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Equine MRI



With such a large equine community in the Ballarat area, BVP has recognised a high demand for accurate lameness diagnostic technology. This is why we are proud to offer diagnostic imaging of the foot and leg using the Hallmarq Standing Equine MRI to give both sport and leisure horses an early, safe and accurate diagnosis. The Hallmarq MRI scanner is located in a purpose designed building at the clinic and a team of vets has been trained to use the scanner and interpret the resulting images to the highest standard. We have established relationships with leading specialist radiologists in the UK and USA who have been providing written reports on our images.

The Hallmarq Standing Equine MRI uses a strong magnetic field to produce images of soft tissues and bone. The procedure is non-invasive and does not require general anaesthesia. Sedation is used to prevent the horse from moving throughout the procedure. In most cases we will remove the front or back shoes depending on the region of interest to prevent interference with the magnetic field. The scan itself takes around 1-2 hours and you may be able to pick up your horse later the same day depending on when the scan takes place. However each scan produces up to 500 separate images, so interpretation takes time. The images are sent to a specialist for interpretation and the diagnosis may take a few days.

It is important to keep in mind that Standing MRI does not replace the skill and experience of an equine vet. The initial clinical examination is still essential and preliminary diagnostic imaging (ultrasound, x-ray, bone scan) may be recommended. Our MRI system can image an area approximately the volume of a grapefruit so it is impractical for screening purposes.

HOW MUCH DOES A SCAN COST? - The scan costs $2046, which includes two sites. Horses usually stay for 2 days and with the cost of sedation and specialist reading fees of the images the total cost is $2528.

WHAT IS IT USED FOR? - MRI technology is the "gold standard" in medical imaging of soft tissues including tendon, ligament, joint capsule and articular cartilage, giving exquisite anatomical detail and precise localisation of lesions. MRI also provides precise localisation and differentiation of various pathological processes in bone. MRI finds its greatest use in lameness conditions of the lower limb, principally the foot and has revolutionised the diagnosis of injuries/conditions formerly collectively grouped as "navicular syndrome".

WHAT CASES ARE SUITABLE FOR MRI? - Standing MRI is not suitable for large areas or survey imaging of regions of interest unlike nuclear scintigraphy. Therefore, precise localisation of the source of pain is necessary with nerve blocks or on clinical grounds. Indications include:

 

  • Foot pain localised with nerve blocks but with negative radiographic findings
  • Lameness localised to the pastern and fetlock with negative radiographic findings including "hotspots" diagnosed with scintigraphy
  • Differentiating the cause of subchondral bone pathology of the fetlock in performance horses
  • Localising the source of carpal/subcarpal or tarsal/subtarsal pain where other imaging modalities are inconclusive
  • Chronic lameness has been localised to the foot or lower limb by nerve blocks
  • Nuclear scintigraphy (bone scan) is being considered or is negative
  • Access to the area of interest by ultrasound is difficult or impossible
  • There is a penetrating injury needing urgent attention
  • Treatment and healing need to be monitored before returning to work

 

HOW DO I BOOK IN A CASE? - Please contact Dr Brian Anderson (0418506551 or ba@bvp.com.au or Dr Ian Fulton (0418503551 or if@bvp.com.au) or Mrs Chris Clarken or Mrs Kim Hill at our clinic on 0353346756.

If you are not sure whether MRI would be a good choice for your horse or patient, please contact us or for more information on MRI and its uses in equine medicine please see the Hallmarq website.

 

MRI CASE EXAMPLES


CASE 1: Standardbred Racehorse Pastern

This horse presented with acute severe left hindlimb lameness and pastern swelling. X-rays and ultrasound were inconclusive. MRI revealed severe bone marrow lesion of the short pastern bone (P2). The horse was treated with Tildren to reduce bone turnover and improve healing, followed by 4 months of box rest before a gradual return to training. The horse has since returned to training and remains sound.

Case1 1 Case1 2
STIR sagittal image showing abnormally high fluid content (hyperintense signal, arrows) in the short pastern bone. T2*W frontal image showing fluid accumulation (circle) in the short pastern bone.


CASE 2: Standardbred Racehorse Carpus

This horse presented for an 11-month history of right forelimb lameness. A bone scan revealed a "hot spot" in the third carpal bone (C3) of the right knee and x-rays revealed C3 sclerosis. MRI was performed to better characterize the changes, which revealed severe subchondral bone remodeling of C3 with development of an osseous cyst-like lesion surrounded by sclerosis. There was also evidence of degenerative joint disease.

Case2 1 Case2 2
T1W transverse section of the carpus showing marked sclerosis of the subchondral and trabecular bone of the radial facet of C3 (arrows).

T2*W transverse section of the carpus showing marked sclerosis of the subchondral and trabecular bone of the radial facet of C3 (arrow).

Case2 3 Case2 4
T2*W frontal image showing an osseous cyst in the radial facet of C3 (circle).

T1W sagittal image showing fragmentation (degenerative joint disease) of the dorsal proximal aspect of C3 (arrow).


CASE 3: Thoroughbred Racehorse Fetlock

This horse presented with a history of jumping poorly from the barrier and a short, high-stepping gait behind. Bone scan revealed "hot spots" in the lateral condyles of the cannon in the left (predominantly) and right hind fetlock joints. Subchondral bone disease as diagnosed here can actually be one of several injury types: inflammation or oedema (bone bruise), increased bone mineral density (sclerosis), microfracture or prefracture changes, or end-stage or severe bone damage with pending joint collapse. Given that the recommendations for rest and return to training depend on the nature of the injury, MRI was performed. The MRI scan showed moderate sclerosis of the cannon with mild inflammation associated with this. With this type of injury rest periods of less than 6 months result in resumption of lameness, so an 8-12 month spell was recommended. After this period the horse can gradually return to work, ideally using low-impact treadmill training and swimming as much as possible. Also the horse is to be shod in wide-web supportive shoes.

Case3 1 Case3 2
T1W sagittal image showing moderate bone sclerosis of the distal cannon (arrow).

T1W transverse image showing moderate bone sclerosis of the distal cannon, localized to the lateral and medial condyles (circles).