Diagnostic Imaging

Computed Tomography (CT)

Under general anesthesia, computed tomography (CT) illustrates bony and soft tissue lesions in transverse slices that usually can’t be seen in standard radiographic imaging.

The Use of CT Scans During Surgery

The use of computed tomography (CT) scans during orthopedic surgery to characterize a bone break has been seminal in the treatment protocols. The surgeon can easily comprehend a complete three-dimensional configuration of a fracture.

Many repairs are done with minimally invasive surgery, using a combination of the CT, intraoperative fluoroscopy (real-time X-ray), and arthroscopy.  The procedure is performed through tiny incisions instead of surgically opening up the leg.

Nuclear Medicine

Nuclear medicine, commonly referred to as nuclear or bone scintigraphy, involves the administration of a radiopharmaceutical that binds to bone where there is injury, or at sites of active bone formation. Used in conjunction with lameness examination and diagnostic analgesia, this modality can assist in identifying the cause of lameness.

Potential Candidates for Nuclear Scintigraphy

Horses that might benefit from nuclear scintigraphy include:

• Horses with suspected stress related bone injury
• Horses in which radiographic images are negative or confusing
• Horses in which pain causing lameness can be localized using nerve blocks but the cause of pain cannot be determined on radiography and ultrasonography
• Horses with high-speed lameness, or poor performance
• Horses with numerous, subtle lameness abnormalities 
• Horses with neck, back, or pelvic problems
• Horses with suspected soft tissue injury such as suspensory ligament, skeletal muscle, or soft tissue structures in the navicular region

Bone scan images are most valuable in horses in which a detailed lameness examination, done by your veterinarian or here at New Bolton Center, is completed before imaging and the results are then interpreted along with all other clinical and diagnostic information.  Horses must remain in the hospital for 24 hours after radiopharmaceutical administration to allow the radioactivity to subside.

PET Scan

Limb fractures in horses are often fatal, so diagnosing and preventing these injuries are essential to equine health. An Equine PET (Positron Emission Tomography) Scan is a nuclear medicine imaging technique, similar to scintigraphy.

Both scintigraphic and PET scans detect “hot spots” that may indicate microscopic changes that may develop into more severe injuries. Initially, this type of imaging required horses to undergo general anesthesia. Today, the procedure can be done with simple sedation.

What to Expect

A small dose of a radioactive agent is injected about 30 minutes prior to imaging. This agent distributes through the body and accumulates in regions with increased bone turnover. Once the horse is sedated, the procedure takes between 3-5 minutes to image each site. In less than 30 minutes, both front feet and both front fetlocks can be imaged.

Results

CT/PET fused images of a fetlock in a horse demonstrate many sites of uptake of the radioactive agent in the fetlock indicating multiple sites of bone injury

CT/PET fused images of a carpus (knee) in a horse demonstrate significant uptake of the radioactive agent in the third carpal bone indicating bone injury

Radiology

Radiology encompasses digital imaging in the radiology and surgery suites, stall-side imaging, and imaging in the field.
 
An 800 mA X-ray generator in the radiology suite provides imaging for standing, adult large animals; covering head, neck, chest, shoulders, elbows, and stifles. Standing radiographs of the abdomen assist in diagnosis of gastrointestinal and urinary bladder abnormalities. Myelograms can also be performed on the cervical spine as well as radiographs of the pelvis and lower spine.

For information or to schedule an appointment, please call 610-925-6198 or email sportmed@vet.upenn.edu.

Robotic Imaging

Penn Vet was the world’s first veterinary teaching hospital to use a robotics-controlled imaging system. 

This system has proven value for both clinical and research applications for both animal and human medicine.

What We offer

• Robotic imaging of the head, cervical spine and distal limb (mid-radius to foot and distal tibia to foot)
• Esophagrams / TVEC fluoroscopy

Ultrasonography

Ultrasound is an excellent method to evaluate soft tissue structures and the surface of bone.  Ultrasound is known as a “user dependent modality” and our faculty have advanced training in musculoskeletal ultrasound and general ultrasound imaging. We have several state of the art “console” or hospital units in addition to portable capabilities. In our clinic, ultrasound is routinely but not exclusively used for evaluation for soft tissue injury in the lame horse, causes of acute or chronic colic, weight loss, thoracic disease, neonatal foals, high risk pregnant mares and our farm animal species.  It is used to perform ultrasound guided injections, biopsies and intra-operative procedures, thus improving the accuracy and safety of these procedures over ‘blind’ techniques.

For information or to schedule an appointment, please call (610) 444-5800. Appointments may be made by the owner, trainer, or referring veterinarian.