RIB FRACTURE HORSE LAMENESS POOR PERFORMANCE
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appropriate washout period is recommended prior to scintigraphy if perineural analgesia has been performed to prevent false positive results. Although rib fractures are largely under-reported in adult horses,
this case report and recent retrospective studies confirm they should be considered a differential diagnosis for cases of poor performance and both fore and hindlimb lameness. Diagnostic analgesia could be used to determine the significance of the rib fracture in cases of hind limb lameness.
AUTHOR CONTRIBUTIONS S. Hall wrote the manuscript which was edited by R. Parker.
FIGURE 3 Longitudinal view of a normal costochondral junction. Dorsal is to the left of the image. The white arrow indicates normal rib contour. The star indicates hypoechoic costal cartilage. The margins of the ribs are irregular (red arrows) which is a normal finding at this site.
FUNDING INFORMATION None.
CONFLICT OF INTEREST STATEMENT No conflicts of interest have been declared.
ETHICS STATEMENT Not applicable to this clinical commentary.
ORCID Yvonne S. Hall
https://orcid.org/0000-0001-7986-7982
REFERENCES
Griffin , J.F. , 4th , Young , B.D. , Fosgate , G.T. , Walker , M.A. & Watkins , J.P. ( 2010 ) Focal skeletal muscle uptake of 99mTechnetium-hy- droxymethylene diphosphonate following peroneal nerve blocks in horses . Veterinary Radiology and Ultrasound , 51 ( 3 ), 338 – 343 .
Hall , S. , Smith , R. , Ramzan , P.H. , Head , M. , Robinson , N. & Parker , R. ( 2022 ) Rib fractures in adult horses as a cause of poor performance; diagnosis, treatment and outcome in 73 horses . Equine Veterinary Journal , 55 ( 1 ), 59 – 65 .
FIGURE 4 Transverse view of a normal costochondral junction. Note the irregularly marginated end of the rib (white arrow) which has overlying hypoechoic cartilage (red arrow).
would have been improved if surgical intervention had been per- formed in more cases. Peri-regional analgesia of a rib fracture is commonly used in
human medicine as a therapeutic aid (Martin et al., 2019 ) and is easy to perform on the horse. In this instance, the ipsilateral hindlimb lameness was partially alleviated by this technique in the acute stage of lameness and completely abolished in the chronic stage of lame- ness. Perineural analgesia can result in increased radiopharmaceuti- cal uptake within the soft tissues on bone phase scintigraphy, up to 7 days post blocking (Griffin et al., 2010 ), with 50% of horses having uptake at the site of a tibial perineural injection 1 day post-injection, 25% of horses at the block site 3 days post-injection and 1 horse with increased radiopharmaceutical uptake 7 days post-injection. An
Jimenez-Rihuete , P. , Staempfli , S.A. , Waterhouse , M. & Rubio-Martinez , L.M. ( 2024 ) Rib fracture as a cause of hindlimb lameness in a horse . Equine Veterinary Education , 36 , 284 , e140-e144. Available from:
https://doi.org/10.1111/eve.13904
Mageed , M. , Wegert , J. , Dyab , S. & Gerlach , K. ( 2021 ) Furosemide admin- istration one hour before bone scintigraphy examination in horses does not improve the image quality or reduce the radiation dose rate . Veterinary Radiology and Ultrasound , 62 ( 1 ), 126 – 132 .
Martin , T.J. , Eltorai , A. , Dunn , R. , Varoe , A. , Joyce , M. , Kheiberk , T. et al. ( 2019 ) Clinical management of rib fractures and methods for pre- vention of pulmonary complications: 225 a review . Injury , 50 ( 6 ), 1159 – 1165 .
Wylie , C.E. & Head , M.J. ( 2016 ) Clinical features of 50 cases of rib frac- ture in adult horses . Equine Veterinary Journal , 48 ( S50 ), 25 .
How to cite this article: Hall , Y.S. & Parker , R. ( 2024 ) Rib fractures in horses . Equine Veterinary Education , 36 , 285 – 287 . Available from:
https://doi.org/10.1111/eve.13922
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