Scintigraphic examination of the cartilages of the foot.
Authors: Nagy A, Dyson S J, Murray R M
Journal: Equine veterinary journal
Summary
# Editorial Summary: Scintigraphic examination of the cartilages of the foot Nagy, Dyson & Murray (2007) examined how nuclear scintigraphy could improve our understanding of palmar foot cartilage pathology, an area where radiographic interpretation alone provides limited functional information. The researchers evaluated 223 front feet from 186 horses using both dorsopalmar radiographs and dorsal scintigraphic images, applying both subjective grading and quantitative region-of-interest (ROI) analysis to correlate findings between modalities. Radiographic and scintigraphic grades showed excellent agreement, whilst ROI analysis revealed a characteristic proximal-to-distal gradient in radiopharmaceutical uptake within the cartilages themselves; critically, separate centres of ossification visible on radiographs were detected scintigraphically in 71% of cases, and increased uptake correlated with radiographic abnormalities in 66% of feet showing focal activity—with all cartilage fractures demonstrating increased uptake. For practitioners investigating chronic foot lameness or pre-purchase concerns, these findings suggest that scintigraphy can distinguish between incidental radiographic ossification and clinically significant lesions, potentially justifying further investigation with palmar nerve blocks, MRI or CT before committing to treatment decisions.
Read the full abstract on PubMed
Practical Takeaways
- •Scintigraphy can identify the clinical significance of foot cartilage ossification and associated lesions better than radiography alone, guiding decisions for further diagnostic imaging
- •When increased uptake is detected scintigraphically in a cartilage region, expect radiographic abnormalities in about two-thirds of cases; negative radiographs do not rule out significant pathology
- •Scintigraphic detection of fractures in ossified cartilages is reliable and should prompt advanced imaging (MRI or CT) and consideration of palmar nerve blocks for diagnosis
Key Findings
- •Good correlation and excellent agreement between radiographic and scintigraphic grading of foot cartilages
- •Separate centres of ossification detected scintigraphically in 70.6% (12/17) of feet where radiographically identified
- •Increased radiopharmaceutical uptake found in 38 feet, with 65.8% (25/38) having corresponding radiographic abnormalities
- •Fracture of ossified cartilage manifested as increased uptake in all affected horses