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EQUINE VETERINARY EDUCATION
Equine vet. Educ. (2022) 34 (11) 592-599 doi: 10.1111/eve.13551
Review Article
Ultrasonographic diagnosis of equine thoracolumbar articular process joint lesions A. Beaumont†,‡,*
, L. Bertoni†,‡ and J. M. Denoix† †Ecole Nationale V erinaire d’Alfort, CIRALE, Maisons-Alfort, France; and ‡INRAE, Ecole Nationale V erinaireet et
d’Alfort, BPLC, Maisons-Alfort, France *Corresponding author email:
audrey.beaumont@
vet-alfort.fr
Keywords: horse; ultrasonography; back; imaging; facet joints; articular process
Summary Thoracolumbar lesions are common in horses, but their identification and location remain a challenge in field practice. A precise diagnostis improves therapeutic strategy and, thus, the prognosis of affected horses. Although radiography remains the preferred diagnostic imaging modality used for the back, ultrasound is a useful complementary technique that offers valuable information and can be performed as a stand-alone procedure when high-output radiographic equipment is not available. The aim of this paper is to describe thoracolumbar articular process joint pathology that can be visualised with ultrasound.
Introduction
Back pathology is a major cause of poor performance and gait abnormalities in sport and racehorses (Henson, 2009; Jeffcott, 1981). Thoracolumbar articular process joint (APJ) injuries are described as a common cause of back pain (Denoix, 1998a) and are mainly seen at the level of the thoracolumbar and cranial lumbar regions, where one or several intervertebral joints can be affected (Girodroux et al., 2009). The anamnesis and clinical (physical and dynamic) examination often make it possible to reveal or suspect functional abnormalities of the vertebral column
(Denoix, 1992; Jeffcott, 1981; Riccio et al., 2018). Nevertheless, the definitive diagnosis of the cause of pain
remains difficult to establish for the equine practitioner in field practice. This is especially true when lesions involve the low mobile APJs or ‘facet joints’ made of several small articular surfaces covered by a thick layer of muscles. Radiography is the first-choice imaging modality (Audigie et al., 2013) to explore the vertebral column from T1 to L4, but, because of the large muscle mass, complete radiographic assessment of the back is not easy in routine practice with a portable machine on a mature horse. High- output x-ray equipment, a focussed grid and computed or digital radiographic equipment are required, resulting in a high level of radiation exposure. Ultrasound examination is a safe and non-invasive procedure that can easily be performed with practice and could then be considered as a routine procedure in the field. Rapid advances in ultrasound technology, with the development of compact portable machines with high image quality, have led to the growing interest in this technique that is now widely available for most equine practitioners. The aims of this paper are to describe the indications and current technique used to image the APJs, show normal
ultrasonographic images and present the main abnormal findings.
Fig 1: Up (top image) – Lateral aspect of the axial skeleton. Frames focussing on three areas. Cranial is to the left. Down (bottom image) – Dorsolateral aspect of three thoracolumbar areas showing regional anatomical variation of the articular processes (APs).
© 2021 EVJ Ltd
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