Comparison of the use of scapular ultrasonography, physical examination, and measurement of serum biomarkers of bone turnover versus scintigraphy for detection of bone fragility syndrome in horses.

This research paper presents a comparative study outlining the effectiveness of different diagnostic methods for bone fragility syndrome (BFS) in horses. The methods compared include scintigraphy, physical examination, scapular ultrasonography and measurement of serum biomarkers. The study concludes that while scintigraphy remains the most informative technique, physical examination and scapular ultrasonography are useful in diagnosing moderate to severe cases of BFS.

Methods

• The research used a prospective case-control study design and was conducted with 48 horses, 20 of which were identified with BFS, and the remaining 28 served as control horses.
• All horses underwent a series of tests, including forelimb scintigraphic evaluation, physical examination, scapular ultrasonography and blood sample collection (for serum biomarker measurement).
• The comparing measure for the other diagnostic techniques was scintigraphy, taken as the reference standard.
• The tested serum biomarkers were carboxy-terminal telopeptide of collagen crosslinks and bone-specific alkaline phosphatase activity.

Findings

• Scintigraphy results indicating BFS were identified through the detection of at least two regions of increased radiopharmaceutical uptake, one in the scapular spine and one in the scapular body or ribs.
• Physical examination findings indicating BFS were identified by lateral bowing of the scapulae.
• Ultrasound results indicating BFS were identified by widening of the scapular spine.
• None of the tested methods was accurate enough to substitute scintigraphy for mild BFS, but physical examination and scapular ultrasonography yielded accurate results for moderate to severe BFS.
• The study found serum biomarkers weren’t accurate enough for BFS diagnosis.

Conclusions

• Despite the promising results shown by other methods in severe cases, scintigraphy remained the preferred diagnostic mode for BFS due to its ability to provide more information about the disease’s severity and spread.
• The introduction of severity indices helped categorize the entire spectrum of disease manifestations, providing significant input for examining the effectiveness of BFS treatment methodologies and assessing the progression of the disease.