Equine Imaging

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Shoulder

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Slide 1

Equine Imaging LeeAnn Pack DVM Diplomate ACVR

Slide 2

Shoulder – Supraglenoid Tubercle Fx

Slide 3

Carpus

Slide 4

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

Slide 5

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

Slide 6

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

Slide 7

Flexed Lateral Carpus

Slide 8

Dorsopalmar (DP) Accessory carpal bone is sidelong Dorsopalmar

Slide 9

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

Slide 10

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

Slide 11

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

Slide 12

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

Slide 13

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

Slide 14

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

Slide 15

Cyst-like Lucencies Carpal bones Distal range Often coincidental

Slide 16

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

Slide 17

Angular Limb Deformities

Slide 18

ALD

Slide 19

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

Slide 20

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

Slide 21

Slab Fx

Slide 22

Tarsus

Slide 23

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

Slide 24

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

Slide 25

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

Slide 26

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

Slide 27

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

Slide 28

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

Slide 29

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

Slide 30

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

Slide 31

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

Slide 32

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

Slide 33

Variations in Medial Trochlea

Slide 34

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")

Slide 35

Osteophytes - DJD

Slide 36

DJD

Slide 37

Normal Variants of Medial Trochlear Ridge

Slide 38

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)

Slide 39

DIRT

Slide 40

DIRT

Slide 41

DIRT

Slide 42

DIRT close up

Slide 43

Lateral Trochlear Ridge OCD

Slide 44

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

Slide 45

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

Slide 46

What occurs after some time

Slide 47

Stifle

Slide 48

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

Slide 49

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

Slide 50

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)

Slide 51

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

Slide 52

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

Slide 53

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

Slide 54

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

Slide 55

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

Slide 56

Couple of Examples

Slide 57

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

Slide 58

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

Slide 59

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

Slide 60

Calcinosis Circumscripta

Slide 61

Calcinosis Circumscripta

Slide 62

Misc.

Slide 63

Sequestrum

Slide 64

Sequestrum

Slide 65

Sequestrum

Slide 66

Bone Islands

Slide 67

Side Bones

Slide 68

CHOKE

Slide 69

GP Empyema

Slide 70

GP Tympany

Slide 71

Chondroids

Slide 72

Ethmoid Hematoma

Slide 73

Foal Pneumonia

Slide 74

What Structures Can You Name?

Slide 75

Tooth Root Abscess

Slide 76

What's Abnormal?

Slide 77

Normal Sinuses

Slide 78

Fluid Lines in Sinuses

Slide 79

Bovine

Slide 80

Cow Magnet

Slide 81

Bovine Distal Limb

Slide 82

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

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