Fracture of the ischium in an eight‐year‐old Arabian gelding: A diagnostic challenge

Proximal hindlimb lameness remains a diagnostic challenge despite modern imaging techniques. In the case described here, a fracture of the ischium produced false negative results on initial ultrasound and scintigraphy examinations, despite a 14 day delay from onset of clinical signs to the time of the nuclear bone scan. However, the history and clinical examination were strongly suggestive of a pelvic injury and this was only confirmed by the use of a novel radiographic technique. False negative findings from diagnostic imaging can, and do, occur, even with high sensitivity techniques such as nuclear bone scans used after an appropriate delay period. Therefore, equal weighting should be given to all facets of a lameness investigation, including the history and clinical examination, while remembering the limitations of any imaging modalities used.