Authors: Spriet M, Espinosa-Mur P, Cissell D D, Phillips K L, Arino-Estrada G, Beylin D, Stepanov P, Katzman S A, Galuppo L D, Garcia-Nolen T, Murphy B, Stover S M
Journal: Equine veterinary journal
Summary
# Editorial Summary Catastrophic musculoskeletal injuries in racing Thoroughbreds often follow a period of progressive bone stress remodelling that conventional imaging struggles to detect at early, interventionable stages. Spriet and colleagues evaluated 18F-sodium fluoride positron emission tomography (18F-NaF PET) as a diagnostic tool by scanning twenty fetlocks from nine racehorses using PET alongside computed tomography, scintigraphy, and in selected cases MRI and histological examination, with three board-certified radiologists independently reviewing all imaging findings. PET proved superior at identifying focal areas of increased bone turnover—particularly in the proximal sesamoid bones—where other modalities showed no abnormalities, with standardised uptake values providing quantifiable measures of lesion activity that correlated with histological evidence of increased vascularity and osteoblastic activity. The technique was well-tolerated by all horses, positioning it as a feasible clinical tool for early detection of stress remodelling before catastrophic failure occurs. For racing practitioners, these findings suggest that 18F-NaF PET could bridge a critical diagnostic gap, potentially allowing intervention at preclinical stages when athletic careers might be preserved rather than lost to sudden breakdown.
Read the full abstract on PubMed
Practical Takeaways
- •18F-NaF PET offers superior early detection of stress-related bone changes compared to standard imaging, potentially enabling earlier intervention to prevent catastrophic breakdown
- •PET appears particularly valuable for identifying subtle lesions in proximal sesamoid bones, a common site of racehorse injury
- •Consider PET imaging as part of pre-racing evaluation or when other imaging modalities are inconclusive, though access and cost may be limiting factors
Key Findings
- •18F-NaF PET imaging was well-tolerated in all nine Thoroughbred racehorses studied
- •PET detected focal areas of 18F-NaF uptake in proximal sesamoid bones where CT and scintigraphy did not identify abnormalities
- •Areas of 18F-NaF uptake corresponded histologically to regions of increased vascularity and osteoblastic activity
- •Maximal standardised uptake values could be quantified to measure lesion activity