Diagnóstico ultrasonográfico de fracturas de estrés de tibia mediante Modo B y Doppler de Poder en caballos sangre pura de carrera. Estudio preliminar

V. Ferreira; M. G. Muriel; R. A. López; F. Azcona; C. Tuemmers Apablaza

doi:10.30972/vet.3618108

Authors

V. Ferreira Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias. Hospital Escuela. Servicio de Medicina y Cirugía de Grandes Animales. Cátedra de Medicina Equina https://orcid.org/0000-0003-4981-8084
M. G. Muriel Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias. Hospital Escuela. Servicio de Medicina y Cirugía de Grandes Animales. Cátedra de Medicina Equina https://orcid.org/0009-0004-0929-4719
R. A. López Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias. Hospital Escuela. Servicio de Medicina y Cirugía de Grandes Animales. Cátedra de Medicina Equina https://orcid.org/0000-0002-5112-8085
F. Azcona Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias. Hospital Escuela. Servicio de Medicina y Cirugía de Grandes Animales. Cátedra de Medicina Equina https://orcid.org/0000-0002-6163-6403
C. Tuemmers Apablaza Universidad Católica de Temuco. Facultad de Recursos Naturales. Departamento de Ciencias Veterinarias y Salud Pública https://orcid.org/0000-0002-9723-086X

DOI:

https://doi.org/10.30972/vet.3618108

Keywords:

tibia, ultrasonography, Doppler color, lameness, horses

Abstract

Stress fractures of the tibia are common causes of lameness of the pelvic limbs of young Thoroughbreds (TB). If not detected in time, they can progress to complete tibial fractures, which in most cases leads to equine euthanasia. Historically, nuclear scintigraphy has been the imaging modality of choice for the diagnosis of tibial stress fractures; however, it is a complex and expensive method and is not available in many countries. A preliminary, descriptive and retrospective study was conducted on 12 horses with an ultrasonographic diagnosis compatible with tibial stress fractures. The objective was to describe the use of B-Mode (BM) and Power Doppler (PD) ultrasonography for the diagnosis of tibial stress fractures in TB, between 2 and 3 years old, of both sexes, all with a history of acute pelvic limbs lameness. Ultrasonographic evaluations in MB and DP were always performed by the same operator using a portable ultrasound machine. Images compatible with incomplete stress fractures were obtained in 10/12 horses, and complete displaced tibial stress fractures were found in 2/12 of the horses evaluated. BM ultrasound combined with PD proved to be an accessible and effective method to visualize changes compatible with stress fractures on the cortical surface of the tibia in the horses under study.

Downloads

Download data is not yet available.

References

Almanza A, Whitcomb MB. Ultrasonographic diagnosis of pelvic fractures in 28 horses. Proc. Am. Ass. Equine Pract. 2003. p. 50-54.

Banal F, Gandjbakhch F, Foltz V, Goldcher A, Etchepare F, Rozenberg S, Koeger A, Bourgeois P, Fautrel B. Sensitivity and specificity of ultrasonography in early diagnosis of metatarsal bone stress fractures: a pilot study of 37 patients. J Rheumatol. 2009; 36: 1715-1719.

Bianchi S. Ultrasound and bone: a pictorial review. J. Ultrason. 2020; 23(3): 227-257.

Bodner G, Stöckl B, Fierlinger A, Schocke M, Bernathova M. Sonographic findings in stress fractures of the lower limb: preliminary findings. Eur. Radiol. 2005; 15(2): 356-359.

Bowers, Kristin, Joshua T. Weinhandl y David E. Anderson. A review of equine tibial fractures. Equine Vet J. 2023; 55(2): 171-181.

Chao HC, Kong MS, Lin TY, Chiu CH, Wang CR, Lee ZL. Sonographic and color Doppler sonographic diagnosis of acute osteomyelitis: report of one case. Acta Paediatr Taiwan. 1999; 40(4): 268-270.

Davidson EJ, Martin BB Jr. Stress fracture of the scapula in two horses. Vet Radiol Ultrasound. 2004; 45(5): 407-410.

Davidson EJ. Pathophysiology and clinical diagnosis of cortical and subchondral bone injury. In: Ross MW, Dyson SJ, editors. Diagnosis and Management of Lameness in the Horse. 2nd edition. Philadelphia: W.B. Saunders Co. 2011; 935-946.

Dyson SJ. The elbow, brachium, and shoulder. In: Ross MW, Dyson SJ, editors. Diagnosis and Management of Lameness in the Horse. 2nd edition. Philadelphia: W.B. Saunders Co. 2011; 456-474.

Farkash U, Naftal J, Deranze E, Blankstein A. Ultrasonography as a diagnostic modality of tibial stress fractures. J. Musculoskelet. Res. 2008; 11(02): 55-61.

Ferreira V, Boffa, MF, Monina MI. Ultrasonografía musculo-esquelética con Doppler de poder asociado al modo B en el equino. Rev vet. 2022; 33(2): 235-240.

Leininger AP, Fields KB. Ultrasonography in early diagnosis of metatarsal bone stress fractures. Sensitivity and specificity. J. Rheumatol 2010; 37(7): 1543.

McGlinchey L, Hurley M, Riggs C, Rosanowski S. Description of the incidence clinical presentation and outcome of proximal limb and pelvic fractures in Hong Kong racehorses during 2003-2014. Equine Vet. J. 2017; 49: 789-794.

O’Sullivan CB, Lumsden JM. Stress fractures of the tibia and humerus in Thoroughbred racehorses: 99 cases (1992–2000). J Am Vet Med Assoc. 2003; 222: 491-498.

Paliwal A, Sahdev R, Deshwal A, Ram B. Role of ultrasound in the diagnosis of pediatric acute osteomyelitis. J. Ultrason. 2021; 21(84): 34-40.

Pilsworth R, Webbon P. The use of radionuclide bone scanning in the diagnosis of tibial ‘stress’ fractures in the horse: a review of five cases. Equine Vet J Suppl. 1988; (6): 60-65.

Pohl MB, Mullineaux DR, Milner CE, Hamill J, Davis IS. Biomechanical predictors of retrospective tibial stress fractures in runners. Journal of biomechanics. 2008; 41(6): 1160-1165.

Puccetti M, Beccati F, Denoix JM. Bone stress injuries and fatigue fractures of the pelvis in endurance horses. Equine Vet J. 2022; 54: 1064-1075.

R Core Team R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing, Vienna, Austria. 2024. Disponible en: https://www.R-project.org/.

Ramzan P, Newton J, Sheperd M, Head M. The application of a scintigraphic grading system to equine tibial stress fractures: 42 cases. Equine Vet J. 2003; 35(4):382-388.

Ruggles AJ, Moore RM, Bertone AL, Schneider RK, Bailey MQ. Tibial stress fractures in racing standardbreds: 13 cases (1989-1993). J Am Vet Med Assoc. 1996; 209(3): 634-637.

Samol M, Uzal A, Hill E, Arthur M, Stover M. Characteristics of complete tibial fractures in California racehorses. Equine Vet. J. 2020; 53(5): 911-922.

Sofka CM. Imaging stress fractures. Clin Sport Med. 2006; 25: 53-62.

Sokol B, Zangari J, Kahn R. Stress fractures: pathophysiology, epidemiology, and risk factors. Curr Osteoporos Rep. 2006; 4: 103-109.

Spike L, Bramlage R, Embertson M, Hance R. Tibial fractures in 51 racehorses. Proc. Am. Ass. Equine Pract. 1996; 42: 280-281.

Sprayberry KA, Robinson NE. Robinson’s current therapy in equine medicine. Elsevier Health Sciences. 2014.

Stover SM. Diagnostic workup of upper-limb stress fractures and proximal sesamoid bone stress remodeling. Proc. Am. Ass. Equine Pract. 2013; 59: 427-435.

Vaughan B, McKerney E, Wollenberger C, Cloninger A, Spriet M, Galuppo L, Stover S. Ultrasonographic diagnosis of humeral stress fracture in thoroughbred racehorses. 2024.

Vergara F, Ruta S, Rosa J, Marín J, García-Mónaco R, Soriano ER. Valor de la ecografía con Doppler de poder en pacientes con artritis reumatoide en remisión clínica: ¿reclasificación de la actividad de la enfermedad? Reumatología clínica, 2018; 4: 202-206.

Warden S, Burr D, Brukner P. Stress fractures: pathophysiology, epidemiology, and risk factors. Curr Osteoporos Rep. 2006; 4: 103-109.

Worden P, Peloso J, Legg R. How to Radiograph and Diagnose Fractures of the Tibia in the Field. Proc Am Ass Equine Pract. 2013; 59: 403-9.