Equine Imaging

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Equine Imaging LeeAnn Pack DVM Diplomate ACVR

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Shoulder – Supraglenoid Tubercle Fx

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Carpus (otherwise known as "knee") Standard perspectives Lateral Flexed horizontal DP DLPMO DMPLO Optional Skyline of distal column (most regularly shot) Skyline of proximal line Skyline of distal sweep

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Lateral Antebrachiocarpal joint Does not impart Middle carpal joint Communicates with CMC joint Carpometacarpal joint Radial carpal bone has dorsal arched surface Intermediate carpal bone has straight or curved dorsal surface

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Flexed Lateral Non weight bearing Used to isolate out proximal line "I" is high – spiral drops I ntermediate c arpal bone moves u p ("ICU") 3 rd additionally drops

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Flexed Lateral Carpus

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Dorsopalmar (DP) Accessory carpal bone is sidelong Dorsopalmar

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DLPMO Dorsolateral-palmaromedial 55 degrees parallel of dorsal plane Highlights dorsomedial and palmarolateral viewpoints L can be drawn I U R

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DMPLO Dorsomedial-palmarolateral 55 degrees average of dorsal plane Highlights dorsolateral and palmaromedial angles Splint and 2 nd on top of each other

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Skyline of Distal Row Carpus is flexed (non weight bearing) Dorsoproximal dorsodistal sideways 35 degrees from plane of tape 3 rd carpal bone focal 2 nd and 4 th average and sidelong, individually 3 rd carpal cracks, sclerosis L

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Skyline of Proximal Row Same introductory setup concerning distal line Steeper 55 degree point from plane of tape Radial and transitional chip breaks

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Skyline of Distal Radius Even more extreme (85 degrees) from plane of tape Chip cracks at craniodistal span L

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DJD/Soft Tissue Swelling Soft tissue swelling basic Intracapsular (can't see fat cushions) versus extracapsular Antebrachiocarpal joint does not impart May be focused over a particular joint DJD Osteophytes Entheseophytes

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Cyst-like Lucencies Carpal bones Distal range Often coincidental

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Angular Limb Deformities Physitis in distal sweep Asymmetric physeal development Incomplete solidification of the cuboidal bones Young foals Premature or twins More adjusted not cubelike Can get to be distinctly contorted Valgus or Varus

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Angular Limb Deformities

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Chip Fractures Small piece at articular edge **Dorsomedial part of spiral carpal bone (proximal or distal) **Proximal part of transitional carpal bone May require flexed sidelong or horizon (proximal line) to recognize Dorsodistal span Radial feature of third carpal bone

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Slab Fractures Involve proximal AND distal articular surface **Dorsal part of third carpal bone May be gone before by sclerosis on horizon distal column Seen on parallel, slanted or horizon distal line Less ordinarily outspread or 4 th carpal bones

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Slab Fx

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Tarsus Standard perspectives Lateral DP DLPMO DMPLO Optional Flexed horizontal Skyline of calcaneus

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Lateral Tibiotarsal (talocrural) joint Proximal intertarsal joint Communicates with talocrural joint Distal intertarsal joint Tarsometatarsal joint Communicates with DIJ in 8-24 % of stallions

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Anatomy Lateral and DP 1. Tibia 2. Average malleolus 3. Horizontal malleolus 4. Calcaneus 5. Bone 6. Focal tarsal bone 7. 3 rd tarsal bone 8. 4 th tarsal bone 9. MT3 10. MT2 11. MT4

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Dorsoplantar (DP) Best to assess width of joint spaces Fused 1 st and 2 nd tarsal bones

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DLPMO 45 degrees horizontal of dorsal plane Highlights dorsomedial and plantarolateral parts of bone structure Medial malleolus of tibia Medial trochlear edge of bone Dorsomedial parts of 3 rd and focal tarsal bones MT IV

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Anatomy DLPMO 1. Tibia 2. Bone average trochlear edge 3. Horizontal trochlear edge 4. Base of bone 5. Calcaneus 6. Focal tarsal bone 7. 3 rd tarsal bone 8. 4 th tarsal bone 9. MT3 10. MT4

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DMPLO 45 degrees average of dorsal plane May be acquired from plantar position (PLDMO) Highlights dorsolateral and plantaromedial parts of bone structure Lateral trochlear edge of bone structure ("Larrys nose") Intemediate edge of distal tibia DL parts of proximal and distal intertarsal joints Sustentaculum bone

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Anatomy DMPLO 1. Tibia 2. Calcaneous 3. Sustentaculum bone 4. Bone – horizontal trochlear edge 5. Bone average trochlear edge 6. Focal tarsal bone 7. 3 rd tarsal bone 8. Combined 1 st and 2 nd tarsal bone 9. MT3 10. MT4 11. MT2

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Flexed Lateral Non weight bearing May enhance representation of plantar part of talocrural joint

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Skyline of Calcaneus (Proximoplantar-distoplantar) Non weight bearing Sustentaculum bone Tarsal furrow (DDF and sheath pass through) Tuber calcanei (tuber calcis) Proximal part of average trochlear edge of bone

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Variations in Medial Trochlea

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Tarsal DJD ("Bone Spavin") DIJ or TMTJ influenced most ordinarily Often two-sided and might be coincidental Proximal intertarsal joint less generally Talocrural joint may have emission because of correspondence ("marsh spavin")

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Osteophytes - DJD

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Normal Variants of Medial Trochlear Ridge

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Common locales **Distal transitional edge of tibia ("DIRT" injury) Cranial perspective **Lateral and (less normal) average trochlear edges of bone Medial malleolus of tibia Osteochondrosis or Osteochondritis Dissecans (Fragment regularly present)

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DIRT close up

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Lateral Trochlear Ridge OCD

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Fractures Uncommon Slab cracks Very hard to see, may require different obliques Third and focal tarsal bones Avulsion of malleoli

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Tarsal Bone Collapse Incomplete cuboidal bone solidification Rounded, with granular mistiness Premature, twins If appendage bolster not gave Compression of third and focal tarsal Bones get to be wedge molded, may piece Excess flexion of hawk or valgus

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What occurs after some time

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Stifle Standard perspectives Lateral Caudolateral-craniomedial sideways Caudocranial (CC) Optional Flexed horizontal Skyline of patella

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Lateral Medial trochlear edge is bigger and more cranial Femoropatellar joint Medial and parallel femorotibial joints FPJ and Med FTJ more often than not impart FPJ and Lat FTJ may convey

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Caudolateral Craniomedial Oblique 30 degrees sidelong of caudal plane Highlights sidelong trochlear edge of femur (more cranial distally)and average femoral condyle (all the more caudal)

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Caudocranial (CC) Slight downhill edge to overcome joint Fibula is parallel May have isolate hardening focuses that never meld

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Flexed Lateral Non weight bearing Patella goes dorsal Evaluate proximal part of trochlear edges Look for cranial cruciate separation sections

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Skyline of Patella Cranioproximal-craniodistal perspective of patella Patellar breaks, OCD

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Osteochondrosis or OCD Effusion **Lateral trochlear edge of femur Lateral view or Cd lat-Cr med slanted Medial trochlear edge of femur Articular surface of patella

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Osteochondrosis Cyst-like Lucencies Medial femoral condyle Cyst-like lucency Often encompassed by sclerosis Communicates with joint space Early or gentle injuries may show up as smoothing of articular surface CC view or Cd lat-Cr med angled

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Couple of Examples

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DJD Osteophytes Esp. CC see at average and sidelong tibial condyles Entheseophytes Effusion Joint space narrowing Subchondral sclerosis

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Patella Luxation Upward obsession Usually clinical not radiographic finding Lateral patellar luxation Foals Miniature steeds

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Fractures Tibia Avulsions of tibial tuberosity Fuses by 3 years Medial intercondylar prominence with cranial cruciate bursts Femur Salter Harris fxs of distal femoral physis Trochlear edges or condyles (NOT osteochondrosis) Patella May be connect with femoral trochlear edge breaks Skyline normally important to see degree

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Calcinosis Circumscripta

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Calcinosis Circumscripta

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Bone Islands

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Side Bones

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GP Empyema

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GP Tympany

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Ethmoid Hematoma

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Foal Pneumonia

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What Structures Can You Name?

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Tooth Root Abscess

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What's Abnormal?

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Normal Sinuses

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Fluid Lines in Sinuses

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Cow Magnet

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Bovine Distal Limb

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Thanks to Dr. Paul Rist for utilization of a portion of the slides in this address.