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Walter LJ, Stack JD, Winderickx K, Davies HMS, Simon O, Franklin SH. Review of the clinical diagnosis of sacroiliac dysfunction in horses - Challenges and limitations. Vet J 2024; 305:106106. [PMID: 38556191 DOI: 10.1016/j.tvjl.2024.106106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/06/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
Sacroiliac dysfunction (SID) is a condition seen in horses associated with poor performance that affects hind limb gait and impulsion. The condition comprises pain and dysfunction but there lacks clarity around the aetiopathogenesis and whether SID encompasses abnormal joint pathology, abnormal joint movement, abnormal regional biomechanical function, joint laxity and pain, or various combinations of these that may vary over time. Clinical assessment remains challenging for equine clinicians due to the deep location of the sacroiliac joint (SIJ) and surrounding structures which limits access for palpation, diagnostic imaging and joint-specific injection. There is no recognised single reference standard diagnostic test for SID. Clinical diagnosis has been based on ruling out other causes of hind limb lameness, along with combinations of ultrasonography, scintigraphy and periarticular anaesthesia of the SIJ. Recent studies have highlighted the lack of specificity of injections targeting the SIJ, with significant dispersal of injectate into surrounding structures including around the lumbosacral joint (LSJ). Advanced imaging modalities such as computed tomography offers promise for assessment of the structure and pathology of the SIJ and surrounding bony structures. However, there is a need to improve the understanding of the significance of anatomic variation of the sacroiliac region structures, with recent studies reporting detailed anatomic variation in groups of horses with and without SID. There are also limitations around functional assessment of the joint which is still largely reliant on a thorough clinical examination. This review aims to present an update on clinical approaches to the diagnosis of horses with SID, and to consider the challenges and limitations.
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Affiliation(s)
- L J Walter
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, 5371 SA, Australia.
| | - J D Stack
- Phillip Leverhulme Equine Hospital, Department of Equine Clinical Science, University of Liverpool, Wirral CH64 7TE, UK
| | - K Winderickx
- Lingehoeve Diergeneeskunde, Veldstraat 3a, Lienden 4033 AK, the Netherlands
| | - H M S Davies
- Department of Veterinary BioSciences, University of Melbourne, Parkville, VIC 3010, Australia
| | - O Simon
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, 5371 SA, Australia
| | - S H Franklin
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, 5371 SA, Australia
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Pallesen K, Gebara K, Hopster‐Iversen C, Berg LC. Development of an equine muscle condition score. EQUINE VET EDUC 2023. [DOI: 10.1111/eve.13777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- Kristine Pallesen
- Department of Veterinary Clinical Sciences University of Copenhagen Taastrup Denmark
| | - Katia Gebara
- Department of Veterinary Clinical Sciences University of Copenhagen Taastrup Denmark
| | | | - Lise C. Berg
- Department of Veterinary Clinical Sciences University of Copenhagen Taastrup Denmark
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Ellis KL, Seabaugh K, King MR. Retrospective analysis of horses with ultrasound evaluation of the sacroiliac region and response to local corticosteroid injection: 42 cases. J Equine Vet Sci 2021; 102:103634. [PMID: 34119197 DOI: 10.1016/j.jevs.2021.103634] [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: 11/27/2020] [Revised: 03/22/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
Local injection of corticosteroids is commonly performed in horses with sacroiliac (SI) region pain and/or dysfunction, ,and ultrasound findings of normal horses and those with SI pain have also been well described. However, no studies have been performed that have evaluated if ultrasound findings, injection technique, or medications injected affect prognosis for return to function. The objectives of the current study are to determine if findings on ultrasound, injection technique, or medications injected are predictive of return to function in horses with SI region pain and/or dysfunction. Medical records were evaluated for horses that had ultrasound exam of the SI region as well as local injection with corticosteroids. A client survey was sent to determine the horse's return to performance. Logistic regression was performed to determine which variables were predictive of horses with SI pain and/or dysfunction returning to performance. A return to the same or higher level of work was found in 26 of 42 (62%) of horses after SI injections, 4 of 42 (10%) of horses returned to a lower level of work, and 12 of 42 (28%) did not return to work at any level. Horses that were injected with methylprednisolone were 4.2 times more likely to return to performance than horses injected with triamcinolone. Factors evaluated on ultrasound of the SI region did not predict whether a horse would return to performance following SI region injection.
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Affiliation(s)
- Katherine L Ellis
- Department of Clinical Sciences, Gail Holmes Equine Orthopedic Research Center, Colorado State University, Fort Collins, CO; Department of Clinical Sciences, Colorado State University, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO.
| | - Kathryn Seabaugh
- Department of Clinical Sciences, Gail Holmes Equine Orthopedic Research Center, Colorado State University, Fort Collins, CO; Department of Clinical Sciences, Colorado State University, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO
| | - Melissa R King
- Department of Clinical Sciences, Gail Holmes Equine Orthopedic Research Center, Colorado State University, Fort Collins, CO; Department of Clinical Sciences, Colorado State University, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO
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Mageed M, Wegert J, Dyab S, Gerlach K. Furosemide administration onehour before bone scintigraphy examination in horses does not improve the image quality or reduce the radiation dose rate. Vet Radiol Ultrasound 2020; 62:126-132. [PMID: 33040424 DOI: 10.1111/vru.12917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 11/29/2022] Open
Abstract
This prospective, cross-sectional, pilot study aimed to investigate the effects of furosemide as a diuretic on the image quality of bone scintigraphy performed using 99m Tc-HDP and to investigate the impact of furosemide on the radiation dose rate. Thirty-one horses undergoing bone scintigraphy were included. The horses were divided into the control (n = 14) and furosemide group (n = 17), which received 1 mg/kg furosemide intravenously 1 h post 99m Tc-HDP administration. The image quality was assessed subjectively and semi-quantitatively. The bone-to-soft tissue (B:S) ratio was calculated from the counts per pixel of regions of interest (ROI) positioned over the left radial diaphysis (bone ROI) and its caudal soft tissue area (soft tissue ROI). The radiation rate dose (μSv/h) of both groups was measured at 0, 3, 6, 12, 18, and 24 h post 99m Tc-HDP administration at a distance of 0, 30, and 100 cm from the head, kidney, and pelvis. The results showed no significant differences in the B:S ratio or the radiation dose rate observed between the groups. However, the radiation dose rate decreased by 56% at 3 h post 99m Tc-HDP administration and keeping a distance of 30 cm reduced the radiation dose rate by 65%. Administering furosemide does not improve the image quality or reduce the radiation dose rate. The authors recommend commencing with bone scintigraphy 3 h post 99m Tc-HDP administration and keeping at least a distance of 30 cm from the horse to reduce the staff radiation dose.
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Affiliation(s)
- Mahmoud Mageed
- Tierklinik Lüsche GmbH, Tierklinik Lüsche GmbH, Essenerstr. 39a, Bakum, 49456, Germany
| | - Julius Wegert
- Tierklinik Lüsche GmbH, Tierklinik Lüsche GmbH, Essenerstr. 39a, Bakum, 49456, Germany
| | - Shahlaa Dyab
- Tierklinik Lüsche GmbH, Tierklinik Lüsche GmbH, Essenerstr. 39a, Bakum, 49456, Germany
| | - Kerstin Gerlach
- Departement for Horses, University of Leipzig, Leipzig, Germany
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Nagy A, Quiney L, Dyson S. Long‐term outcome of 84 horses with sacroiliac joint region pain with (n = 69) or without (n = 15) other orthopaedic problems. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. Nagy
- Animal Health Trust Centre for Equine Studies Newmarket Suffolk
| | - L. Quiney
- MV Imaging, Bellshill South Lanarkshire UK
| | - S. Dyson
- Animal Health Trust Centre for Equine Studies Newmarket Suffolk
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Wulster KB. Diagnosis of Skeletal Injury in the Sport Horse. Vet Clin North Am Equine Pract 2018; 34:193-213. [DOI: 10.1016/j.cveq.2018.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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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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Comparison of two ultrasound-guided injection techniques targeting the sacroiliac joint region in equine cadavers. Vet Comp Orthop Traumatol 2017; 29:386-93. [DOI: 10.3415/vcot-16-03-0041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 06/21/2016] [Indexed: 11/17/2022]
Abstract
Summary
Objectives: To compare the accuracy and distribution of injectate for cranial (CR) and caudomedial (CM) ultrasound-guided injections of equine sacroiliac joints.
Methods: Both sacroiliac joints from 10 lumbo sacropelvic specimens were injected using cranial parasagittal (CR; curved 18 gauge, 25 cm spinal needles) and caudomedial (CM; straight 18 gauge, 15 cm spinal needles) ultrasound-guided approaches. Injectate consisted of 4 ml iodinated contrast and 2 ml methylene blue. Computed tomo-graphical (CT) scans were performed before and after injections. Time for needle guidance and repositioning attempts were recorded. The CT sequences were analysed for accuracy and distribution of contrast.
Results: Intra-articular contrast was detected in sacroiliac joints following 15/40 injections. The CR and CM approaches deposited injectate ≤ 2 cm from sacroiliac joint margins following 17/20 and 20/20 injections, respectively. Median distance of closest contrast to the sacroiliac joint was 0.4 cm (interquartile range [IQR]: 1.5 cm) for CR approaches and 0.6 cm (IQR: 0.95 cm) for CM approaches. Cranial injections resulted in injectate contacting lumbosacral intertrans-verse joints 15/20 times. Caudomedial injections were perivascular 16/20 times.
Limitations: Safety and efficacy could not be established.
Clinical relevance: Cranial and CM ultra-sound-guided injections targeting sacroiliac joints were very accurate for periarticular injection, but accuracy was poor for intra- articular injection. Injectate was frequently found in contact with interosseous sacroiliac ligaments, as well as neurovascular and synovial structures in close vicinity of sacroiliac joints.
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9
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Dyson S. Evaluation of poor performance in competition horses: A musculoskeletal perspective. Part 2: Further investigation. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12498] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- S. Dyson
- Centre for Equine Studies; Animal Health Trust; Newmarket Suffolk UK
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Barstow A, Dyson S. Clinical features and diagnosis of sacroiliac joint region pain in 296 horses: 2004-2014. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12377] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. Barstow
- Centre for Equine Studies; Animal Health Trust; Lanwades Park, Kentford Newmarket Suffolk UK
| | - S. Dyson
- Centre for Equine Studies; Animal Health Trust; Lanwades Park, Kentford Newmarket Suffolk UK
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Sporn A, Berner D, Winter K, Mageed M, Brehm W, Gerlach K. Quantitative evaluation of bone scintigraphy of the spinous processes of the equine thoracic spine at different times after administering 99m
Tc-hydroxymethylene-diphosphonate. Vet Rec 2014; 174:505. [DOI: 10.1136/vr.102104] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- A. Sporn
- Faculty of Veterinary Medicine; University of Leipzig; Large Animal Clinic for Surgery; Leipzig Germany
| | - D. Berner
- Faculty of Veterinary Medicine; University of Leipzig; Large Animal Clinic for Surgery; Leipzig Germany
| | - K. Winter
- University of Leipzig; Translational Centre for Regenerative Medicine (TRM); Leipzig Germany
| | - M. Mageed
- Faculty of Veterinary Medicine; University of Leipzig; Large Animal Clinic for Surgery; Leipzig Germany
- Faculty of Veterinary Medicine; Department of Surgery and Anaesthesiology Khartoum; University of Khartoum; Khartoum Sudan
| | - W. Brehm
- Faculty of Veterinary Medicine; University of Leipzig; Large Animal Clinic for Surgery; Leipzig Germany
| | - K. Gerlach
- Faculty of Veterinary Medicine; University of Leipzig; Large Animal Clinic for Surgery; Leipzig Germany
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Abe T, Kearns C, Rogers B. Reliability of ultrasound-measured muscle thickness of the longissimus dorsi muscle in Thoroughbreds. COMPARATIVE EXERCISE PHYSIOLOGY 2012. [DOI: 10.3920/cep12015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to determine the reliability of B-mode ultrasound measured muscle thickness of the longissimus dorsi muscle in horses. Thirteen Thoroughbreds (5 colts, 5 fillies and 3 mares) had their muscle thickness measured by B-mode ultrasound at four sites; the longissimus dorsi (LD at 30%, 50% and 70% of back length) and extensor carpi radialis (ECR) muscle on two separate test sessions (T1 and T2). Paired t-tests revealed that there was no systematic bias in any of the muscle thickness measures. There were high intraclass correlation coefficients between the LD muscle thickness at 30, 50 and 70% of back length obtained at the T1 and T2 measurements (range: 0.95-0.98). The ECR muscle thickness was positively correlated to body weight and fat-free mass while LD muscle thickness at 50% and 70% of back length did not correlate to body dimensions. Our results suggest that ultrasound measures of muscle thickness of the LD and ECR muscles are reliable and repeatable when taken with the horse standing in a relaxed and evenly balanced position.
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Affiliation(s)
- T. Abe
- Department of Health, Exercise Science and Recreation Management, The University of Mississippi, 215 Turner Center, Oxford, MS 38677, USA
| | - C.F. Kearns
- Rutgers Equine Science Center, Rutgers, the State University of New Jersey, 57 U.S. Highway 1, New Brunswick, NJ 08850, USA
| | - B. Rogers
- Performance Genetics LLC, 400 Queensway Dr, Lexington, KY 40502, USA
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Engeli E, Haussler KK. Review of injection techniques targeting the sacroiliac region in horses. EQUINE VET EDUC 2011. [DOI: 10.1111/j.2042-3292.2011.00313.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lindner A, Signorini R, Vassallo J, Tomatis F, Flores FM, Gagliano ME, Curiotti J, Terragona E. Reproducibility and Repeatability of Equine Muscle Thickness Measurements with Ultrasound. J Equine Vet Sci 2010. [DOI: 10.1016/j.jevs.2010.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Erichsen C, Eksell P, Holm KR, Lord P, Johnston C. Relationship between scintigraphic and radiographic evaluations of spinous processes in the thoracolumbar spine in riding horses without clinical signs of back problems. Equine Vet J 2010; 36:458-65. [PMID: 15460068 DOI: 10.2746/0425164044877341] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY Radiography and scintigraphy are used to aid diagnosis of the cause of back pain, but a large variation in appearance and radiopharmaceutical uptake in fully functioning horses make diagnosis difficult. OBJECTIVES To describe the range of and compare scintigraphic and radiographic findings in the spinous processes of horses without clinical signs of back problems. METHODS Thirty-three apparently normal riding horses underwent scintigraphic and radiographic examinations of the spinous processes in the thoracolumbar spine. Scintigraphic images were evaluated in a continuous blue, green and red colour scale, and the level of radiopharmaceutical uptake in the spinous processes from T10-L2 was graded into none, mild, moderate or severe increased radiopharmaceutical uptake. Structural changes along the borders of the spinous processes and the width of the interspinous spaces from T10-L2 were recorded. RESULTS Only 7 horses had no scintigraphic or radiographic findings. Nine horses had no increased radiopharmaceutical uptake, 17 had no sclerosis, 21 had no radiolucencies and 11 had normal spacing of the spinous processes (>4 mm wide). The majority of findings in 26 horses were located from T13-18 and were mild. CONCLUSIONS The findings of a wide spectrum of scintigraphic and radiographic changes leads to the conclusion that changes within this range found in affected horses cannot be interpreted as clinically significant. POTENTIAL RELEVANCE To determine whether scintigraphy and/or radiography can be used to separate horses with back pain from horses without clinical signs, the results from this study should be compared to the scintigraphic and radiographic findings in horses with clinical signs.
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Affiliation(s)
- C Erichsen
- Department of Companion Animal Clinical Sciences, Norwegian School of Veterinary Science, 0033 Oslo, Norway
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Ultrasound-guided periarticular injections of the sacroiliac region in horses: A cadaveric study. Equine Vet J 2010; 40:160-6. [DOI: 10.2746/042516408x245252] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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GORGAS DANIELA, LUDER PATRIC, LANG JOHANN, DOHERR MARCUSG, UELTSCHI GOTTLIEB, KIRCHER PATRICK. SCINTIGRAPHIC AND RADIOGRAPHIC APPEARANCE OF THE SACROILIAC REGION IN HORSES WITH GAIT ABNORMALITIES OR POOR PERFORMANCE. Vet Radiol Ultrasound 2009; 50:208-14. [DOI: 10.1111/j.1740-8261.2009.01519.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] 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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Engeli E, Yeager AE, Erb HN, Haussler KK. ULTRASONOGRAPHIC TECHNIQUE AND NORMAL ANATOMIC FEATURES OF THE SACROILIAC REGION IN HORSES. Vet Radiol Ultrasound 2006; 47:391-403. [PMID: 16863059 DOI: 10.1111/j.1740-8261.2006.00159.x] [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: 11/30/2022] Open
Abstract
The purpose of this study was to establish the normal percutaneous ultrasonographic appearance of anatomic structures within the equine sacroiliac region. Percutaneous ultrasonography was performed in a cranial-to-caudal direction in 10 normal adult live horses. The following structures were examined in detail: supraspinous ligament, lumbar and sacral spinous processes, thoracolumbar fascia and its caudal extension, tubera sacralia, ilial wings, dorsal and lateral portions of the dorsal sacroiliac ligaments, lateral part of the sacrum, and the lateral sacral crest. After ultrasonography, all animals were euthanized and detailed dissection of the lumbosacropelvic region was performed in six horses. Four lumbosacropelvic specimens were frozen and sectioned transversely for evaluation of cross-sectional anatomy. Gross anatomic findings were correlated with ante-mortem ultrasonographic images. On percutaneous ultrasonography, all horses had tubera sacralia with a mild-to-moderate roughened surface with occasional irregular hyperechoic mineralizations located within the apophyseal cartilage of younger horses. At the level of the tuber sacrale the caudal extension of the thoracolumbar fascia joined the dorsal portion of the dorsal sacroiliac ligament and assumed two different configurations relative to the dorsal portion of the dorsal sacroiliac ligament, with the predominant configuration of the thoracolumbar fascia located medial to the dorsal portion of the dorsal sacroiliac ligament. The less frequently encountered configuration had the thoracolumbar fascia positioned dorsal to the dorsal portion of the dorsal sacroiliac ligament. Caudal to the tuber sacrale the dorsal portion of the dorsal sacroiliac ligament and thoracolumbar fascia consolidated to form a single, fused structure with a common insertion on the sacral spinous processes. A large variability in linear fiber pattern, echogenicity (small focal hypoechoic areas), ligament height, and cross-sectional measurements was identified in the fused dorsal portion of the dorsal sacroiliac ligament and thoracolumbar fascia of normal horses. Diagnosing mild-to-moderate desmitis of the fused dorsal portion of the dorsal sacroiliac ligament and thoracolumbar fascia based solely on ultrasonography may therefore be difficult. To correlate ultrasonography with histology, samples of a fused dorsal portion of the dorsal sacroiliac ligament and thoracolumbar fascia with bilateral hypoechoic lesions were submitted for histology and revealed diffuse mild-to-moderate loss of fiber density, multifocal fibrocyte degeneration, and cartilagenous metaplasia with multifocal, mild myofiber mineralization, which was compatible with age-related changes. As controls, sections of ultrasonographically normal fused dorsal portion of the dorsal sacroiliac ligament and thoracolumbar fascia from three horses demonstrated similar but milder histologic findings, which were considered normal.
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Affiliation(s)
- Emmanuel Engeli
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
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