Digital Lameness Diagnostics
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Equine Musculoskeletal Ultrasonography
Dr. Morgan gets very excited about musculoskeletal ultrasongraphy! It's one of her favorite subjects to talk about, to do, to teach, to research. Under the guidance of Dr. Jean-Marie Denoix and the International Society of Locomotor Pathology she has learned how to effectively evaluate every joint, tendon and ligament in the horse from the neck, back and pelvis to the entire front and hind limb using ultrasound.
Morgan Equine has a GE LogicE laptop digital ultrasound machine that it full of features and specialty probes to see detail with extraordinary clarity. We are no longer limited to fuzzy black and white static while ultrasounding the tendons on the back of a cannon bone. Every soft tissue part including the eye, spinal cord and some bone structures can be ultrasounded. Its an extremely sensitive diagnostic tool.
Because our ultrasound is a sophisticated hospital unit, it is not portable. Horses must come to the hospital for evaluation. Although there have been many requests, reproductive work is not with in our ultrasounding repertoire.
Once a focal area of concern has been established, usually confirming by blocking, the horse may need to be clipped to be evaluated. Hair does not make a good acoustic window. The quality of the scan may be compromised if not clipped. In the summer time in some areas on the body this may not be necessary. The skin is prepared with warm to hot water and acoustic ultrasound gel.
The appropriate probe (big, little, deep or shallow) is used to evaluate the area. Ultrasound allows us to evaluate the morphological characteristics of soft tissue and bone structures. We can determine the size, shape, echogenicity (whiteness or brightness), fiber pattern and fluid associated with any structure.
Although we may find abnormalities, it is important to consider the clinical examination and the diagnostics that have been done to get to this point and assign importance to them. We often find abnormalities that are not causing a problem or are not a problem to the horse in its current athletic use.
Initial lameness ultrasound evaluations may take up to an hour to fully evaluate an area of interest. Progress evaluations typically take 20 to 30 minutes or less.
Ultrasound can be used to administer therapies as well. You may see Dr. Morgan do an ultrasound guided injection of a lesion or into a joint. This technique more precisely delivers treatment to the intended area. Its crucial for the neck, back, sacroiliac, foot and stifle areas and requires advanced ultrasound skills.
To accomplish ultrasound guided injection, the probe is prepared with a sterile cover, the area to be injected is prepared with surgical scrub techniques and a sterile injection protocol is followed. It is imperative that the horse remains still during this procedure, even if they are so very good, a small amount of sedation may be administered. The preparation and definitive placement can take a half hour. The actual injection part of the procedure is very quick. A bandage may or may not be used depending on the location of the injection. Written instructions on how to manage the injection site are thoroughly reviewed. Any questions you have will be answered. The next step: Exercise and Riding Protocols.
Morgan Equine has a GE LogicE laptop digital ultrasound machine that it full of features and specialty probes to see detail with extraordinary clarity. We are no longer limited to fuzzy black and white static while ultrasounding the tendons on the back of a cannon bone. Every soft tissue part including the eye, spinal cord and some bone structures can be ultrasounded. Its an extremely sensitive diagnostic tool.
Because our ultrasound is a sophisticated hospital unit, it is not portable. Horses must come to the hospital for evaluation. Although there have been many requests, reproductive work is not with in our ultrasounding repertoire.
Once a focal area of concern has been established, usually confirming by blocking, the horse may need to be clipped to be evaluated. Hair does not make a good acoustic window. The quality of the scan may be compromised if not clipped. In the summer time in some areas on the body this may not be necessary. The skin is prepared with warm to hot water and acoustic ultrasound gel.
The appropriate probe (big, little, deep or shallow) is used to evaluate the area. Ultrasound allows us to evaluate the morphological characteristics of soft tissue and bone structures. We can determine the size, shape, echogenicity (whiteness or brightness), fiber pattern and fluid associated with any structure.
Although we may find abnormalities, it is important to consider the clinical examination and the diagnostics that have been done to get to this point and assign importance to them. We often find abnormalities that are not causing a problem or are not a problem to the horse in its current athletic use.
Initial lameness ultrasound evaluations may take up to an hour to fully evaluate an area of interest. Progress evaluations typically take 20 to 30 minutes or less.
Ultrasound can be used to administer therapies as well. You may see Dr. Morgan do an ultrasound guided injection of a lesion or into a joint. This technique more precisely delivers treatment to the intended area. Its crucial for the neck, back, sacroiliac, foot and stifle areas and requires advanced ultrasound skills.
To accomplish ultrasound guided injection, the probe is prepared with a sterile cover, the area to be injected is prepared with surgical scrub techniques and a sterile injection protocol is followed. It is imperative that the horse remains still during this procedure, even if they are so very good, a small amount of sedation may be administered. The preparation and definitive placement can take a half hour. The actual injection part of the procedure is very quick. A bandage may or may not be used depending on the location of the injection. Written instructions on how to manage the injection site are thoroughly reviewed. Any questions you have will be answered. The next step: Exercise and Riding Protocols.
Indications for Equine Ultrasonography
- Diagnosis of soft tissue injuries. These can be muscular, vascular, tendon, tendon sheaths, ligament, joint capsule, or bursal defects
- Assessment of fluid accumulation
- Evaluation of joint and bony surfaces
- Monitoring healing progress
- Monitoring the effect of training on soft tissue structures, especially tendons and ligaments
Equine Extremity Digital Radiography
As an industry standard, digital radiography equipment has provided us with consistent image quality, ability to find small bone and soft tissue detail on a single image with superior versatility of the display characteristics within the software system. We also have significantly less exposure of radiation to horses and humans and the time it takes to process information is undeniably one of the most attractive features.
We use an Eklin DR system with a minXray generator. We can image limbs, the skull, neck and portions of the back. Pelvic images require a much bigger machine to capture images in the standing horse. Most horses tolerate radiography well. They are either cross tied or held in our imaging area. Depending on the nature of the horse; sedation may or may not be necessary to take diagnostic quality images.
Images are obtained by capturing x-rays on a plate that is connected to a computer that processes information with complex logarithms. The coolest part for clients is that images are taken, viewed and interpreted immediately during the visit. You will know what is happening with your horse before you leave, and yes, we write it all down and can email a digital invoice with all of the information.
Dr. Morgan will interpret the images and explain any unusual findings and their significance. She will take her time making sure you are confident in your understanding of the findings. It is important to remember that abnormalities found on radiographs might not necessarily be a problem.
We use an Eklin DR system with a minXray generator. We can image limbs, the skull, neck and portions of the back. Pelvic images require a much bigger machine to capture images in the standing horse. Most horses tolerate radiography well. They are either cross tied or held in our imaging area. Depending on the nature of the horse; sedation may or may not be necessary to take diagnostic quality images.
Images are obtained by capturing x-rays on a plate that is connected to a computer that processes information with complex logarithms. The coolest part for clients is that images are taken, viewed and interpreted immediately during the visit. You will know what is happening with your horse before you leave, and yes, we write it all down and can email a digital invoice with all of the information.
Dr. Morgan will interpret the images and explain any unusual findings and their significance. She will take her time making sure you are confident in your understanding of the findings. It is important to remember that abnormalities found on radiographs might not necessarily be a problem.
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It can take about a half hour to an hour to radiograph a horse. Evaluation of images and consultation will take as long as you need to understand the issues.
Typically, after radiographs are evaluated there are two possibilities. Either more information will be necessary to come to a conclusion or a therapeutic plan begins to develop. |
Radiography can be diagnostic for many conditions, but remember it's use is fairly well confined to evaluating bone structures.
Many people ask about Pre-purchase radiography. What should I have done? How many? How much does it cost? Taken by Who? Can Dr. Morgan evaluate them?
The answers to those questions are different for each situation. Each horse has a specific job it needs to fulfill. It might take 4 radiographs or 36 to make a decision. A general rule of thumb is to set aside 5% of the cost of the horse for a pre-purchase exam and diagnostics including radiography. Any Equine Veterinarian who has digital radiography and can transmit images will be appropriate. Have images sent to morganequine@gmail.com.
Many people ask about Pre-purchase radiography. What should I have done? How many? How much does it cost? Taken by Who? Can Dr. Morgan evaluate them?
The answers to those questions are different for each situation. Each horse has a specific job it needs to fulfill. It might take 4 radiographs or 36 to make a decision. A general rule of thumb is to set aside 5% of the cost of the horse for a pre-purchase exam and diagnostics including radiography. Any Equine Veterinarian who has digital radiography and can transmit images will be appropriate. Have images sent to morganequine@gmail.com.
Dynamic Respiratory Evaluations
Upper airway function is critical to equine athletic performance. We can arrange to have wireless upper endoscopic examination of horses as they work under normal conditions. Using the newest version of the Dynamic Respiratory Scope (DRS Version 3) from Optomed, high quality images of the equine airway can be obtained to maximize diagnostic accuracy.
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