46TH
ANNUAL
CONGRESS
OF
THE
SAEVA
SKUKUZA
16-‐20
FEBRUARY
2014
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In young foals with acute lameness, radiographic evidence of septic physitis or
osteomyelitis can lag behind radiographic abnormalities, and may delay targeted
treatment (such as flushing joints, debriding physeal lesions). Ultrasound of the
physes can often allow you to identify some focal fluid accumulation or soft tissue
thickening around the septic physis.10 Evaluation of the upper limb, paying specific
attention to the gluteal region, coxofemoral region and stifle region is also useful in
the acutely lame foal with no definitive localising signs.10 Ultrasonography can also
identify rib fractures or osteomyelitis in foals that are not apparent on clinical
examination or radiography.11
In horses with suspect upper limb fractures, ultrasound can allow you to trace the
scapula, ilium, and femur and evaluate the coxofemoral joint. Unless a fracture is
easily identifiable on ultrasound, I try to perform standing radiographs and/or nuclear
scintigraphy for confirmation. However, pelvic radiographs are limited in both
positioning and diagnostic quality, especially in adults, and nuclear scintigraphy should
be delayed at least a week after onset of lameness.12-14
Ultrasonography is also an excellent tool for the identification of foreign bodies,
especially non-metallic foreign bodies that cannot be identified radiographically.
Foreign bodies will usually cast an acoustic shadow on ultrasound. Reverberation
artefact will be seen with gas and some metallic foreign bodies. I routinely ultrasound
all clinical cases with a suspect foreign body on the table prior to making an incision,
and finds this helps with surgical planning.15
Ultrasound can help map fractures associated with the orbit and sinuses, allowing for
better preoperative planning. The limitation of radiographs producing a 2
dimensional image can make fracture repair or head and sinus fractures confusing
when CT or MRI is not available.
References:
1.
Hinz A, Fischer AT Jr “Comparison of the accuracy of radiography and ultrasonography for
detection of articular lesions in horses” Vet Surg 2011; 40(7):881-5.
2. Relave F, Meulyzer M, Alexander K, Beauchamp G, Marcoux M “Comparison of radiography
and ultrasonography to detect osteochondrosis lesions in the tarsocrural joint: a prospective
study” Eq Vet J 2009; 41(1): 34-410.
3. Raes EV, Vanderperren K, Pille F, Saunders JH “Ultrasonographic findings in 100 horses with
tarsal region disorders” Vet J 2010; 186 (2): 201-9.
4. Dik KJ “Ultrasonography of the equine stifle” Eq Vet Ed 1995; 7(3): 154-160.
5. Cauvin ERJ, Munroe GA, Boyd JS, Paterson C “Ultrasonographic examination of the
femorotibial articulation in horses: imaging of the cranial and caudal aspects” Eq Vet J 1996
28(4): 285-296.
6. Maulet BEB, Mayhew IG, Jones E, Booth TM “Radiographic anatomy of the soft tissue
attachments of the equine stifle” Eq Vet J 2005 37(6) 530-535.
7. Beccati F, Chalmers HJ, Dante S, Lotto E, Pepe M “Diagnostic sensitivity and interobserver
agreement of radiography and ultrasonography for detecting trochlear ridge osteochondrosis
lesions in the equine stifle” Vet Radiol & Ultrasound 2013; 54(2): 176-84.
8. Vanderperren K, Bergman HJ, Spoormakers TJ, Pille F, Duchateau L, Puchalski SM, Saunders
JH “Clinical, radiographic, ultrasonographic and computed tomographic features of nonseptic
osteitis of the axial border of the proximal sesamoid bones” Eq Vet J 2013; Jul 16. doi:
10.1111/evj.12141. [Epub ahead of print]
9. Young A, Whitcomb MB, Vaugh B, MacDonald MH “Ultrasonographic Features of Septic
Synovial Structures in 62 Horses (2004-09)” Proc ACVR 2010: 41.
10. Rottensteiner U, Palm F, Kofler J “Ultrasonographic evaluation of the coxofemoral joint
region in young foals” Vet J 2012; 191(2): 193-8.
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