Ultrasound Diagnosis of Pelvic Fractures
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"The equine practitioner is likely to be faced with a horse that he/she suspects to have a pelvic fracture at some point in his or her career," began Agustin Almanza, MV, of the University of California, Davis, in his presentation on ultrasound examination for pelvic fractures at the 2003 American Association of Equine Practitioners convention. "The definitive diagnosis of a pelvic fracture in these cases can be a challenge, especially in the ambulatory setting.
"The incidence of pelvic fractures has historically been low, but recent research suggests a higher incidence," he said. "Most reports have focused on ilial wing stress fractures in Thoroughbreds.
"Clinical exam findings of crepitus (grating sound associated with fracture), pelvic asymmetry, muscle atrophy, soft tissue swelling, and abnormal rectal exam findings are useful indicators of pelvic fracture; however, these clinical findings are often absent in many horses with pelvic fractures," he cautioned.
He explained that radiographic examination can be done in the standing horse, but its availability is limited; ventrodorsal projections (shot from the belly) on a horse under general anesthesia can be done, but that is expensive and carries the risk of displacement of pelvic fragments and the risk, albeit low, of injury during recovery from anesthesia. He added that nuclear scintigraphy can be quite helpful, but it can be expensive. Both imaging modalities for this area require transport to a referral facility
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