain. Methods: Scintigraphic images of the feet of 264 horses with front foot pain were analysed subjectively and using region of interest analysis. Magnetic resonance images of all feet were analysed prospectively; the navicular bones were reassessed retrospectively and assigned a grade. A Spearman rank co...
Use of concurrent scintigraphic and magnetic resonance imaging evaluation to improve understanding of the pathogenesis of injury of the podotrochlear apparatus. Use of physiological methods of diagnostic imaging could provide insight into the pathogenesis of foot pain in live horses. Objective: To describe patterns and intensity of increased radiopharmaceutical uptake (IRU) in the navicular bone, and relate this to distribution and types of signal intensity change in the navicular bone and to the presence or absence of lesions of the related soft tissue structures detected using MRI. Methods: Scintigraphic and MR images of 264 horses with unilateral or bilateral foot pain were analysed and graded. A Spearman rank correlation was used to test for relat...
Scintigraphic evaluation of the stifle in normal horses and horses with forelimb lameness. We tested the hypotheses that mature horses without lameness have a repeatable radiopharmaceutical uptake pattern in the stifle, which is bilaterally symmetric; immature horses have a different radiopharmaceutical uptake pattern; and forelimb lameness alters the radiopharmaceutical uptake pattern in the stifle. The objectives of the study were to describe the normal radiopharmaceutical uptake patterns using region of interest (ROI) analysis; to compare uptake patterns between left and right stifles of the same horse and between mature and immature horses; to compare radiopharmaceutical uptake ...
Exposure of veterinary personnel to ionising radiation during bone scanning of horses by nuclear scintigraphy with 99mtechnetium methylene diphosphonate. The aim of this study was to compare the radiation doses received by the personnel drawing up and injecting the radiopharmaceutical and operating the nuclear scintigraphy equipment, and those restraining nine horses while they were being scanned during scintigraphic investigations of lameness. Sensitive electronic dosimeters were worn by the personnel and the doses they received during the administration of the radiopharmaceutical and during the period of image acquisition were recorded at intervals. On average, 90 per cent of the total doses were received during the period of image acquisitio...
Scintigraphic examination of the cartilages of the foot. Radiographic examination of the cartilages of the foot is well documented; however, there is limited information about their scintigraphic assessment. Objective: To evaluate the scintigraphic appearance of the cartilages of the foot using subjective and quantitative image analysis and to correlate radiographic and scintigraphic findings. Objective: An ossified cartilage would have similar radiopharmaceutical uptake (RU) to the ipsilateral aspect of the distal phalanx; RU would extend throughout the length of the ossified cartilage; a separate centre of ossification (SCO) would be identified on...
Efficacy of tiludronate in the treatment of horses with signs of pain associated with osteoarthritic lesions of the thoracolumbar vertebral column. To evaluate the efficacy of tiludronate for the treatment of horses with signs of pain associated with lesions of the thoracolumbar vertebral column. Methods: 29 horses with clinical manifestations of pain associated with lesions of the thoracolumbar vertebral column and abnormal radiographic findings indicative of osteoarthritis of the articular processes-synovial intervertebral joints. Methods: Horses were initially examined in accordance with a standardized protocol, which included radiographic, ultrasonographic, and scintigraphic examinations. Fifteen horses were randomly assigned to recei...
Scintigraphic evaluation of the proximal metacarpal and metatarsal regions of horses with proximal suspensory desmitis. The aim of the study was to characterize radiopharmaceutical uptake patterns in horses with clinical and ultrasonographic evidence of proximal suspensory desmitis. It was hypothesized that radiopharmaceutical uptake in the proximal palmar (plantar) aspect of the third metacarpal (metatarsal) bone would be greater in lame limbs of horses with proximal suspensory desmitis than in sound limbs and that there would be a positive correlation between the severity of ultrasonographic abnormalities and the degree of radiopharmaceutical uptake. Nuclear scintigraphic evaluation of the proximal metacarpal...
Technetium-99m-HDP uptake characteristics in equine fractures: a retrospective study. Bone scintigraphy is a very sensitive diagnostic tool to detect elevated bone metabolism. In cases of fractures and fissure fractures, the radiopharmaceutical uptake in the bone is said to be increased within a few hours after the injury. In this retrospective study, the scintigraphic uptake characteristics at the fracture site of 36 horses with radiographically confirmed fractures or fissure fractures were evaluated. Uptake ratios between the fracture region and adjacent normal bone or soft tissue activity respectively were calculated and compared to different anamnestic and radiographic data...
Scintigraphic evaluation of the proximal metacarpal and metatarsal regions in clinically sound horses. In recent years, pain arising from the proximal metacarpal and metatarsal regions has become well recognized as a cause of lameness and various disease entities have been identified. However, our knowledge of normal patterns of radiopharmaceutical uptake is limited, making interpretation of images problematic. It is therefore important to characterize normal patterns of radiopharmaceutical uptake at specific sites to ensure valid interpretation of images in clinical cases with subtle lesions. The purpose of this study was to describe the pattern of radiopharmaceutical uptake in the proximal me...
Histomorphologic evaluation of extracorporeal shock wave therapy of the fourth metatarsal bone and the origin of the suspensory ligament in horses without lameness. To determine via histologic examination and scintigraphy the effect of focused extracorporeal shock wave therapy (ESWT) on normal bone and the bone-ligament interface in horses. Methods: 6 horses without lameness. Methods: Origins of the suspensory ligament at the metacarpus (35-mm probe depth) and fourth metatarsal bone (5-mm probe depth) were treated twice (days 0 and 16) with 2,000 shocks (energy flux density, 0.15 mJ/mm2). One forelimb and 1 hind limb were randomly treated, and the contralateral limbs served as nontreated controls. Bone scans were performed on days -1 (before ESWT), 3, 16,...
Imaging features of discospondylitis in two horses. Two horses with discospondylitis are described with emphasis on the imaging modalities used and their contribution to the final diagnosis and outcome. Radiographic findings were vertebral endplate lysis with sclerosis in both horses, with additional vertebral subluxation and ventral spondylosis in one horse. Ultrasonographic findings included vertebral malalignment and obliteration of the intervertebral disc by spondylotic bone in one horse and irregular endplates, a widened disc space, a hypoechoic paravertebral abscess and hypoechoic, atrophic adjacent musculature with loss of linear fiber p...
Lymphoscintigraphy of draught horses with chronic progressive lymphoedema. Early diagnosis of chronic progressive lymphoedema (CPL) may result in more effective interventions and provide a basis for further investigation of whether early diagnosis could be used as a means of eliminating potential genetic influences by cessation of breeding from affected individuals. Objective: Lymphoscintigraphy may be useful in draught horses to differentiate early lesions of CPL from other conditions in the pastern region. Methods: Forelimbs of 2 normal and 5 CPL-affected draught horses were evaluated with lymphoscintigraphy. Results: Lymphoscintigraphy showed clearly the presence ...
Use of scintigraphy for diagnosis of equine paranasal sinus disorders. To describe and analyze subjective and objective scintigraphic findings in horses with paranasal sinus disorders. Methods: Horses with suspected disorders of the paranasal sinuses or cheek teeth (n = 48) and control horses (n = 30). Methods: 99Technetium-methylenediphosphate (99Tc-MDP; 7500 MBq) was administered for scintigraphic examination of the skull. Abnormal patterns of increased radionuclide uptake (IRU) were identified and subjectively described. Scintigrams and radiographs were blindly assessed by 2 clinicians and the accuracy of the imaging modalities was compared. Objective analysis...
The role of protective lead clothing in reducing radiation exposure rates to personnel during equine bone scintigraphy. Bone scintigraphy is often used in horses because of its sensitivity and noninvasive nature. A 99mTc labeled radiopharmaceutical is injected at a dose of between 5.7 and 7.3GBq. Images are acquired immediately postinjection and 2-4h post. People are often in the room with the horse during the acquisition process. Objectives of this study were to (a) document the radiation exposure rates at different distances from various sites of the horse at varying times post injection and (b) study the usefulness of wearing lead aprons to reduce exposure rates to personnel. Radiation exposure rates were me...
Stress remodeling and stress fracture of the humerus in four standardbred racehorses. 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 wi...
Skeletal scintigraphy in the horse: current indications and validity as a diagnostic test. 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 tes...
Non-skeletal scintigraphy of the horse: indications and validity. Gamma scintigraphy is an established imaging modality in the horse and is principally utilised to investigate skeletal disease using bone-seeking radiopharmaceuticals. However, depending on the radiopharmaceutical and imaging sequence, scintigraphy can be used to investigate disease in virtually any organ system. In this article the indications and validity of scintigraphy as a clinical diagnostic tool to investigate non-skeletal disease in the horse are reviewed. These indications include: investigation of dental disease, identification of inflammatory foci, vascular lesions, muscle and tendo...