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Nuclear scintigraphy
Bone-Scintigraphy at Burg Müggenhausen Equine Clinic
A centre for scintigraphy (also called bone scan), including new stables, is currently under construction at Burg Müggenhausen. Therewith we will be able to offer another recognized imaging system, in addition to ultrasound, X-ray and MRI, for diagnostic evaluation.
What does bone-scintigraphy used on horses entail?
The horse has to be stabled at the clinic when undergoing scintigraphic examination and has to remain for at least 2 days due to radiation exposure. When examined a harmless radioactive marker will be injected into the horse’s blood. Within two hours the marker, which is bound to a carrier, accumulates in the skeleton.
A special gamma ray camera will detect the accumulation of radioactivity radiation, which will be translated by a computer into pictures. A kind of “map” is created, which reflects the metabolic and inflammatory status of the musculoskeletal system. Areas with increased metabolism are called ”hot-spots”.
When examined the horse will be slightly sedated and then brought into a purpose built room where the gamma camera and the computer are kept.
When the horse is standing in the room the gamma camera will be moved towards the horse and a variety of pictures can be taken to determine the cause of lameness.
When should scintigraphy be used?
There are different possibilities to determine the cause of the lameness in a horse.
Usually the local veterinary surgeon will do a thorough clinical examination using diagnostic methods such as nerve blocking and/or joint anaesthetization to identify the exact location of the pain causing lameness. X-ray and ultrasound analysis are also used regularly to examine the lame horse. Often the above mentioned diagnostic methods are enough to determine the cause of lameness. But it is becoming more frequent that horses with long term lameness of unknown origin as well as horses with rideability problems due to neck and back problems are referred to the clinic to undergo scintigraphy. Scintigraphy can be useful for the diagnosis of specific lameness of the front and back legs, where the injured site can not be reached by x-rays.
Under these circumstances scintigraphy is a useful complementary examination tool that can determine the cause of lameness or rideability problems.
Scintigraphy can also be used when examining acute lameness problems caused by bone fissures, circulatory disturbance or joint problems that cannot be seen on x-rays.
How is a bone scan performed?
The scintigraphy is usually performed when the horse is standing. Most horses tolerate the procedure when lightly sedated. The sedation is given to prevent anxiety and to make the positioning of the camera easier. Each exposure takes about 60-150 seconds and the computer creates a picture that can be immediately evaluated and be repeated if necessary. The duration of the entire examination depends on the injury and the cooperation of the horse. A whole body scan takes about 1-1,5 hours, a single leg or the vertebral column between 10-30 minutes.
What does scintigraphy reveal?
As with other imaging methods, the evaluation of the pictures requires certain experience. On the site where the bone-metabolism has increased, more radioactive material will have accumulated and higher radiation will be emitted. This shows up on the pictures as being more intensive in colour than the surrounding tissue. Inflammation, fissures, fractures, bone reaction, ligament- lesions or tears as well as bone growth have an increased bone-metabolism, which can be seen as a hot-spot on the picture
How much does a bone scan cost?
Scintigraphy is expensive in comparison to other imaging methods, even so the horse does not need to be put under general anaesthetic. The expenses vary between €350 and €800 depending on the problem that is being evaluated and the effort.
Conclusion
To the veterinary surgeon scintigraphy offers an additional diagnostic technique to evaluate lameness . Its not a miracle diagnostic tool, but it complements the other diagnostic techniques well. In many cases scintigraphy reveals the cause of lameness, particularly in the neck-, pelvis and thigh region, which can not be seen or are difficult to reach with x-rays.
