"Lameness Imaging Like You've Never Seen It Before"
Led by Dr. Shannon Holmes, UGA CVM Department of Diagnostic Imaging
Bullet points, because this lady had a lot of information and it went so over my head. Also, she had an intelligent, dry wit and made me think of Daria.
- If treatment isn't working, then you have the wrong diagnosis.
- Diagnostic analgesia (blocking): lesions are clinically significant if they correspond with blocking. (Which, I think also can be taken the other way: if there's a lesion but lameness doesn't improve with blocking of that lesion, then it isn't clinically significant.)
- Imaging modalities:
- radiographs (x-rays): due to cost/size/ability to transport, this is still the first line.
- Always take all four directions, because it's easy to miss stuff. In fact, you still might be in the wrong area or performing the wrong test (which leads back to performing correct diagnostic analgesia).
- There has to be a 30-50% increase in bone mineral before the human eye can detect it. So, you know, shit has to be pretty fucked up.
- ultrasound: high user dependency, which means that if the person performing the u/s isn't the best at his or her job, you may miss stuff or misread stuff.
- nuclear scintigraphy: (I'd never heard of this one until I googled it later and found out that this is the fancy name for a bone scan) sensitive, but not specific. Difficult for soft tissue, but good for the sacro-illiac joint. Rood and Riddle has some pretty good information and photos on it.
- computed tomography: AKA, "Cat Scan". She didn't even touch on this one because she said that it just doesn't happen.
- magnetic resonance imaging (MRI): this was Dr. Holmes' favorite. She said that in the past, there was an issue with horses waking up from general anesthesia, but that it is now very safe. She talked a little bit about the two types of MRI magnets and what they were for and showed a few photos, but essentially: it's safe and they're going to shove as much of the horse into the machine as they safely can.
|Here's a photo of an MRI. Of course, it isn't a UGA photo because they haven't shared the presentations. (I've requested!)|