Standing magnetic resonance imaging detection of bone marrow oedema-type signal pattern associated with subcarpal pain in 8 racehorses: a prospective study.
Abstract: The proximal metacarpal region is a common site of origin of lameness in the performance horse. A number of disease entities are recognised as causes of proximal metacarpal lameness but a definitive diagnosis is often elusive. Magnetic resonance imaging (MRI) is hypothesised to offer advantages over traditional imaging modalities in the investigation of proximal metacarpal pain. Objective: To describe clinical and imaging features of cases of lameness in racehorses arising from the proximal metacarpal region in which standing MRI identified 'bone marrow oedema-type' (BMO-type) signal patterns. Methods: Records for all horses undergoing standing MRI of the proximal metacarpus/distal carpus from September 2006 to December 2008 were reviewed. Cases underwent a standardised protocol for diagnostic analgesia, radiography and ultrasonography of the proximal metacarpus and distal carpus. Cases with proximal metacarpal lameness displaying a characteristic BMO-type signal pattern on MRI were identified and outcomes analysed. Results: Eight cases were identified with characteristic MRI findings of extensive hyperintensity on T2* gradient echo and short tau inversion fast spin echo sequences and corresponding hypointensity on T1 gradient echo images within the palmaroproximal aspect of the third metacarpal bone. Follow-up information was available for all cases; at the time of writing 7/8 had returned to full work and were free from lameness. Conclusions: The BMO-type signal patterns visible on MR images in these cases may signal the existence of a previously under-diagnosed pathological process associated with proximal metacarpal lameness in racehorses. This finding is postulated to be associated with a stress reaction and possible prodromal stress fracture of the palmaroproximal metacarpus not appreciable radiographically or ultrasonographically. Conclusions: MRI of the proximal metacarpal region permits detection of pathological processes, which may elude conventional imaging and, therefore, has important therapeutic and prognostic implications in these cases.
Publication Date: 2010-02-04 PubMed ID: 20121907DOI: 10.2746/042516409X471467Google Scholar: Lookup
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- Journal Article
Summary
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The researchers in this study used magnetic resonance imaging (MRI) to identify ‘bone marrow oedema-type’ (BMO-type) signals associated with pain in the proximal metacarpal region of racehorses. This technology revealed potential cases of a previously under-diagnosed condition which could have important therapeutic implications.
Research Methodology
- The research was based on an examination of records from all horses that had undergone MRI of the proximal metacarpus/distal carpus region between September 2006 to December 2008.
- A standardised protocol was used for the application of diagnostic analgesia, radiography and ultrasonography in this region.
- The researchers were specifically looking for cases displaying the characteristic BMO-type signal pattern related to lameness in the proximal metacarpal region.
Findings
- Eight cases of racehorses were found that exhibited extensive hyperintensity on T2* gradient echo and short tau inversion fast spin echo sequences and hypointensity on T1 gradient echo images within the palmaroproximal aspect of third metacarpal bone.
- The researchers consider these BMO-type signals in the MRI images to represent a previously under-diagnosed pathological process linked to lameness arising from the proximal metacarpal region in racehorses.
- The findings are strongly suggested to be linked to stress reactions and a possible pre-injury stage (prodromal) stress fracture of the palmaroproximal metacarpus that is not easily visually detected or appreciated using traditional radiography or ultrasonography.
Outcome
- Follow-up information was available for all the eight cases studied, seven of which had returned to full work and were free from lameness at the time of writing.
Conclusion
- The researchers concluded that MRI permits the detection of pathological processes linked to proximal metacarpal lameness which could potentially go undetected using traditional imaging techniques. This finding has important therapeutic and prognostic implications especially in the medical management of sport horses.
Cite This Article
APA
Powell SE, Ramzan PH, Head MJ, Shepherd MC, Baldwin GI, Steven WN.
(2010).
Standing magnetic resonance imaging detection of bone marrow oedema-type signal pattern associated with subcarpal pain in 8 racehorses: a prospective study.
Equine Vet J, 42(1), 10-17.
https://doi.org/10.2746/042516409X471467 Publication
Researcher Affiliations
- Rossdales Equine Diagnostic Centre, Cotton End Road, Exning, Suffolk CB8 7NN, UK.
MeSH Terms
- Animals
- Bone Marrow Diseases / diagnostic imaging
- Bone Marrow Diseases / veterinary
- Edema / diagnostic imaging
- Edema / veterinary
- Female
- Horse Diseases / diagnostic imaging
- Horses
- Lameness, Animal / diagnosis
- Lameness, Animal / diagnostic imaging
- Magnetic Resonance Imaging / veterinary
- Male
- Pain / diagnosis
- Pain / veterinary
- Prospective Studies
- Radiography
Citations
This article has been cited 10 times.- Nahas AE, Hagag U. Magnetic resonance imaging of the dromedary camel carpus. BMC Vet Res 2024 Sep 6;20(1):394.
- van Veggel ECS, Vanderperren K, Selberg KT, Bergman HJ, Hoogelander B. The Evolution of Lesions on Follow-Up Magnetic Resonance Imaging of the Proximal Metacarpal Region in Non-Racing Sport Horses That Returned to Work (2015-2023). Animals (Basel) 2024 Jun 8;14(12).
- Daniel CR, Taylor SE, McPhee S, Wolfram U, Schwarz T, Sommer S, Kershaw LE. Relationship between CT-Derived Bone Mineral Density and UTE-MR-Derived Porosity Index in Equine Third Metacarpal and Metatarsal Bones. Animals (Basel) 2023 Aug 31;13(17).
- Stewart HL, Easley JT, Selberg KT, Puttlitz CM, Nakamura LK, Johnson JW, Kawcak CE. Experimental models of bone marrow lesions in ovine femoral condyles. Vet Surg 2023 Feb;52(2):284-298.
- van Veggel E, Selberg K, van der Velde-Hoogelander B, Bolas N, Vanderperren K, Bergman HJ. Magnetic Resonance Imaging Findings of the Proximal Metacarpal Region in Warmblood Horses: 36 Lame and 26 Control Limbs (2015-2021). Front Vet Sci 2021;8:714423.
- Brown HR, Peloso JG, Werner WC, Mecholsky JJ, Cohen ND, Vogler JB. A Thoroughbred racehorse with a unicortical palmar lateral condylar fracture returned to training 14 days after surgery: a hypothesis on the role of a single bone screw on crack propagation. J Equine Sci 2019 Mar;30(1):7-12.
- Mizobe F, Nomura M, Ueno T, Yamada K. Bone marrow oedema-type signal in the proximal phalanx of Thoroughbred racehorses. J Vet Med Sci 2019 Apr 16;81(4):593-597.
- Yamada K, Inui T, Itoh M, Yanagawa M, Sato F, Tominari M, Mizobe F, Kishimoto M, Sasaki N. Characteristic findings of magnetic resonance imaging (MRI) and computed tomography (CT) for severe chronic laminitis in a Thoroughbred horse. J Equine Sci 2017;28(3):105-110.
- Mizobe F, Nomura M, Kato T, Nambo Y, Yamada K. Signal changes in standing magnetic resonance imaging of osseous injury at the origin of the suspensory ligament in four Thoroughbred racehorses under tiludronic acid treatment. J Equine Sci 2017;28(3):87-97.
- MacEoin F, Robinson P. Repetitive stress-related injury of the proximal metacarpus in a seven-year old Thoroughbred racehorse with emphasis on diagnostic analgesia of the proximopalmar metacarpus. Ir Vet J 2014;67(1):26.
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