Imaging Foot Lamenesses
In a paper entitled "The Relationship Between Nuclear Scintigraphy and Standing MRI in 79 Horses With Lameness of the Foot," investigators presented some new information regarding the diagnosis of foot lameness. The author, Mark Martinelli, DVM, MS, PhD, Dipl. ACVS, of California Equine Orthopedics, and Norm Rantanen, DVM, MS, Dipl. ACVR, a consultant radiologist, used nuclear scintigraphy and magnetic resonance imaging (MRI) to investigate difficult lameness cases in 79 sport horses. The findings, along with a brief discussion of each imaging modality, formed the centerpiece of the author’s presentation at the 51st annual American Association of Equine Practitioners convention, held Dec. 3-7 in Seattle, Wash.
Traditionally the diagnosis of foot lameness involved regional anesthesia and radiographs. In this study, horses had lameness localized to the foot via regional anesthesia and/or a coffin joint block. Most of the horses had no radiographic changes, or the diagnosis was still in question following radiography. These horses then were imaged with nuclear scintigraphy and magnetic resonance imaging (MRI).
Nuclear scintigraphy proved very helpful in locating the area of injury in these horses, while MRI was useful in defining which structure or structures were involved. Nuclear scintigraphy is considered more sensitive than radiographs for determining specific problems of the foot. While radiographs are useful, they can only show changes in the bone that occur over time. For this reason, they are still very important in the pre-purchase examination. In contrast, scintigraphy can show areas of bone remodeling from recent injury before any appreciable changes are visible on radiographs.
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