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HALL and PARKER
FIGURE 1 Nuclear scintigraphic images of the left (above left) and right (above right) dorsal 45-degree lateral oblique projections of the thoracolumbar spine. There is marked increased radiopharmaceutical uptake within the left 18th rib (arrow) highlighting rib fracture. The right kidney has been drawn around (dotted line above right). Circles highlight costochondral junctions.
FIGURE 2 Longitudinal ultrasound images of a normal right 18th rib (above right) and the fracture within the left 18th rib (above left). The fracture site has irregularly marginated periosteal new bone bridging callus at the discontinuity within the cortex.
are normally irregular at this site. In contrast, a rib fracture does not contain hypoechoic cartilage, though the rib margins are likely to be irregular and commonly periosteal new bone may be seen. In this case of hindlimb lameness due to a fracture of the 18th
rib (Jimenez-Rihuete et al., 2024 ), the horse took 12 months to recover and resume ridden exercise with conservative therapy. Ultrasonographic examination can monitor fracture healing and is useful in identifying non-healing fractures which may represent surgical candidates. Hall et al.
( 2022 ) reported six horses which
underwent surgery due to failed initial conservative management which resulted in continued fracture instability, callus at the fracture site or fracture displacement causing impingement on adjacent ribs. One horse which underwent wedge ostectomy and internal fixation with a locking compression plate returned to its previous level of exercise. All other surgically managed cases (5/73) underwent par- tial rib resection. Most horses in this study were managed conser- vatively (67/73). Given the very small number of surgically managed cases, it is not possible to determine if fracture healing or outcome
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