Radiographic Features of the Normal Equine Thoracolumbar Spine

The normal radiographic anatomy of the equine thoracolumbar (TL) spine is described from birth to maturity. Closure of the vertebral epiphyses was found to take place from 30 to 38 months of age. In a series of 110 normal horses, there were few incidental radiologic abnormalities seen apart from changes associated with crowding and overriding of the dorsal spinous processes. Sixty-six percent of horses were free from any detectable radiologic lesion, and an additional 12 percent showed only impingement of the dorsal tips of one or more summits. The remainder (22 percent) exhibited some evidence of overriding of the dorsal spinous processes, but in only 3 percent were the changes pronounced. This reduction or obliteration of the normal interspinous spaces occurred chiefly in the midback from T13 to T18 and was associated with pressure points between adjacent spines with local periosteal reaction and focal areas of radiolucency. The tips of the processes sometimes overlapped one another and became misshapen, presumably as a result of continued pressure from the adjacent impinging spines.     

RADIATION EXPOSURE DURING EQUINE RADIOGRAPHY

All personnel present in the X-ray examination room during equine radiography were monitored using low energy direct reading ionization chambers (pockets dosimeters) worn outside the lead apron at neck level. The individuals' task and dosimeter readings were recorded after each examination. Average doses ranged from 0 to 6 mrad per study. The greatest exposures were associated with radiography of the shoulder and averaged less than 4 mrad. The individual extending the horse's limb was at greatest risk although the individual holding the horse's halter and the one making the X-ray exposure received similar exposures.
A survey of the overhead tube assembly used for some of the X-ray examinations also was performed. Meter readings obtained indicated an asymetric dose distribution around the tube assembly, with the highest dose occurring on the side to which the exposure cord was attached.
Although the exposures observed were within acceptable limits for occupational workers, we have altered our protocol and no longer radiograph the equine shoulder unless the horse is anesthetized. Continued use of the pocket dosimeters and maintenance of a case record of radiation exposure appears to make the technologists more aware of radiation hazards.     

COMPARISON OF FLAT-PANEL DIGITAL TO CONVENTIONAL FILM-SCREEN RADIOGRAPHY IN DETECTION OF EXPERIMENTALLY CREATED LESIONS OF THE EQUINE THIRD METACARPAL BONE

Radiographic diagnosis of equine bone disease using digital radiography is prevalent in veterinary practice. However, the diagnostic quality of digital vs. conventional radiography has not been compared systematically. We hypothesized that digital radiography would be superior to film-screen radiography for detection of subtle lesions of the equine third metacarpal bone. Twenty-four third metacarpal bones were collected from horses euthanized for reasons other than orthopedic disease. Bones were dissected free of soft tissue and computed tomography was performed to ensure that no osseous abnormalities were present. Subtle osseous lesions were produced in the dorsal cortex of the third metacarpal bones, and the bones were radiographed in a soft tissue phantom using indirect digital and conventional radiography at standard exposures. Digital radiographs were printed onto film. Three Diplomates of the American College of Veterinary Radiology evaluated the radiographs for the presence or absence of a lesion. Receiver operator characteristic curves were constructed, and the area under these curves were compared to assess the ability of the digital and film-screen radiographic systems to detect lesions. The area under the ROC curves for film-screen and digital radiography were 0.87 and 0.90, respectively ( P =0.59). We concluded that the digital radiographic system was comparable to the film-screen system for detection of subtle lesions of the equine third metacarpal bone.     

COMPARISON OF COMPUTED RADIOGRAPHY AND CONVENTIONAL FILM-SCREEN RADIOGRAPHY OF THE EQUINE STIFLE

Major advantages of computed radiography are the potential reduction of dose and the possibility of postprocessing. In our study, we compared conventional radiographs to digital radiographs of the equine stifle by subjective evaluation of diagnostic quality when using a decreasing photon flux (mAs). Twelve equine stifle joints from horses of different weight and size were examined. Conventional and digital radiographs were performed identically in a caudocranial projection with the tube angled 15 degrees. A series of four radiographs was performed in each technique with an increasing photon flux starting with 2.5 mAs and going up to 5, 10, and 20 mAs. All radiographs were evaluated subjectively in a blinded fashion by seven readers in terms of contrast, bone structure, and diagnostic value and were graded using a 1-5 scale. Results from conventional and digitized radiographs were compared, and differences between the individual observers were analyzed statistically. Contrast, bone structure, and diagnostic value from digital images were rated significantly better than from conventional images (p < .001). For both techniques, a decrease in ranking was found with a decrease of photon flux. There was only slight interobserver variability. A dose reduction up to a factor of 4 compared to a 100 speed film-screen system seems to be possible without loss of information. Weight and size of the horse are not major influences.     

THE DORSOPROXIMAL-DORSODISTAL PROJECTION OF THE DISTAL CARPAL BONES IN HORSES: AN EVALUATION OF DIFFERENT BEAM-CASSETTE ANGLES

To estimate the extent of the third carpal bone (C3) visible for evaluation in the dorsoproximal-dorsodistal oblique projection of the distal row of carpal bones, 13 forelimbs collected at post mortem from 7 horses were examined radiographically. The limbs were frozen with the carpal joints flexed then radiographed using fixed beam-cassette angles of 15 degrees to 45 degrees, at 5 degree intervals. The influence of beam-cassette angle on; the depth of the proximal articular surface examined, the radiographic appearance of C3 and the assessment of subchondral sclerosis was evaluated. Beam-cassette angles of 25 degrees to 40 degrees produced subjectively acceptable radiographs and did not appear to influence assessments of sclerosis. The mean depth of the examined proximal articular surface of the C3 increased significantly with each 5 degree increase in beam-cassette angle up to 40 degrees. The use of beam-cassette angles >35 degrees is recommended for the DPr-DDiO projection.     

HEMANGIOMA OF THE DISTAL PHALANX IN A COLT

A yearling Thoroughbred colt was admitted to the University of Florida College of Veterinary Medicine with severe, progressive lameness of the left forelimb. A centrally located expansile lytic lesion involving approximately 40% of the distal phalanx with a large associated vascular channel was identified by radiography. Increased vascular phase pooling, increased soft tissue phase uptake, and a photopenic area on bone phase images corresponding to the lytic lesion within the left distal phalanx were identified by vascular, soft tissue, and bone phases of a three phase bone scan, respectively. Contrast medium accumulation and disappearance in dilated vessels within the lesion was apparent angiographically. The colt was euthanized and the histologic diagnosis was hemangioma of the distal phalanx with a pathologic fracture.     

A pilot study of the effects of acupuncture treatment on objective and subjective gait parameters in horses

Objectives

To investigate whether acupuncture can alter gait in horses as assessed by objective and subjective parameters.

MAGNETIC RESONANCE IMAGING OF THE EQUINE DIGIT WITH CHRONIC LAMINITIS

Chronic laminitis is a severe disease affecting the equine digit. It was hypothesized that magnetic resonance (MR) imaging would improve visualization of structures within the foot and pathology associated with chronic laminitis. This study aimed to describe the MR imaging findings in chronic laminitis, compare different pulse sequences for visualization of pathology, and to compare MR imaging with standard radiography. Twenty (10 forelimb, 10 hindlimb) cadaver limbs from 10 horses clinically diagnosed with chronic laminitis (group L) and 10 limbs without laminitis (group N) were used. Lateromedial radiographs and sagittal and transverse MR images of the foot were obtained. Radiographs and MR images were evaluated for anatomic definition and evidence of pathology. Dorsal hoof wall thickness and angle of rotation and displacement distance of the distal phalanx were measured. Comparisons were made between group L and N, forelimb and hindlimb within each horse, and MR imaging and radiography. Features consistently noted with MR images in group L, but not detected using radiography, included laminar disruption, circumscribed areas of laminar gas, laminar fluid, and bone medullary fluid. Other findings seen only on MR images included increased size and number of vascular channels, alterations in the corium coronae, and distal interphalangeal joint distension. Magnetic resonance imaging allowed better definition of laminar gas lines and P3 surface irregularity observed on radiographs. Based on measurements, group L had a greater angle of rotation, distal displacement, and dorsal hoof wall thickness than group N; forelimb hoof wall thickness was greater than hindlimb; and distal displacement and hoof wall thickness measurements were smaller using MR imaging than radiography, but had a similar pattern. It is concluded that there are features of chronic laminitis consistently observed using MR imaging and that these may be additional to features observed radiographically.     

RADIOGRAPHY AND COMPUTED TOMOGRAPHY IN THE DIAGNOSIS OF NONNEOPLASTIC EQUINE MANDIBULAR DISEASE

We compared the information gained from computed tomography (CT) vs. radiography in horses with nonneoplastic disease of the mandible. We hypothesized that CT would provide additional diagnostic information. Medical records, radiographs, and CT images of horses with nonneoplastic mandibular disease evaluated between 1994 and 2008 were reviewed. Nineteen horses were identified; 11 had a tooth root abscess and related disease, four had a fracture of the teeth and/or mandible, and four had a nonneoplastic mass. Both CT images and radiographs allowed identification of diseased teeth that appeared clinically normal otherwise. CT allowed identification of teeth that were clinically affected but appeared normal radiographically. Parameters such as tooth pulp involvement, lamina dura destruction, presence of bone fragments, lingual and buccal mandibular bone periosteal reaction, and cortical bone destruction were more conspicuous with CT. Performing radiography and CT in horses with nonneoplastic mandibular disease provides a more complete evaluation than either technique alone. CT contributes additional information that could otherwise be overlooked with radiographs alone in horses with a mandibular fracture. CT provides ancillary information to radiographs in horses with dental infection or a nonneoplastic mass of the mandible.     

RADIOGRAPHIC CHARACTERISTICS OF THE FORELIMB DISTAL PHALANX AND MICROSCOPIC MORPHOLOGY OF THE LATERAL PALMAR PROCESS IN FOALS 3–32 WEEKS OLD

Developmental morphology of the forelimb distal phalanges and lateral palmar processes of 9 Thoroughbred foals aged 3–32 weeks was assessed using radiography, microradiography and histology. For inclusion in the study, all distal phalanges had no pathologic radiographic abnormalities.
Vascular channels that are characteristically found in the dorsal region of the distal phalanx were not evident radiographically in the palmar process. The proximal and distal angles of the palmar processes were separated by a lucent line continuous with the incisure in foals only through 12 weeks of age. The distal phalanges were triangular-shaped in foals 3–12 weeks of age, and were oval-shaped in older foals.
The palmar aspect of the distal phalanx was the major contributor to growth of the distal phalanx in the sagittal plane, especially between 3 and 12 weeks of age. Growth of the lateral palmar process occurred through the means of endochondral ossification. The body and cortices of the lateral palmar process were composed of coarse cancellous bone. Porosity within the lateral palmar process was greater in regions sampled axial, compared to abaxial, to the parietal sulcus and did not change with age.
A fracture was identified microradiographically and/or histologically in 9 of 18 (50%) and 10 of 17 (59%), respectively, of the lateral palmar processes examined. The fracture line was consistently associated with the parietal sulcus on the dorsal cortical surface and was always immediately abaxial to the deep digital flexor tendon attachment. No age-related morphological changes of the lateral palmar processes were identified with microradiography or histological examinations.