Читать книгу Fractures in the Horse - Группа авторов - Страница 134
Clinical Indications
ОглавлениеThe decision to use MRI in the equine fracture patient is multifactorial, but prior regionalization of the injury is a prerequisite. Lesion location, patient comfort level and the type of system available are all determinants. In the absence of definitive radiographic findings, the commonality of fracture location in horses in training (carpus, fetlock and pastern) means that sMRI can provide a safe method to determine the presence, suspicion or absence of features supportive of a fracture (Figure 5.12). MRI has also proved beneficial in sports horses for fractures when there are discrete clinical findings, but radiographs have been negative [141] or following localization with diagnostic analgesia, again with negative radiographic and ultrasonographic findings (Figure 5.13). In addition to assisting in diagnosis, MRI also gives an insight into the health of subchondral bone [142]. When considering the bone stress injury continuum, a BML depicting stress reaction at a predilection site for an exercise‐related fracture can represent prodromal damage [88, 143]. Following the bone’s normal pathogenetic response, a discernible fracture line may, in time, become evident [144] and demonstrate a lesion that requires surgical intervention. MRI under general anaesthesia is not usually indicated in suspected equine fractures.