Interpretation of cervical radiographs can be challenging due to the complex anatomy and superimposition of osseous structures on either side of the vertebrae. This report describes the investigation of neck pain in a Thoroughbred gelding following a traumatic fall. Several imaging modalities were used to demonstrate the presence of a fracture of the left cranial articular process of the fourth cervical vertebra (C4), including nuclear scintigraphy, ultrasonography, oblique radiographic projections and a novel cineradiographic technique.
Vertebral fractures in horses are relatively common and often occur due to trauma. Clinical signs may range from neck pain and mild neurological dysfunction to tetraplegia and death. Severity of signs and prognosis depends on extent of damage to the spinal cord. In this Case Report, serial radiographs, which track the bony changes associated with fracture healing, were performed over one year.
An enostosis-like lesion was diagnosed in the left femur of a Swedish Warmblood horse that had a left hindlimb lameness of 3 weeks duration. With scintigraphy using technetium 99m-hydroxymethylene diphosphonate (99m Tc-HDP) a marked regional focal increase in radioactivity was identified in the medullary cavity of the left femur. Radiographically there was a corresponding focal increase in bone opacity in the middiaphysis of the left femur. Histopathologically, a 5 cm area of bone matrix was present in the diaphysis of the left femur and confirmed as an enostosis-like lesion.
An 8-year-old Paint Horse gelding was evaluated for a persistent left forelimb lameness (grade 4/5), with a hard swelling at the dorsomedial aspect of the carpometacarpal joint, due to osteoarthritis. Previous systemic and local anti-inflammatory therapy had only a temporary effect. Partial carpal arthrodesis was suggested, but the owner elected for conservative treatment. The horse was confined to a small paddock and received phytotherapeutic supplementation with Harpagophytum procumbens. The lameness gradually resolved but a similar hard swelling developed on the right carpus.
A cyst filled with fluid was found to be the cause of an enlarged antebrachium in a horse. Communication between the cyst and the elbow joint was demonstrated by: 1) finding, during radiographic examination of the elbow, radiopaque contrast solution instilled into elbow joint within the cyst; 2) finding cytological values in fluid aspirated from the cyst that were similar to those in fluid aspirated from the elbow joint; and 3) finding hyperechoic foci, assumed to be air bubbles, during ultrasonographic examination of the cyst after administration of air into the elbow joint.
A 24-hour-old male Shetland pony was presented for evaluation of unilateral hindlimb lameness of unknown duration. Physical and radiographic findings confirmed a diagnosis of medial luxation of the patella. A traumatic or congenital aetiology was suspected but could not be confirmed. Surgical correction of the luxation, using a modified recession trochleoplasty technique, was carried out. At 6 months follow-up, no discernbile lameness could be observed. In the literature, descriptions of medially luxated patellae in equids are rare.
A 3-year-old filly was presented for severe lameness referable to the left front fetlock joint. Radiographs confirmed an osseous cyst-like lesion and synovial fluid cytology ruled out sepsis. The filly responded poorly to medical management and was subsequently subjected to euthanasia. Post mortem examination confirmed an impact fracture of the proximal phalanx, previously undiagnosed in the horse.
This report documents the case presentation, evaluation, treatment and outcome of 5 horses with an osseous cyst-like lesion (OCLL) of the intertubercular groove of the proximal aspect of the humerus. In 3 of the 5 cases, delayed phase gamma scintigraphic findings demonstrated increased radiopharmaceutical uptake in the region of the intermediate tubercle of the proximal humerus of the affected limb, demonstrating increased bone remodelling in this region.
The radiological examination of bone lesions can be challenging, considering the complex superimposition of the 3D anatomy of a region on to a 2D image. This report describes the findings achievable with different diagnostic imaging modalities (radiography, arthrography, spiral computed tomography) and the correlation with the post mortem and histopathological findings in a horse with a fracture associated with an osseous cyst-like lesion in the third phalanx.