Detection of rib trauma in newborn foals in an equine critical care unit: a comparison of ultrasonography, radiography and physical examination.
Authors: Jean D, Picandet V, Macieira S, Beauregard G, D'Anjou M A, Beauchamp G
Journal: Equine veterinary journal
Summary
# Editorial Summary: Detecting Rib Trauma in Newborn Foals Birth-related rib fractures represent a significant but often-underdiagnosed injury in neonatal foals presenting to critical care facilities. Jean and colleagues prospectively examined 29 foals using physical examination, radiography, and ultrasonography to compare diagnostic accuracy and characterise fracture patterns. Ultrasonography identified 49 rib fractures across 19 foals (65%), substantially outperforming radiography which detected only 10 fractures in 5 foals (19%)—a finding consistent with human medicine. The vast majority of fractures (90%) occurred within 3 cm of the costochondral junction with lateral displacement of the distal fragment, and fillies were disproportionately affected (68% of cases), suggesting trauma occurs during parturition rather than handling post-birth. With 65% of fractured ribs showing moderate displacement (1–4 mm), most injuries are likely subclinical by radiographic standards yet clinically relevant for pain management and monitoring. For equine practitioners, this work strongly supports ultrasonography as the diagnostic modality of choice for rib fractures in neonates and highlights the importance of thoracic screening in foals with difficult births or fillies specifically, allowing timely intervention to improve welfare outcomes.
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Practical Takeaways
- •Use ultrasonography as the primary imaging modality for suspected rib fractures in newborn foals, as it detects 3.4× more fractures than radiography
- •Expect a high incidence of rib fractures in foals presenting to emergency units (65%), particularly fillies with left-sided trauma, suggesting routine screening may be warranted
- •Most fractures occur at the costochondral junction during birth; focus monitoring and supportive care on pain management and prevention of displacement complications
Key Findings
- •Ultrasonography detected 49 rib fractures in 19 of 29 foals (65%), compared to only 10 fractures in 5 of 26 foals (19%) on radiography
- •Fillies were significantly over-represented in rib fracture cases (68%), with 78% of fractures located on the left thorax
- •90% of detected fractures were located within 3 cm of the costochondral junction with lateral displacement of the distal rib fragment
- •65% of fractured ribs exhibited moderate displacement (1-4 mm), suggesting most trauma occurs during parturition