NEW INNOVATIONS IN THE DIAGNOSIS AND TREATMENT OF LAMENESS
Fig. 6. T1W3D transverse images demonstrate mild dorsal margin fraying and degenerative change to the dorsal margin of the deep digital flexor tendon (A) and a parasagittal split of the deep digital flexor tendon (B). In both cases A and B these were incidental findings in the nonclinical limb, but are reported as mild degenerative injury with unknown clinical significance. This is in contrast with the T1W 3D transverse image demonstrating extensive degenerative change with structural injury to the tendon (C), which was also seen on STIR and T2W FSE sequences. D–F, In another case, the deep digital flexor tendon lesion identified as a core lesion extending to the insertion of the tendon on to the third phalanx was visible on all sequences. In this case, a palmar digital neurectomy would be contraindicated given the nature and extent of the injury. All images were obtained in the standing low-field system.
of the migration of diagnostic analgesia, it is possi- ble that the region ordered for the MR evaluation did not include potential other areas that could be affected by perineural or intra-articular blocks.9 In these cases, the margins of the studies must be expanded during MR imaging. Subtle cartilage de- fects can also be overlooked in certain systems and should be considered in cases where persistent sy- novitis is present and diagnostic analgesia has been accurately and repeatedly performed in a manner that localizes the lameness to the joint.10 Lame- ness without structural injury to the live tissues of the foot can result in a negative MR study (hoof wall or solar pain).11 In cases where the appropriate
366 2015 Vol. 61 AAEP PROCEEDINGS
region has been imaged, a negative report may be the best result for the patient from a prognostic standpoint, as no major structural lesions were iden- tified, and a relatively short course of rest may be all that is required to return to work. A negative re- sult on MRI may also indicate that the pathologic condition may need to be imaged with another mo- dality such as nuclear scintigraphy.12 Understand- ing these potential situations can help manage client expectations before the MR examination is performed so the client understands the value of the examination, regardless of the results. The cornerstone of lameness evaluation is still the clinical examination; advanced diagnostic imaging
