High field magnetic resonance imaging contributes to diagnosis of equine distal tarsus and proximal metatarsus lesions: 103 horses

Abstract

Injury of the distal tarsus and proximal metatarsus commonly causes lameness. Magnetic resonance imaging (MRI) allows concurrent assessment of both the distal tarsal joints and suspensory ligament origin, and aids identification of lesions that may otherwise go undetected by other modalities. In this retrospective observational study, the medical records of a veterinary imaging center were searched for MRI exams of the distal tarsus and proximal metatarsus for the years 2012 through 2014. Studies for 125 limbs of 103 horses were identified and retrospectively evaluated by two board-certified veterinary radiologists. Soft tissue and osseous changes were characterized and graded by degree of severity. The patients' signalment, lameness severity, and results of diagnostic analgesia were recorded. Osteoarthritic changes of the distal intertarsal and tarsometatarsal joints were the most common findings. Other findings included bone marrow lesions, degenerative changes of the small cuboidal bones, subchondral cystic lesions, and intertarsal desmopathy. Suspensory ligament desmopathy was found in 53% of limbs. Fourty-seven percent of limbs that responded to analgesia of the proximal suspensory ligament had more severe lesions in the distal tarsus. Bone marrow lesions of the third tarsal bone were the only MRI finding that correlated with grade of lameness in patients for which lameness grade was reported. The grade of lameness has a poor correlation with the severity of lesions found on MRI. The findings support the use of MRI for simultaneous evaluation of the proximal metatarsus and distal tarsus, particularly given the difficulty of lesion localization with diagnostic analgesia.

Standing low‐field MRI of the equine proximal metacarpal/metatarsal region is considered useful for diagnosing primary bone pathology and makes a positive contribution to case management: A prospective survey study

“…In this survey, abnormalities previously reported in the context of the imaging diagnosis of suspensory ligament disease such as adhesion formation, ultrasonographic divergence, or changes to the MRI appearance of muscle/adipose tissue bundles were given low prevalence and/or significance ratings, suggesting that these are either uncommon, not perceived to be important, or not being recognized. Given the recently suggested association of muscle/adipose tissue signal change with lameness and histopathological measures of disease, which had not been observed as a feature of proximal suspensory desmitis in previous high‐field MRI studies, a better understanding of this feature, its prevalence, and significance is required. However, given this information was not available at the time of the survey, users’ responses can only be interpreted in light of their personal experience and knowledge available at the time of the survey.…”

“…Adopting the best possible imaging protocol is crucial for standing low‐field MRI due to lower image resolution, higher sensitivity to motion artifact, and patient compliance affecting the quality of diagnostic information, particularly when imaging further proximally from the ground than the foot . With the clinical benefit of high‐field MRI established and reports of standing low‐field MRI of the proximal metacarpus available, understanding the potential diagnostic yield and impact of standing low‐field MRI on clinical case management, specifically in the case of suspensory ligament disease, is essential to manage the client's financial commitments and ensure best case selection for treatment. Also, knowledge of standing low‐field MRI user preferences may aid in the optimization of imaging procedures and diagnostic outcomes.…”

“…the clinical benefit of high-field MRI established [13][14][15][16][17] and reports of standing low-field MRI of the proximal metacarpus available, [18][19][20] understanding the potential diagnostic yield and impact of standing low-field MRI on clinical case management, specifically in the case of suspensory ligament disease, is essential to manage the client's financial commitments and ensure best case selection for treatment.…”

The Anatomy, Histology and Physiology of the Healthy and Lame Equine Hoof

“…The number of studies comparing MRI methods to more traditional methods is also highlighting the knowledge that can be gained in not only osseous tissue but also in soft tissue. For example in recent studies in equine limbs lesions where MRI was considered against retrospective patient data/ultrasonography radiography [96,97]. In addition anatomical knowledge and imaging are becoming increasingly important for new discoveries and techniques in relation to stem cell and gene therapy as highlighted by recent studies using gene therapy to treat equine lameness [78,98].…”

Magnetic resonance imaging of the normal dromedary camel tarsus

“…Hind limb lameness due to tarsal lesions is common and affects many breeds and disciplines [9]. Tarsal MRI in horse proved to be speci c and sensitive for detection of all types of pathology concerning soft tissues [10] and osseous lesions [5] as well as detection of articular surface alterations through quantitative assessment of the osteochondral tissue and subchondral bone thickness [11].…”