The sacroiliac joints: evaluation using nuclear scintigraphy. Part 1: The normal horse

Dyson, Sue; Murray, Rachel C.; Branch, M.; Whitton, C.; Donovan, Tim; Harding, Edward F

doi:10.2746/042516403776148219

Cited by 35 publications

(22 citation statements)

References 11 publications

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“…Similar patterns of radiopharmaceutical uptake have been documented in horses with sacroiliac joint region pain and normal horses . Diagnostic analgesia can confirm the presence of pain in the sacroiliac joint region .…”

Section: Discussionsupporting

confidence: 63%

“…Unlike hindlimb proximal suspensory desmopathy, there was no association between lesion severity as determined by ultrasonography and the presence of increased radiopharmaceutical uptake, however severely lame horses with mild ultrasonographic abnormalities may have increased radiopharmaceutical uptake reflecting injury at the enthesis. Although stress fractures are infrequently seen in sports horses compared with racehorses, one exception is proximal palmar cortical stress fracture (incomplete longitudinal fracture) of the third metacarpal bone which occurs in mature sports horses . There is invariably increased radiopharmaceutical uptake, which must be distinguished from an avulsion fracture or proximal suspensory desmitis .…”

Section: Discussionmentioning

confidence: 99%

“…Although stress fractures are infrequently seen in sports horses compared with racehorses, one exception is proximal palmar cortical stress fracture (incomplete longitudinal fracture) of the third metacarpal bone which occurs in mature sports horses . There is invariably increased radiopharmaceutical uptake, which must be distinguished from an avulsion fracture or proximal suspensory desmitis . Palmar cortical stress fractures can often be seen radiographically …”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the diagnostic accuracy of skeletal scintigraphy in lame and poorly performing sports horses

Quiney

Ireland

Dyson

2018

Vet Radiology Ultrasound

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Skeletal scintigraphy is an established imaging modality, however, its validity as a diagnostic test in lame or poorly performing sports horses has not been determined. The objective of this retrospective cross-sectional analytical study was to determine the accuracy of skeletal scintigraphy as an indiscriminate screening test in sports horses. All sports horses that underwent scintigraphic examination between March 2008 and December 2014 for which a definitive diagnosis was reached were included. Examinations were evaluated blindly. Characteristics of increased radiopharmaceutical uptake were recorded and subjectively categorized as possibly relevant or non-relevant. Kappa statistics were used to assess agreement between test results and final diagnosis. There were 1222 positive clinical diagnoses in 480 horses, of which 687 regions (56.4%) had no associated increased radiopharmaceutical uptake and 99 regions (8.1%) had non-relevant increased radiopharmaceutical uptake. The sensitivity of increased radiopharmaceutical uptake for identification of final diagnosis was low (43.8%) and specificity was high (94.0%). The agreement was fair (κ = 0.36). Relevance categorization improved the test; the sensitivity for final diagnosis was low (35.7%), specificity was high (98.9%), and the agreement was moderate (κ = 0.45). The agreements of increased radiopharmaceutical uptake and relevance categorization with final diagnosis were only substantial for feet (κ = 0.67 and κ = 0.66, respectively) and proximal aspect of the forelimb (elbow, shoulder, and scapula combined) (κ = 0.69 and 0.78, respectively). Scintigraphic examination is unlikely to lead to a full and correct diagnosis of the cause(s) of lameness or poor performance in sports horses when used as an isolated or indiscriminate screening tool.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evaluation of the diagnostic accuracy of skeletal scintigraphy in lame and poorly performing sports horses

Quiney

Ireland

Dyson

2018

Vet Radiology Ultrasound

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“…Recent studies (Tucker et al 1998;Dyson et al 2001Dyson et al , 2003a have investigated the scintigraphic appearance of the sacroiliac joint in normal and diseased horses. It was concluded that the scintigraphic appearance of the sacroiliac joint is influenced by age and that there is a wide range in scintigraphic uptake between horses.…”

Section: Anatomymentioning

confidence: 99%

Ultrasonographic examination of the equine sacroiliac region

Kersten

Edinger

2004

Equine Veterinary Journal

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Summary Reasons for performing study: Little information exists about the normal ultrasonographic appearance of the equine sacroiliac region, but knowledge of the ultrasonographic anatomy is necessary to understand the possible pathological changes in sacroiliac diseases. Objectives: The normal ultrasonographic appearance of soft tissues and bony structures of the sacroiliac region in horses was studied in order to establish clinically relevant reference parameters. Methods: Thirteen cadaver specimens were examined using a transcutaneous approach above the tubera sacrale to image the dorsal sacroiliac ligament and the tendon of the longissimus dorsi muscle. A rectal approach was used to outline the sacroiliac joint and its adjacent structures. Thirteen sound horses with no history of back pain were examined following the same protocol as for the post mortem examinations. Results: The tendon of the longissimus dorsi muscle can clearly be distinguished from the dorsal sacroiliac ligament, especially in longitudinal images. Transrectal examination of the sacroiliac joint consists of evaluation of the bony surfaces of the sacrum and ilium in comparison with the contralateral side. Conclusions: Ultrasonographic examination of the sacroiliac region provided clear images of the caudomedial border of the sacroiliac joint and its adjacent structures and is a useful aid in the diagnosis of sacroiliac joint diseases and adjacent lesions. The study has shown ultrasonography to be a useful method for examining and differentiating the longissimus dorsi muscle and the dorsal sacroiliac ligament at the level of the tubera sacrale. Potential relevance: Diagnostic ultrasound is available to most practitioners. These reference ultrasound parameters may help to improve the diagnosis of sacroiliac diseases.

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“…Reference has been made to the use of local analgesia (Dyson et al 2001;Haussler 2003), but there are no published studies documenting the results. The use of nuclear scintigraphy as an aid to diagnosis has been recently described (Tucker et al 1998;Philipp and Ueltschi 1999;Dyson et al 2001Dyson et al , 2003a.…”

Section: Introductionmentioning

confidence: 99%

Pain associated with the sacroiliac joint region: a clinical study of 74 horses

Dyson

Murray

2003

Equine Veterinary Journal

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102

115

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Summary Reasons for performing study: There has been no large study of horses with suspected sacroiliac (SI) joint region pain in which the clinical diagnosis has been supported by either abnormal radiopharmaceutical activity in the SI joint region or by periarticular infiltration of local anaesthetic solution. Objectives: To describe the clinical features of horses with SI joint region pain, to document the age, breed, sex, discipline, size and conformation of affected horses and to compare these with the author's (SD) normal case population and to document the results of infiltration of local anaesthetic solution around the SI joint region. Methods: Horses were selected for inclusion in the study based upon the exclusion of other causes of lameness or poor performance, together with clinical signs suggestive of SI joint pain and abnormal radiopharmaceutical activity in the SI joint region and/or a positive response to periarticular infiltration of local anaesthetic solution. Results: Sacroiliac joint region disease was identified in 74 horses between November 1997 and March 2002. Dressage and showjumping horses appeared to be at particular risk (P < 0.001). Affected horses were generally slightly older than the normal clinic population (P < 0.0001), taller at the withers (P < 0.0001) and of greater bodyweight (P < 0.01). There was a significant effect of breed (P < 0.001), with a substantially higher proportion of Warmblood horses (51%) in the SI pain group compared to the normal clinic population (29%). There was no correlation between conformation and the presence of SI joint region pain. The tubera sacrale appeared grossly symmetrical in most (95%) horses. Poordevelopment of the epaxial muscles in the thoracolumbar region and asymmetry of the hindquarter musculature were common. Twenty‐six horses (35%) showed restricted flexibility of the thoracolumbar region and 10 (16%) had an exaggerated response to pressure applied over the tubera sacrale. Fourteen horses (19%) were reluctant to stand on one hindlimb for prolonged periods. The majority of horses (75%) had a straight hindlimb flight and only 18% moved closely behind or plaited. In all horses restricted hindlimb impulsion was the predominant feature; invariably this was most obvious when the horse was ridden. Stiffness, unwillingness to work on the bit and poor quality canter were common. Sacroiliac joint region pain was seen alone (47%), or in conjunction with thoracolumbar pain (16%), hindlimb lameness (20%), forelimb lameness (7%) or a combination of problems (10%). Seventy‐three horses (99%) had abnormalities of the SI joint region identified using nuclear scintigraphy. Infiltration of local anaesthetic solution around the SI joint region produced profound improvement in gait in all 34 horses in which it was performed. Conclusions and potential relevance: Careful clinical examination combined with scintigraphic evaluation of the SI joint region and local analgesia can enable a more definitive diagnosis of SI joint region pain than has previously b...

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The sacroiliac joints: evaluation using nuclear scintigraphy. Part 1: The normal horse

Cited by 35 publications

References 11 publications

Evaluation of the diagnostic accuracy of skeletal scintigraphy in lame and poorly performing sports horses

Evaluation of the diagnostic accuracy of skeletal scintigraphy in lame and poorly performing sports horses

Ultrasonographic examination of the equine sacroiliac region

Pain associated with the sacroiliac joint region: a clinical study of 74 horses

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