Hard to Diagnose Lameness? Nuclear Scintigraphy is Available to Help

Chicago Equine Medical Center has had nuclear scintigraphy since 1997 and has scanned over 2000 horses. Using our extensive experience, we have developed several new ways to look at the bones of the horse. Our nuclear technicians have the ability to pick up changes in the bone while they are scanning the horse and take different views so the radiologist can tell exactly were the lesion is located. We don’t just use a cookbook style of scanning a horse. We will design a scan for each specific horse. Our Front End Bone Scan with Soft Tissue phase starts with 29 basic images; Hind End Bone Scan with Soft Tissue phase starts with 36 images; Whole Body Bone Scan with Soft Tissue phase start with 73 images. There is no increase in fee for extra images. Our goal is to get the best possible images so that you can get an accurate diagnosis.  We utilize the skills of Dr. Sarah Puchalski, a board certified radiologist to read our Bone Scans and can usually have a report within 24 hours of the completion of the scan.

Bone Scintigraphy

Bone scintigraphy is the most commonly performed nuclear medicine scan in horses and is indicated in a variety of skeletal disorders because of its high sensitivity and the ease at which the entire skeleton can be imaged. Nuclear scintigraphy represents images of physiology. This contrasts with radiography, which represents images of morphology. Nuclear scintigraphy (Bone Scan) can detect diseases that alter physiology before there are morphologic changes in structure. Since there is often a lag period of 7-14 days before morphologic changes in bone density, a bone scan can detect bony abnormalities earlier, thus providing better case management. Although nuclear medicine is more sensitive than other imaging modalities, it is often less specific. Specificity of bone scintigraphy has advanced with improvements in image quality and increasing experience in clinical interpretation.  However, it is still recommended that scintigraphy be combined with Digital Radiographs (DR), Ultrasound Scan (US) or other imaging modality such as CT or MRI to determine the cause of the bony lesion.

Advantages over radiography

  • High sensitivity for detecting early disease
  • Ease of surveying the entire skeleton (the whole horse); especially helpful for areas that are difficult to radiograph, for example the pelvis
  • A negative scan virtually rules out active bone pathology and many forms of joint disease (except osteochondrosis, OCD lesions
  • Ability to follow-up lesions for resolution

Advantages over MRI

  • Bone scan doesn’t require a specific location of interest
  • MRI requires a specific location (such as the horse blocks sound to the fetlock).
  • Bone scan can be done on the whole horse even its teeth.

Indications for bone scintigraphy

  • Diagnosis of occult or intermittent lameness
  • Bone survey for multiple limb lameness
  • Early detection of skeletal injury – fracture
  • Determining extent and severity of skeletal lesion – activity of radiographic lesions
  • Localization of pain but inability to diagnose cause using radiography and ultrasonography
  • Poor performance of ill-defined cause
  • Suspected thoracolumbar or pelvic region pain
  • Evaluation of healing response
  • Evaluation of blood flow to bone

Please note that Bone Scintigraphy should not be a substitute for comprehensive exam.

If you would like more information or would like to send a referral for a bone scan, please don’t hesitate to contact our office.