Received: 31 August 2023 | Accepted: 7 December 2023 DOI: 10.1111/eve.13941
R E V I EW A R T I C L E
Should cervical radiographs be included in a pre- purchase examination?
Rupert F. Dash 1 | Rhiannon E. Morgan 2
1 The Royal Veterinary College, Equine Referral Hospital , Hertfordshire , UK 2 IVC Evidensia, The Chocolate Factory , Bristol , UK
Correspondence: Rupert F. Dash Email:
rdash1@rvc.ac.uk
Summary Cervical radiographs are more frequently being acquired or requested as part of a pre- purchase examination (PPE). Evaluating radiographs allows for detection of diseases which may prejudice the horse ' s suitability for its intended purpose. A thorough clinical examination is the most important element of a PPE and limits the list of possible radiographic findings to those that can be subclinical. Radiographic findings such as morphological variations of the vertebrae, osteoarthritis and osteochondral fragmentation are often present in asymptomatic horses. Furthermore, current evidence suggests that most findings present on cervical radiographs acquired at PPE are of unknown or low significance in a clinically normal horse. There is also minimal evidence of the progression of subclinical cervical radiographic abnormalities and their future impact on performance. Due to the high level of superimposition that is inherent to cervical radiographs, the reliability of interpretation of these findings is often variable. Additionally, PPE radiographs are often acquired in the ambulatory setting and the limitations of the equipment and environment can compromise their diagnostic value. Therefore, at this time, there is little evidence to support the acquisition of cervical radiographs as part of a PPE.
K E YWORDS horse , neck , PPE , X- ray
INTRODUCTION
A radiographic examination can be performed as part of a pre- purchase examination (PPE) at request of the vendor, the purchaser or the insurance company. It is the role of the veterinarian to advise these parties on the value of a radiographic examination, which may depend on the horse ' s intended use and value. Cervical radiographs are rarely requested by insurance companies and therefore are gen- erally performed at the discretion of veterinarians and clients. Gesellschaft für Pferdemedizin (GPM—Society for Equine
Medicine, Germany) states that ‘A thorough clinical examination is the most important basis in assessing the actual physical condition of the horse in the pre- purchase inspection’. Indications for cervical
radiography for clinical cases include abnormal neck posture, neck stiffness or pain, ataxia, muscle atrophy, soft tissue swellings, trauma, poor performance and forelimb lameness which is unaltered by diagnostic anaesthesia (Butler et al., 2017 ). Guidance notes on PPE released jointly by the Royal College of Veterinary Surgeons (RCVS) and the British Equine Veterinary Association (BEVA) state that the preliminary examination should include a ‘thorough … pal- pation and manipulation’ and that the horse should be ‘walked and trotted in hand’ and be ‘turned sharply each way and backed up for a few paces’ to detect abnormalities of gait and action. The RCVS/ BEVA guidance notes also state that a veterinary surgeon may vary the examination where there are ‘good practical or clinical reasons’. However, given the increasing interest in cervical disease in poor
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2024 The Authors. Equine Veterinary Education published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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aaep.org/wiley-redirect Equine Vet Educ. 2024;36:366–374.
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