The mare was injected 7000 MBq Technetium 99 MDP and the bone phase examination was performed about three hours later.

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Amice Miles
6 years ago
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1 12 year old female used as Show Jumper History The mare was referred for scintigraphy of the front distal limbs. The referring veterinarian s complaint was chronic lameness located on the left front limb. The lameness occurred during the last months, and had intermittent character, ranging from moderate to severe (4/5 degrees). The mare was referred to respond positively to the diagnostic analgesia of the palmar digital nerves. The only radiographic finding detected was mineralization of the lateral cartilage ( sidebone ). Scintigraphy was aimed at confirming the foot and the ossified cartilage as the cause of lameness. Clinical examination and diagnostic imaging As usual, the mare was trotted in a circle on both hands before injection of the radiopharmaceutical. A left front lameness (1/5 degrees) was evident with the horse trotted with the left limb on the inside. On the other hand, with the left limb on the outside, the lameness was more severe, with the tendency to worsen. The mare was injected 7000 MBq Technetium 99 MDP and the bone phase examination was performed about three hours later. The most significant finding was a spot of radionuclide accumulation on the proximal medial aspect of the proximal phalanx of the left limb, well visible on both dorsal and lateral scans (Fig.1, 2, 3). 1 / 5

2 Fig.1 Fig.2 Fig.3 According with the referring veterinarian, the diagnostic blocks were repeated. The palmar digital nerve block was negative, as well as the intra-articular analgesia of the fetlock joint. The lameness was abolished after the block of the common digital nerves, at the base of the proximal sesamoid bones, and a moderate degree of contralateral lameness became apparent when the mare was trotted in a circle. Radiographic examination revealed the presence of a large osseous cyst like lesion affecting the proximal medial aspect of the proximal phalanx, corresponding to the scintigraphic finding (Fig.4, 5) 2 / 5

3 Fig. 4,5 3 / 5

4 No confirmed Among recently 6). joint the communication introduced but different was considered by surgical Santschi: was radiographically options, non a cortical significant. it was screw decided visible. inserted to The treat presence in a the lag mare fashion of using a lateral through the sidebone technique the cyst was (Fig. 4 / 5

5 Surgery given Comment focused horse distal They adjacent bone, been insertion showed Fig. etiology 6seem recently metacarpus/metatarsus, and bone encouraging was of joint month the a traumatic to marrow of fast cortical space. proposed be most bone of and more stall and cysts Treatment screw results. or recovery common develepmental by intra-lesional rest Dr followed location the a Elizabeth proximal uneventful. lag includes horse areas fashion is by injection has origin. radius, the Santschi two rest, of The been through maximum medial months debridement, Bone of distal mare long corticosteroids. from femoral the cysts of was scapula load debated Ohio paddock cyst. dismissed represent and condyle filling State Dr and frequently Santschi s turn A the University proximal new the of a one out. cyst the non main surgical week femur, communicate cavity rare preliminary and hypotheses after feature distal option with consists followed surgery cancellous phalanx. studies in has with the of byand the 5 / 5

Case Studies. A. Kent Allen, DVM LAMENESS AND IMAGING IN THE SPORT HORSE

Case Studies. A. Kent Allen, DVM LAMENESS AND IMAGING IN THE SPORT HORSE Case Studies A. Kent Allen, DVM Author s address: Virginia Equine Imaging, 2716 Landmark School Road, The Plains, VA 20198; e-mail: vaequine@aol.com. 2007 AAEP. 1. Case Study #1: Medial Collateral Desmitis