title: The application of a scintigraphic grading system to equine tibial stress fractures: 42 cases.
abstract: BACKGROUND
  Tibial stress fractures are an important cause of lameness in the Thoroughbred racehorse. While it is recognised that these injuries can vary in clinical presentation and radiographic or scintigraphic appearance, little has been done to quantify lesion severity. By contrast the scintigraphic grading of tibial stress fractures in human athletes is widely reported and assists in the selection of appropriate management regimes.
  
  
  OBJECTIVE
  To determine the relationship between scintigraphic grade, clinical severity and radiographic appearance of tibial stress fractures.
  
  
  METHODS
  The current study involved the retrospective analysis of records from 42 Thoroughbreds with abnormal tibial scintigraphic activity.
  
  
  RESULTS
  There was a significant association between lesion site and scintigraphic grade and good correlation of scintigraphic scoring between investigators. No significant association was found between scintigraphic grade and either radiographic grade or degree of lameness.
  
  
  CONCLUSIONS
  The study confirmed that radiographic appearance is an unreliable measure of clinical severity or stage of progression of lesions. The scintigraphic grading system used in the study was not of use in defining stress fracture severity in the equine tibia.
  
  
  CONCLUSIONS
  Despite this finding, there is clearly a need for prospective investigations to explore the potential for targeted management regimes for tibial injuries based on lesion site or clinical criteria.
authors.affiliation: Beaufort Cottage Stables, High Street, Newmarket, Suffolk CB8 8JS, UK.
authors.forename: P H L
authors.initials: PH
authors.lastname: Ramzan
authors.forename: J R
authors.initials: JR
authors.lastname: Newton
authors.forename: M C
authors.initials: MC
authors.lastname: Shepherd
authors.forename: M J
authors.initials: MJ
authors.lastname: Head
mesh_terms: D000818:Animals; D005260:Female; D015775:Fractures, Stress / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000662:veterinary*; D006734:Horse Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D006736:Horses / Q000293:injuries*; D007794:Lameness, Animal / Q000175:diagnosis / Q000000981:diagnostic imaging; D008297:Male; D011877:Radionuclide Imaging / Q000379:methods / Q000662:veterinary; D012189:Retrospective Studies; D013314:Stress, Mechanical; D013669:Technetium Tc 99m Medronate; D013978:Tibial Fractures / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000662:veterinary*; D015599:Trauma Severity Indices
chemical_list: D013669:Technetium Tc 99m Medronate