Detection of rib trauma in newborn foals in an equine critical care unit: a comparison of ultrasonography, radiography and physical examination

Abstract

Summary Reasons for performing study: Previous studies have shown that in man ultrasonography is more accurate than radiography for detecting rib fractures. Objectives: To describe clinical, radiographic and ultrasonographic findings related with rib fractures in newborn foals in an equine critical care unit; and to compare diagnostic accuracy of ultrasonography to radiography. Methods: A prospective ultrasonographic study was performed on 29 foals presented to the emergency unit. This study was performed at the Centre Hospitalier Universitaire Vétérinaire (CHUV), University of Montreal. Physical examination as well as radiographic and ultrasonographic examinations were performed. Results: Thoracic radiographs revealed 10 rib fractures in 5 of 26 (19%) foals. Ultrasonography revealed 49 fractures in 19 of 29 (65%) foals of which fillies (n = 13; 68%) were significantly over represented as were fractures to the left thorax (n = 15; 78%). Seventeen of 19 foals (90%) had rib fractures located 3 cm or less from the costochondral junction, the distal part of the rib being displaced laterally in all cases. In 2 foals, where both thoracic radiographs and ultrasonography detected rib fractures, the site of fractures was located on the mid portion of the rib. Rib fractures were detected only by thoracic radiographs in one foal. Sixty‐five percent (32/49) of fractured ribs had a moderate displacement (1–4 mm). Conclusions: Rib fractures are seen frequently in newborn foals in equine critical care units. Ultrasonography is more accurate than radiography and reveals fractures in most patients presented in emergency. The position (costochondral junction) of rib fractures and of the fragments suggest that most thoracic trauma probably occurs during parturition. Potential relevance: Ultrasound imaging increases awareness and improves the diagnosis of rib fractures in newborn foals.

Rib osteomyelitis in three foals

“…Thoracic trauma in the form of rib fractures or costochondral dislocation is common in foals. Palpation of the cranioventral thorax to detect rib fractures is considered an integral component of the physical examination of the neonatal foal; however, fractures are easily overlooked – only 69% of confirmed rib fractures were detected on physical examination in a recent prospective study 10 . Ultrasonography is considered to be a superior diagnostic modality for detecting rib fractures in foals compared with radiography, 9,10,12 and has been suggested as a superior modality for diagnosing osteomyelitis 22 .…”

“…Rib fractures in foals commonly occur at or near the costochondral junction of the cranial ribs, in particular ribs 3 to 8, with a left‐sided bias often documented 9–11,23 . Complications are usually related to laceration of organs by displaced fracture ends 11,12 and secondary osteomyelitis is uncommon.…”

Equine haemothorax

“…The value of thoracic radiography in foals for identifying rib fractures is questionable as it is less sensitive than ultrasonography in detecting fractures (Jean et al . ).…”

“…Rib fractures are common causes of haemothorax in foals and ultrasonography is the diagnostic modality of choice (Jean et al . ) and may be beneficial in adults.…”

Traumatic Multiple rib Fracture and Patella Ligaments Rupture in an Argentine Parade Horse-Case Report

“…Generally, rib fractures are frequent in newborn foals especially at the costochondral junction which suggests that most thoracic traumas probably occur during parturition [2]. Ribs fracture also occur in adults horses but not common and are usually associated with traumatic events [3].…”