[Low-field magnetic resonance imaging of penetrating hoof injuries in 10 horses].
Authors: Gerlach, Mader, Delling, Theuß, Müller, Offhaus, Berner
Journal: Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere
Summary
# Editorial Summary: Low-field MRI for Diagnosing Penetrating Hoof Injuries Penetrating nail wounds to the equine foot present a diagnostic challenge because infection can involve multiple deep structures—navicular bone, digital flexor tendon, and collateral sesamoidean bursa—each requiring different treatment approaches. Researchers used low-field MRI to evaluate 10 horses with sole injuries and compared imaging findings against clinical examination, surgery, radiography, ultrasound, computed tomography, and histopathology to validate diagnostic accuracy. Low-field MRI successfully identified all penetration tracts across all imaging planes and demonstrated high sensitivity for deep digital flexor tendon involvement (best visualised on transverse T2-weighted fast spin echo sequences), though specificity for tendon pathology was lower than for navicular bone changes. Navicular bone involvement was most reliably detected using fat-suppressed T2 or STIR sequences, whilst septic bursitis proved most challenging to diagnose on MRI alone. For practitioners managing puncture wounds, low-field MRI offers critical intravital assessment of hoof structures that influences treatment decisions—particularly distinguishing between superficial tract contamination and deep structure involvement—potentially reducing unnecessary aggressive therapy whilst ensuring appropriate targeted intervention when serious pathology is present.
Read the full abstract on PubMed
Practical Takeaways
- •Low-field MRI is a reliable diagnostic tool for evaluating nail puncture wounds to the foot and should be considered when clinical diagnosis is uncertain or when surgical planning requires detailed tissue assessment
- •Transverse T2w FSE sequences are most effective for identifying penetration tracts and secondary tendon/bone damage, helping direct targeted therapy and avoid unnecessary treatment
- •MRI provides the only intravital method to fully assess structures within the hoof capsule (tendon, bone, bursa), enabling evidence-based clinical decision-making in cases of foreign body penetration
Key Findings
- •Low-field MRI detected navicular bone involvement with high predictability using fat-suppressed T2 or STIR sequences
- •Transverse T2-weighted fast spin echo (T2w FSE) sequences reliably demonstrated penetration tracts in all 10 cases across all planes
- •Deep digital flexor tendon defects showed high sensitivity on MRI but lower specificity than navicular bone changes
- •Septic bursitis was least accurately detected by MRI; sagittal plane imaging was most useful for bursal disease recognition