Retrospective study of scintigraphic and radiological findings in 21 cases of enostosis-like lesions in horses.
Authors: O'Neill H D, Bladon B M
Journal: The Veterinary record
Summary
# Editorial Summary O'Neill and Bladon reviewed eight years of lameness investigations at a UK equine clinic to characterise enostosis-like lesions (ELLs)—focal areas of abnormal bone remodelling visible on both scintigraphy and radiography—in 21 horses, identifying 68 distinct lesions across 57 long bones. Notably, hindlimbs bore significantly more lesions than forelimbs, though laterality was balanced, and approximately 71 per cent of cases presented with lameness attributable to the ELLs themselves rather than as incidental findings during investigation of other problems. Follow-up imaging in five horses revealed new lesion development in the same or contralateral limbs, suggesting these are potentially progressive or recurrent lesions, yet all 18 horses with available outcome data responded to conservative management and returned to work, with thoroughbreds subsequently performing at pre-diagnosis levels. These findings indicate that ELLs, whilst often causing clinical lameness, carry a favourable prognosis under appropriate management and warrant consideration as a differential diagnosis in lameness cases—particularly hindlimb lameness—where scintigraphic changes are not fully explained by conventional radiography. The predilection for hindlimbs may reflect higher loading demands or suggest a metabolic or training-related aetiology worth investigating further in future prospective studies.
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Practical Takeaways
- •ELLs identified on scintigraphy and radiography in lame horses respond well to conservative management, with most horses returning to full soundness
- •New ELL lesions can develop over time in the same or different limbs, so repeat imaging may be warranted in horses with recurrent lameness
- •Hindlimbs are more commonly affected than forelimbs; consider this distribution when investigating lameness with imaging
Key Findings
- •68 foci of increased radiopharmaceutical uptake were identified across 57 long bones in 21 horses with enostosis-like lesions
- •ELLs were the attributed cause of lameness in 71% (15/21) of cases, with remainder being incidental findings
- •Hindlimbs had significantly more lesions than forelimbs, with no difference between right and left limbs
- •All 18 horses with follow-up information returned to soundness with conservative treatment; thoroughbreds maintained pre-investigation performance levels