The role of scintigraphy in the lameness evaluation.
Abstract: Bone scanning to help diagnose orthopedic disease has been used in human patients for over two decades. The value of this diagnostic tool has been well established in helping to identify a variety of musculoskeletal conditions. It has only recently been used by veterinarians for more accurate characterization of equine musculoskeletal disease. The technique offers the major advantage of increased sensitivity over standard radiographic imaging. The case material illustrated here shows that except for consistent identification of bone cysts, most of the pathologic changes to the horse's musculoskeletal system that might cause lameness are detected on bone scans. Many acute bone diseases can be diagnosed by scintigraphy that cannot be discerned by radiographs until the condition has become chronic: Because of their body size, these conditions may not be diagnosed at all in horses. Scintigraphy in horses offers the other major advantage of affording accurate imaging of the upper limbs, pelvis, and vertebral column without general anesthesia. Therefore, it has a final advantage of increased safety over conventional radiography because it eliminates the need to perform general anesthesia to study these areas. In the author's experience, if abnormal uptake of isotope in the upper limbs, pelvis or spine is not observed, general anesthesia to radiograph those areas is not warranted. A second major benefit of scintigraphic imaging is to differentiate mixed lameness conditions in which the component of bone disease must be separated from that of soft tissues to arrive at a rational course of treatment or prognosis. Finally, for athletic horses suspected of having lameness due to localized myositis, scintigraphy not only allows confirmation of muscle inflammation but also identifies the muscle bellies injured reasonably accurately so that specific local treatment may be given. Nuclear imaging of equine skeletal disease is an option that should be employed more frequently by equine practitioners for diagnosis of difficult lameness cases. The technique is safe and comparatively inexpensive when one considers the total expense of multiple examinations or radiographic surveys of patients without conclusively diagnosing the source or sources of skeletal pain. This is particularly true when a horse owner becomes dissatisfied and enlists the services of one or more other veterinarians. The equine specialist will maintain better client rapport if he or she suggests referral of the horse to a veterinary medical teaching center or private clinic where scintigraphic imaging can be done rather than having the client become frustrated and seek another opinion elsewhere.(ABSTRACT TRUNCATED AT 400 WORDS)
Publication Date: 1991-08-01 PubMed ID: 1933561DOI: 10.1016/s0749-0739(17)30498-4Google Scholar: Lookup
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Summary
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This research article explores the use of bone scanning, also known as scintigraphy, in accurately identifying and diagnosing orthopedic diseases in horses. The use of this diagnostic tool significantly enhances the sensitivity of detection over standard radiographic imaging, thus providing a more effective and safer method of diagnosing these conditions.
Role and Benefits of Scintigraphy
- The paper discusses how scintigraphy, a radioactive diagnostic test, has been a well-established tool in detecting various musculoskeletal conditions in humans over the past two decades. The same is now being utilized by vets to identify potential issues in horses, providing an improved and more precise understanding of equine musculoskeletal diseases.
- The method offers increased sensitivity when compared to standard radiographic imaging, thus it is able to detect changes in the horse’s musculoskeletal system that might result in lameness, except for bone cysts.
- Scintigraphy can diagnose many acute bone diseases not discernable by radiographs until they have progressed to a chronic stage. Given the size of horses, some of these conditions may not be diagnosed at all.
Increased Safety and Accuracy
- Scintigraphy not only provides a safer alternative to traditional radiography but it also allows for the accurate imaging of the upper limbs, pelvis, and vertebral column without general anesthesia. This additional level of safety arises from the fact that it removes the need for the horse to be anesthetized for these regions to be studied.
- If no abnormal isotope uptake is seen in these areas, the paper suggests that putting the horse under general anesthesia for radiographs is not necessary. This reduces unnecessary risk exposure to general anesthesia.
Differentiation and Specific Treatment
- Scintigraphy can help separate bone disease from soft tissue conditions in mixed lameness situations. This helps determine an appropriate treatment strategy or prognosis.
- For athletic horses potentially suffering from lameness due to localized myositis, scintigraphy can confirm muscle inflammation, accurately identify the injured muscle bellies, and assist in providing specific treatment to those areas.
Cost-Effective and Client Friendly
- As per the author’s experience, despite seeming costly upfront, scintigraphy provides a cost-effective technique when compared to the overall expenses encountered in multiple tests or radiographic surveys without conclusive diagnosis.
- It appeases the client as it reduces uncertainty and reassurance in cases where the horse owner may be dissatisfied and seek more opinions from other vets.
- Utilizing scintigraphy can maintain better client rapport as the specialist would be able to suggest the patient for referral to a proper veterinary center, preventing frustration and the seeking out of alternative opinions elsewhere.
Cite This Article
APA
Steckel RR.
(1991).
The role of scintigraphy in the lameness evaluation.
Vet Clin North Am Equine Pract, 7(2), 207-239.
https://doi.org/10.1016/s0749-0739(17)30498-4 Publication
Researcher Affiliations
- Department of Clinical and Population Sciences, University of Minnesota College of Veterinary Medicine, St. Paul.
MeSH Terms
- Animals
- Bone and Bones / diagnostic imaging
- Extremities / diagnostic imaging
- Horse Diseases / diagnostic imaging
- Horses
- Lameness, Animal / diagnostic imaging
- Radionuclide Imaging
References
This article includes 59 references
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