A suspected fracture is every horse owner’s worst nightmare. In the case of minor breaks, diagnosis is not always easy and your vet will very often use X-rays to try to see exactly what’s happened beneath the skin and soft tissues surrounding the suspected fracture site.
Diagnostic imaging is changing fast however. Traditional X-ray plates have been largely replaced by digital radiography and MRI and ultrasound technology has been routinely used by equine hospitals for many years. That said, diagnostic centres with access to the latest computerised tomography or CT are still relatively few.
CT scanning is high-resolution radiography where images are produced of a virtual ‘slice’ of the region that is being examined. Traditional X-ray imaging shows the internal structures superimposed on top of one another which can make interpretation problematic. CT scanning allows the vet to view the relevant structures a slice at a time. In an interesting experiment, vets in the Netherlands and Belgium took both X-rays and CT scans of horses suspected of having lower limb fractures to see which images produced the most accurate diagnosis. Four experienced equine orthopaedic specialists compared the images, without conferring.
Whilst the comparative diagnosis among the vets was very good, the correlation between the X-rays and CT images was not so impressive. Although both methods highlighted the majority of the fractures, the CT images revealed more detail and showed up tiny cracks around the main fractures and more fragments. For the X-rays the horses were imaged whilst standing and weight-bearing but in order for the CT scans to be carried out, they were under anaesthesia. The vets agreed that there was a possibility that the fractures were more ‘opened up’ for the CT scans but thought nonetheless that this method produced a much better assessment.
All the vets made the valid point that, regardless of the quality and clarity of diagnostic imagery available to them, there was no substitute for surgical evaluation of the bone under anaesthetic in the operating theatre.
In the light of emerging 3D printing technology and its emerging use in the medical field, I for one will be watching the latest veterinary news with interest as I suspect today’s cutting edge technology will be consigned to the history books within the next few years.
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