Diagnostic Imaging in Equine Lameness Diagnosis—Where Are We in 2024?

A special issue of Animals (ISSN 2076-2615). This special issue belongs to the section "Equids".

Deadline for manuscript submissions: closed (10 June 2024) | Viewed by 7442

Special Issue Editors


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Guest Editor
Equine Department and Clinic, University of Veterinary Medicine, Dóramajor, 2221 Üllő, Hungary
Interests: lameness; poor performance; imaging; magnetic resonance imaging; computed tomography; diagnostic anaesthesia

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Guest Editor
Department of Environmental and Radiological Health Science, Gail Holmes Orthopedic Research Center, College of Veterinary Medicine & Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
Interests: musculoskeletal diagnostic imaging; equine; sports medicine; MRI; ultrasound

Special Issue Information

Dear Colleagues,

Advanced—particularly three-dimensional—diagnostic imaging has changed the concept of many equine orthopaedic conditions. New techniques are emerging or are becoming adaptable for use in horses. We can describe diagnostic imaging details of diseases, yet determining their clinical significance often remains a challenge. With new information gained, it is imperative that we thrive to establish what we can consider normal or expected for a particular animal (considering age, discipline, stage of training, etc.), and to relate advanced diagnostic imaging findings to the results of clinical examination and traditional diagnostic imaging.

This Special Issue aims to provide an update on what is currently available and achievable when using various diagnostic imaging techniques in equine lameness and poor performance investigations. Original research articles and critical reviews are welcome. Review articles may include (but are not limited to) the following topics: comparative imaging of a specific region and updates on the value and limitations of diagnostic imaging techniques. We are particularly interested in research articles regarding comparative imaging, longitudinal studies, and in ones that describe a new diagnostic imaging technique or contain novel information relating to previously described diseases.

I look forward to receiving your contributions.

Dr. Annamaria Nagy
Dr. Myra F. Barrett
Guest Editors

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Keywords

  • ultrasound
  • radiography
  • comparative imaging
  • magnetic resonance imaging
  • computed tomography
  • scintigraphy
  • positron emission tomography

Published Papers (6 papers)

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15 pages, 2908 KiB  
Article
Magnetic Resonance Imaging, Computed Tomographic and Radiographic Findings in the Metacarpophalangeal Joints of 31 Warmblood Showjumpers in Full Work and Competing Regularly
by Annamaria Nagy and Sue Dyson
Animals 2024, 14(10), 1417; https://doi.org/10.3390/ani14101417 - 9 May 2024
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Abstract
There is a limited description of magnetic resonance imaging (MRI) and no information on computed tomographic (CT) findings in the fetlock of non-lame, non-racing sports horses. This study aimed to document comparative CT, MRI and radiographic findings in the metacarpophalangeal joints of showjumpers [...] Read more.
There is a limited description of magnetic resonance imaging (MRI) and no information on computed tomographic (CT) findings in the fetlock of non-lame, non-racing sports horses. This study aimed to document comparative CT, MRI and radiographic findings in the metacarpophalangeal joints of showjumpers in full work. Clinical and gait assessments, low-field MRI, fan-beam CT and radiographic examinations of both metacarpophalangeal joints were performed on 31 showjumpers. Images were analysed descriptively. In most limbs (53/62, 85.5%), there were CT and MRI changes consistent with densification in the sagittal ridge and/or condyles of the third metacarpal bone (McIII). Hypoattenuation (subchondral bone resorption) was seen in CT reconstructions in the metacarpal condyle dorsoproximally (n = 2) and dorsodistally (n = 1), in the sagittal groove (n = 2) and medial fovea (n = 1) of the proximal phalanx. The McIII resorptive lesions were detected on MR images but not the proximal phalanx lesions. None were identified on radiographs. In conclusion, MRI and CT abnormalities previously associated with lameness were seen in the front fetlocks of showjumpers without relevant lameness. Densification in the sagittal ridge and the metacarpal condyles likely reflects an adaptive change to exercise. Subchondral bone resorption may indicate an early stage of disease; follow-up information is needed to establish its clinical significance. Full article
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17 pages, 3312 KiB  
Article
Follow-Up Magnetic Resonance Imaging of Sagittal Groove Disease of the Equine Proximal Phalanx Using a Classification System in 29 Non-Racing Sports Horses
by Josephine E. Faulkner, Zoë Joostens, Bart J. G. Broeckx, Stijn Hauspie, Tom Mariën and Katrien Vanderperren
Animals 2024, 14(1), 34; https://doi.org/10.3390/ani14010034 - 21 Dec 2023
Cited by 5 | Viewed by 1005
Abstract
Evolution of magnetic resonance imaging (MRI) findings in horses with sagittal groove disease (SGD) of the proximal phalanx is relatively sparsely described. This retrospective, descriptive, longitudinal study describes the findings of sequential low-field MRI fetlock examinations in horses with SGD of the proximal [...] Read more.
Evolution of magnetic resonance imaging (MRI) findings in horses with sagittal groove disease (SGD) of the proximal phalanx is relatively sparsely described. This retrospective, descriptive, longitudinal study describes the findings of sequential low-field MRI fetlock examinations in horses with SGD of the proximal phalanx using a classification system. Twenty-nine horses were included, predominantly warmbloods used for show jumping (79%). For 29 limbs re-examined during the initial rehabilitation period, classification remained constant (n = 18), increased (n = 2), decreased (n = 7), and fluctuated (n = 2). Notably, two limbs with initial classification 4b (bone oedema-like signal with subchondral microfissure) and one with 4c (bone oedema-like signal with subchondral demineralisation) progressed to classification 5 (incomplete macrofissure/fracture), highlighting their potential as prodromal or imminent fissure pathology. Following conservative (n = 28) and surgical (n = 1) treatment, 86% of the horses re-entered full training and competition with a mean ± sd recovery time of 9.4 ± 4.4 months. In total, 20% of horses in the study subsequently presented for repeat MRI due to recurrent lameness after resuming full work, with classification that was the same (n = 2), increased (n = 2), or decreased (n = 2) compared with the last scan. This study underscores the variability in progression of SGD MRI findings, emphasising the need for further larger-scale research into patterns of progression. Full article
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16 pages, 2274 KiB  
Article
Three-Dimensional Imaging and Histopathological Features of Third Metacarpal/Tarsal Parasagittal Groove and Proximal Phalanx Sagittal Groove Fissures in Thoroughbred Horses
by Szu-Ting Lin, Alastair K. Foote, Nicholas M. Bolas, Vanessa G. Peter, Rachel Pokora, Hayley Patrick, David R. Sargan and Rachel C. Murray
Animals 2023, 13(18), 2912; https://doi.org/10.3390/ani13182912 - 14 Sep 2023
Cited by 7 | Viewed by 1326
Abstract
Fissure in the third metacarpal/tarsal parasagittal groove and proximal phalanx sagittal groove is a potential prodromal pathology of fracture; therefore, early identification and characterisation of fissures using non-invasive imaging could be of clinical value. Thirty-three equine cadaver limbs underwent standing cone-beam (CB) computed [...] Read more.
Fissure in the third metacarpal/tarsal parasagittal groove and proximal phalanx sagittal groove is a potential prodromal pathology of fracture; therefore, early identification and characterisation of fissures using non-invasive imaging could be of clinical value. Thirty-three equine cadaver limbs underwent standing cone-beam (CB) computed tomography (CT), fan-beam (FB) CT, low-field magnetic resonance imaging (MRI), and macro/histo-pathological examination. Imaging diagnoses of fissures were compared to microscopic examination. Imaging features of fissures were described. Histopathological findings were scored and compared between locations with and without fissures on CT. Microscopic examination identified 114/291 locations with fissures. The diagnostic sensitivity and specificity were 88.5% and 61.3% for CBCT, 84.1% and 72.3% for FBCT, and 43.6% and 85.2% for MRI. Four types of imaging features of fissures were characterised on CT: (1) CBCT/FBCT hypoattenuating linear defects, (2) CBCT/FBCT striated hypoattenuated lines, (3) CBCT/FBCT subchondral irregularity, and (4) CBCT striated hypoattenuating lines and FBCT subchondral irregularity. Fissures on MRI appeared as subchondral bone hypo-/hyperintense defects. Microscopic scores of subchondral bone sclerosis, microcracks, and collapse were significantly higher in locations with CT-identified fissures. All imaging modalities were able to identify fissures. Fissures identified on CT were associated with histopathology of fatigue injuries. Full article
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12 pages, 1752 KiB  
Article
Relationship between CT-Derived Bone Mineral Density and UTE-MR-Derived Porosity Index in Equine Third Metacarpal and Metatarsal Bones
by Carola Riccarda Daniel, Sarah Elizabeth Taylor, Samuel McPhee, Uwe Wolfram, Tobias Schwarz, Stefan Sommer and Lucy E. Kershaw
Animals 2023, 13(17), 2780; https://doi.org/10.3390/ani13172780 - 31 Aug 2023
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Abstract
Fatigue-related subchondral bone injuries of the third metacarpal/metatarsal (McIII/MtIII) bones are common causes of wastage, and they are welfare concerns in racehorses. A better understanding of bone health and strength would improve animal welfare and be of benefit for the racing industry. The [...] Read more.
Fatigue-related subchondral bone injuries of the third metacarpal/metatarsal (McIII/MtIII) bones are common causes of wastage, and they are welfare concerns in racehorses. A better understanding of bone health and strength would improve animal welfare and be of benefit for the racing industry. The porosity index (PI) is an indirect measure of osseous pore size and number in bones, and it is therefore an interesting indicator of bone strength. MRI of compact bone using traditional methods, even with short echo times, fail to generate enough signal to assess bone architecture as water protons are tightly bound. Ultra-short echo time (UTE) sequences aim to increase the amount of signal detected in equine McIII/MtIII condyles. Cadaver specimens were imaged using a novel dual-echo UTE MRI technique, and PI was calculated and validated against quantitative CT-derived bone mineral density (BMD) measures. BMD and PI are inversely correlated in equine distal Mc/MtIII bone, with a weak mean r value of −0.29. There is a statistically significant difference in r values between the forelimbs and hindlimbs. Further work is needed to assess how correlation patterns behave in different areas of bone and to evaluate PI in horses with and without clinically relevant stress injuries. Full article
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11 pages, 1849 KiB  
Article
Comparison of Ultrasound and Magnetic Resonance Imaging for Identifying Soft Tissue Abnormalities in the Palmar Aspect of the Equine Digit
by Myra F. Barrett, Georgette E. Goorchenko and David D. Frisbie
Animals 2023, 13(14), 2328; https://doi.org/10.3390/ani13142328 - 17 Jul 2023
Cited by 1 | Viewed by 1368
Abstract
Damage to the soft tissue structures of the digit is a common source of equine lameness. While magnetic resonance imaging (MRI) allows for the most complete diagnostic imaging of the equine digit, ultrasound is more readily available and less expensive. This prospective diagnostic [...] Read more.
Damage to the soft tissue structures of the digit is a common source of equine lameness. While magnetic resonance imaging (MRI) allows for the most complete diagnostic imaging of the equine digit, ultrasound is more readily available and less expensive. This prospective diagnostic accuracy study compares ultrasound to MRI for the diagnosis of injuries visible with ultrasound within the digit, including the deep digital flexor tendon (DDFT), collateral sesamoidean ligament (CSL), and navicular bursa. Clinical patients underwent an MRI of the digit and a blinded ultrasound of the digit between the heel bulbs, and results of the two modalities were compared. A total of 70 ultrasound and MRI exams of 45 horses were included. Ultrasound had good sensitivity (85%), moderate specificity (60%), and accuracy of 70% for evaluating the dorsal tearing of the DDFT. Accuracy was lower for navicular bursa effusion (67%), navicular bursa proliferation (61%), and CSL enlargement (61%). Tearing of the DDFT distal to the navicular bone was identified with MRI in 27 limbs, 20 of which also had dorsal damage proximal to the navicular bone identified with ultrasound. Ultrasound evaluation remains a useful screening tool, particularly for the assessment of DDFT tearing proximal to the navicular bone but risks under-diagnosing pathology to the navicular bursa and CSL. Clinically significant concurrent damage to the distal DDFT and other osseous and soft tissues in the hoof capsule is unlikely to be identified without MRI. Full article
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12 pages, 11252 KiB  
Case Report
The Evolution of Lesions on Follow-Up Magnetic Resonance Imaging of the Proximal Metacarpal Region in Non-Racing Sport Horses That Returned to Work (2015–2023)
by Elisabeth C. S. van Veggel, Katrien Vanderperren, Kurt T. Selberg, Hendrik-Jan Bergman and Brenda Hoogelander
Animals 2024, 14(12), 1731; https://doi.org/10.3390/ani14121731 - 8 Jun 2024
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Abstract
Background: This study evaluates the change in an MRI of the proximal metacarpal region in a group of sport horses that returned to work. This retrospective analysis evaluated 18 limbs represented by 17 horses. Results: The hyperintense signal within the dorsal collagenous part [...] Read more.
Background: This study evaluates the change in an MRI of the proximal metacarpal region in a group of sport horses that returned to work. This retrospective analysis evaluated 18 limbs represented by 17 horses. Results: The hyperintense signal within the dorsal collagenous part of the proximal suspensory ligament (PSL) on T1W/T2*W GRE sequences decreased or stayed the same in the majority of cases. The hyperintense STIR signal within the dorsal collagenous part of the PSL resolved in the majority of the patients, and the third metacarpal bone (McIII) hyperintense STIR signal resolved in all patients. The dorsal margin irregularity of the PSL stayed the same, and McIII sclerosis and resorption of the palmar margin of McIII stayed the same in the majority of cases. McIII hyperintense STIR signal resolution carries a broad time range, with a mean of 94 days and a range of 47–202 days. Conclusions: Complete normalization of the dorsal collagenous part of the PSL does not appear necessary for a return to soundness, but a resolution of the McIII hyperintense STIR signal is expected for horses returning to soundness. A rescan period of 120 days for the proximal metacarpal region is suggested. In addition, there was no significant change in the size of the PSL between the initial and final MRI. Full article
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