Computed tomography of proximal metatarsal and concurrent third tarsal bone fractures in a Thoroughbred racehorse

A 2‐year‐old Thoroughbred filly presented to the William R. Pritchard Veterinary Medical Teaching Hospital at the University of California at Davis for whole body nuclear scintigraphic evaluation after an acute onset of nonweightbearing right hindlimb lameness post race. The use of computed tomography (CT) enabled visualisation of additional pathology that was not initially appreciable using combined imaging modalities of nuclear scintigraphy and digital radiography, which ultimately altered the selected course of treatment. Computed tomography in horses with fractures of the cuboidal bones of the hock can provide valuable additional information regarding fracture configuration and radiographically occult pathology, which may help to guide clinical decisions about treatment.     

Computed tomographic diagnosis of incomplete palmar cortical (fatigue) fracture of the third metacarpal bone in two young adult endurance horses

Two young adult endurance horses were presented for investigation of sudden-onset forelimb lameness during competition. Clinical examination revealed a severe forelimb lameness and pain on palpation of the proximal palmar metacarpal area. Initial radiographic survey of the affected forelimb was unremarkable in both cases. A week of box rest resulted in only a mild improvement in the lameness. A second radiographic examination did not reveal any significant abnormalities. In both cases, scintigraphic examination was suggested, but was declined by the owner, and the lameness had significantly improved after local infiltration of 3 mL of anaesthetic solution in the proximal suspensory region. Radiographic and ultrasonographic examinations of the carpus and proximal suspensory region were unremarkable in Case 2. Case 1 had increased thickness of the medial lobe of the proximal aspect of the suspensory ligament. A computed tomographic examination was performed and an incomplete longitudinal (fatigue) fracture of the proximal third metacarpal bone was detected. After 8 months of box rest and rehabilitation, re-examination revealed resolution of the lameness in both cases. Advanced diagnostic imaging should be considered in young endurance horses with severe lameness during competition or training, in which radiographic and ultrasonographic examinations are unremarkable or do not explain the severity of the lameness. Computed tomography imaging is considered a useful diagnostic imaging technique to detect incomplete longitudinal palmar metacarpal cortical (fatigue) fractures due to its ability to provide excellent bone detail.     

Computed tomography assisted repair of a central tarsal bone slab fracture in a horse

A 13‐year‐old Quarter Horse gelding was presented for repair of a central tarsal bone fracture. Radiographs showed a single large nondisplaced sagittal slab fracture; however, computed tomography (CT) revealed an additional small, displaced central tarsal bone fragment. The complex fracture was repaired, under the same anaesthetic period as the CT examination, using the CT hard copies images, intraoperative fluoroscopy and radiographs. The horse recovered well and after rehabilitation showed no residual lameness at work. Computed tomography was instrumental in achieving precise screw placement and successful fracture repair.     

Diffuse osteomyelitis of the fourth metacarpal bone in a horse caused by Clostridium perfringens

Osteomyelitis in adult horses, often associated with trauma or iatrogenic infection following surgery, usually presents as a focal area of infected bone. Diffuse osteomyelitis, affecting both the cortex and medulla, along the full length of a bone is encountered less frequently and treatment of such infections is not well reported in horses. The 2-year-old Warmblood mare in this case was diagnosed with diffuse osteomyelitis affecting the 4th metacarpal bone with concurrent unicortical fracture of the third metacarpal bone following traumatic injury. Computed tomography (CT) aided diagnosis in this case, providing critical additional detail to that obtained with radiography and ultrasound. This case highlights the value of CT in the diagnosis of diffuse osteomyelitis. This is the first reported case of diffuse osteomyelitis caused by Clostridium perfringens in horses. Successful treatment in this case consisted of surgical debridement of the associated abscess, followed by systemic and locoregional antimicrobial therapies.     

Musculoskeletal responses of 2-year-old Thoroughbred horses to early training. 6. Bone parameters in the third metacarpal and third metatarsal bones

AIM: To determine the effect of a known training regimen on the size and mineral content of the third metacarpal (Mc3) and third metatarsal (Mt3) bones of 2-year-old Thoroughbred horses trained on racetracks.

METHODS: Mc3 and Mt3 of seven horses trained on grass and sand tracks were scanned at several sites using conventional quantitative and peripheral computed tomography (CT). Bone dimensions and density in the diaphysis and epiphysis were compared with those from seven untrained horses. Calcein label was injected in two clusters, during Weeks 9 and 12. The extent and rate of diaphyseal modelling was determined by confocal fl uorescent microscopic examination of thin plane parallel sections of the mid-metacarpal region.

RESULTS: Volumetric bone mineral density (BMDv) of the epiphysis was markedly higher and of the diaphysis was slightly higher in trained compared with untrained horses, but greater bone size in the trained horses had the greatest effect on an index of bone strength. Active osteons, defined as Haversian systems containing calcein label, were fewer, of smaller diameter at the time of calcein injection, and had a greater bone apposition rate in trained than in untrained horses.

CONCLUSIONS: Conventional training of 2-year-old Thoroughbred racehorses over a 13-week period had a significant effect on bone size, density and strength index when compared to untrained horses.

CLINICAL RELEVANCE: Bone responded rapidly to early training. The data provide reference values and sites for use in longitudinal studies of commercial training regimens.     

Computed tomography of the upper cheek teeth in horses with infundibular changes and apical infection

Reasons for performing study: Infundibular changes are frequently encountered computed tomographic studies of the equine maxillary cheek teeth but the possible importance of this finding is not known. Infundibular caries is a possible cause for pulpitis and apical infection in some horses. Objectives: To study the relationship between the 2 pathologies and the frequency of changes. Methods: The maxillary cheek teeth 108‐ 208 , 109–209 and 110–210 of 25 horses were evaluated using computed tomography and both the prevalence of infundibular and apical infection changes as the possible link with apical infection evaluated statistically. Results: The prevalence of infundibular changes was high in both normal and diseased teeth. Both apical infection and the occurrence of infundibular changes were more prevalent in 109–209 and 110–210. In spite of this, the 2 processes could not be linked to one another. No differences were noted between the left and right sides. Conclusions: A direct relationship between the 2 processes was not established statistically and other underlying causes for the high occurrence of both apical infection and infundibular changes in diseased and normal 108‐ 208 , 109–209 and 110210 are considered.     

Estimation of bone mineral density and breaking strength of laying hens based on scans of computed tomography for body composition analysis

1. The objective of this study was to evaluate the prediction potential of a computer tomography (CT) data collection protocol for determining total body composition used for analysis of tibiotarsal bone quality features.

2. The CT image acquisition was performed on 54 healthy TETRA SL genotype laying hens at 90 weeks of age as well as in the 69th week of the egg production period in vivo and their tibiotarsal bones, ex vivo.

3. Breaking strengths and ash content of the tibiotarsal bones were estimated based on the calculated mineral density of skeletal and tibiotarsal bones by means of CT with an estimation accuracy R² 0.963 and 0.975, respectively.

4. In conclusion, the current investigation demonstrated that the acquisition protocol of CT for total-body composition analysis has a good potential for measuring the mineral status and breaking strength of the reference bone in laying hen.     

Quantitative CT assessment of bone mineral density in dogs with hyperadrenocorticism

Canine hyperadrenocorticism (HAC) is one of the most common causes of general osteopenia. In this study, quantitative computed tomography (QCT) was used to compare the bone mineral densities (BMD) between 39 normal dogs and 8 dogs with HAC (6 pituitary-dependent hyperadrenocorticism [PDH]; pituitary dependent hyperadrenocorticism, 2 adrenal hyperadrenocorticism [ADH]; adrenal dependent hyperadrenocorticism) diagnosed through hormonal assay. A computed tomogaraphy scan of the 12th thoracic to 7th lumbar vertebra was performed and the region of interest was drawn in each trabecular and cortical bone. Mean Hounsfield unit values were converted to equivalent BMD with bone-density phantom by linear regression analysis. The converted mean trabecular BMDs were significantly lower than those of normal dogs. ADH dogs showed significantly lower BMDs at cortical bone than normal dogs. Mean trabecular BMDs of dogs with PDH using QCT were significantly lower than those of normal dogs, and both mean trabecular and cortical BMDs in dogs with ADH were significantly lower than those of normal dogs. Taken together, these findings indicate that QCT is useful to assess BMD in dogs with HAC.     

Standing repair of an articular dorsal medial oblique fracture of the proximal third metacarpal bone in a racing Standardbred

The third metacarpal bone (McIII) is a common site of long bone fractures in racehorses. However, articular fractures of the dorsomedial aspect of McIII are a rare location of such injuries. This report describes the successful standing surgical repair of an articular fracture of the dorso-medial proximal McIII in a 4-year-old Standardbred racing mare using lag screw fixation.     

Bone mineral content of the third metacarpal bone in Quarter Horse foals from birth to one year of age

Dual photon absorptiometry (DPA) is a valid method for bone mineral content (BMC) evaluation, but there are no reports on the use of this technology in in vivo studies in the horse. The aim of the current study was to evaluate the changes of BMC of the third metacarpal bone (MC3) in vivo in foals during their first year of life using DPA. The BMC of the MC3 of 41 Quarter Horse foals was evaluated every 4 weeks during their first year of life by DPA using a bienergetic Gadolinium-153 (¹⁵³Gd) source. To the authors' knowledge, this is the first report of an in vivo study of BMC in foals using DPA by means of a bienergetic ¹⁵³Gd source. The results demonstrated a positive correlation of age, heart girth, and withers height with BMC of the MC3 independent of gender and an exponential behavior of the BMC increment along the first year of life. There was an effect of weaning associated with change in diet and stall confinement on BMC in foals weaned at age 17 weeks, but not in foals weaned at age between 19 and 24 weeks.     

Computed tomographic features of the temporomandibular joint in 10 Jeju horses

BackgroundThe equine temporomandibular joint (TMJ) has a complex anatomical structure that makes diagnosis of TMJ disorders difficult. Computed tomography (CT) is now available in equine medicine; hence, TMJ evaluation has become more convenient.ObjectivesThe objectives of this study were to describe the CT features of the TMJ in Jeju horses and to compare these features with those of Thoroughbreds.MethodsIn this report, the TMJs of 10 Jeju horses (mean age: 4.5 ± 1.9 yr; mean body weight: 282.6 ± 40.3 kg) and 6 Thoroughbreds (mean age: 7.3 ± 1.6 yr; mean body weight: 479.7 ± 44.0 kg) were examined using CT. After CT scanning, the Hounsfield units (HU) and height to width ratio (H:W) of the mandibular condyle were measured.ResultsThe mean H:W in Jeju horses was significantly lower than that in Thoroughbreds. The mean HU in Jeju horses was lower than that in Thoroughbreds; however, the difference was not significant. The most frequent CT finding was an irregular medial margin of the mandibular condyle in both breeds.ConclusionsIn this study, the shape of the mandibular condyle in Jeju horses was flatter than that in Thoroughbreds. This report could be useful in evaluating the TMJ in Jeju horses. Moreover, CT could be a pragmatic choice for the examination of the TMJ in horses.     

Computed tomography of nuchal ligament and semispinalis capitis tendon avulsions in a foal

Head trauma is a common injury in young horses. This case report describes a 10‐week‐old Thoroughbred foal with an open wound following trauma to the poll region, showing abnormal head carriage and depression. A computed tomography (CT) study was performed under general anaesthetic (GA). This identified a complete avulsion of the nuchal ligament (NL) and partial avulsions of the left and right semispinalis capitis (SS) tendons. Following diagnosis and conservative treatment the foal made a good recovery and 18 months later the filly had no detectable neurological or physical abnormalities. Computed tomography enabled an accurate and rapid diagnosis of a novel injury.     

Ex vivo calibration and validation of in vivo equine bone strain measures

Reasons for performing study: Data are required to confirm that strain gauges recording high bone strains in Thoroughbred racehorses provide an accurate record of bone strain. Objective: To test the accuracy and reliability of very high in vivo strain recordings made during fast exercise in Thoroughbred racehorses. Methods: Strains were recorded during exercise from rosette gauges implanted onto the mid‐shaft dorsal cortex of each third metacarpal bone (MC3) in 6 yearling and 6 mature Thoroughbreds in a previous experiment. Bulk elastic modulus (E_US) was calculated from ultrasound speed and single photon absorptiometry measures. Each cleaned MC3 with the original gauge in situ and new gauges placed in a region of strain similarity (as shown by photoelastic coating) was loaded in a materials testing system (MTS) and strains recorded during loading. Elastic moduli were calculated from strain measures from new rosette gauges on the medial, dorsal, lateral and palmar surfaces (E_m; E_d; E_l; E_p), and bulk moduli calculated from the displacement of the MTS machine heads during loading (E_bt). Peak loads were increased incrementally to failure. Results: Of 14 original gauges tested against new gauges, 11 recorded strains from 80–115% of the new gauges and 3 showed reduced function (31–40%). E_bt were similar to E_m, and E_US were similar to E_l and not significantly different from E_d. Maximum strains at yield were recorded by the medial gauges and ranged from ?7500 to ?16,000 μ?. Conclusions and clinical relevance: Similarities between recordings from gauges used in vivo and new gauges confirmed the reliability and likely accuracy (or possible underestimate) of very high strains (exceeding ?6000 μ?) recorded in exercising Thoroughbred racehorses. The similarity between E_bt and E_mconfirms that the gauges measured the true distortion of the bone in the MTS. These results confirm that mammalian bone may withstand much greater compressive loads than ?4000 μ? under some conditions at least.     

Comparison of bone healing,as assessed by computed tomography,following tibial tuberosity advancement in dogs with and without autogenous cancellous bone grafts

Abstract

AIMS: To objectively compare measures of bone healing, using computed tomography (CT) in dogs following bilateral tibial tuberosity advancement (TTA), between tibiae treated with and without autogenous cancellous bone grafts.

METHODS: Ten dogs with bilateral cranial cruciate ligament disease requiring surgical stabilisation were prospectively recruited to undergo single-session bilateral TTA, with only one, randomly assigned, tibia receiving bone graft in the osteotomy deficit. Bone healing at the osteotomy site was assessed using CT performed 38–70 days post-operatively. CT images were evaluated using both objective measurements of osseous bridging and subjective evaluation by six radiologists. Repeated measures ANOVA was used to compare the objective outcomes between the grafted and non-grafted tibiae.

RESULTS: The mean percentage of the osteotomy deficit bridged at the lateral cortex was greater in grafted (77.6, SD 35.2%) compared to non-grafted (63.0, SD 36.5%) tibiae (p=0.001), but did not differ at the medial cortex (p=0.1). The mean minimum callus width was greater in grafted (7.2, SD 3.3 mm) compared to non-grafted (3.6, SD 2.9 mm) tibiae (p<0.001). There was no difference in mean attenuation (measured in Hounsfield units) of the callus between grafted and non-grafted tibiae (p=0.5). The grafted tibia was deemed to have superior bone healing in 50/60 subjective assessments made by radiologists.

CONCLUSIONS: Superior osseous bridging was detected by CT analysis following TTA using autogenous cancellous bone grafts compared with no graft. This was shown by greater bridging percentage at the lateral cortex and formation of a broader callus. Qualitative assessments made by six radiologists also supported the conclusion that bone healing was improved by use of autogenous cancellous bone graft. CT was a useful method for assessing evidence of bone healing following TTA.

CLINICAL RELEVANCE: These findings justify the application of autogenous cancellous bone graft to augment healing following TTA in dogs.     

Congenital hypodontia in three horses diagnosed by computed tomography

Dental agenesis is a congenital disease defined as failure of formation of one or more teeth, which has been extensively described in human literature and that has been documented in several other species including cats, dogs, seals and sea lions, mice, and ungulates. The aim of this study was to review the clinical and computed tomographic (CT) features of tooth agenesis in a population of horses. Retrospective review of the imaging records from the Langford Equine Hospital was performed, including all horses that underwent head CT between January 2015 and June 2017. Of a total number of 167 CT scans, three horses with hypodontia were found. All three cases had agenesis of the maxillary 08s and one case had additional agenesis of the 307 and 308 teeth. Delayed resorption of the corresponding deciduous teeth was reported in all cases. The empty space left by the absent teeth was filled either by heterogeneous bone tissue alone (two cases) or by a combination of bone and soft tissue (one case). Alignment between teeth was preserved, and there was no displacement of the neighbouring teeth adjacent to the agenesis site. All three horses presented a symmetric pattern of dental agenesis within the maxillary arcades. The maxillary 08s, which are the latest to erupt, were the most affected teeth. This was similar to that reported in human literature, where the teeth that form later during development are the most vulnerable to dental agenesis.     

Computed tomography dacryocystography evaluation of the nasolacrimal apparatus

Computed tomography-dacryocystography (CT-DCG) was used to evaluate the nasolacrimal system in four patients (three dogs and one horse) that were admitted for evaluation of chronic epiphora, facial swelling, or facial trauma. The four patients are reviewed and the technique for performing CT-DCG is described. Additionally, the indications for this procedure are discussed. CT-DCG is advantageous because cross-sectional imaging provides superior resolution of the nasolacrimal apparatus and the relatively long, small-diameter, bony nasolacrimal canal in most veterinary patients.