title: Use of concurrent scintigraphic and magnetic resonance imaging evaluation to improve understanding of the pathogenesis of injury of the podotrochlear apparatus.
abstract: BACKGROUND
  Use of physiological methods of diagnostic imaging could provide insight into the pathogenesis of foot pain in live horses.
  
  
  OBJECTIVE
  To describe patterns and intensity of increased radiopharmaceutical uptake (IRU) in the navicular bone, and relate this to distribution and types of signal intensity change in the navicular bone and to the presence or absence of lesions of the related soft tissue structures detected using MRI.
  
  
  METHODS
  Scintigraphic and MR images of 264 horses with unilateral or bilateral foot pain were analysed and graded. A Spearman rank correlation was used to test for relationships between scintigraphic grade of the navicular bone and MRI scores for each region of the bone. Chi-square tests were used to test for associations between scintigraphy grade and presence of increased signal intensities, for differences in the proportion of focal and diffuse IRU between MRI grades, and for associations between an abnormal scintigraphic grade of the navicular bone and presence or absence of a lesion.
  
  
  RESULTS
  There were significant positive correlations between scintigraphy grade and both maximum and total MRI grades for the navicular bone and between scintigraphy grade and the MRI grades for the flexor border, the distal border and medulla. However, there was no difference in the proportions of focal and diffuse IRU between navicular bone MRI grades, although diffuse IRU was relatively under-represented in Grade 3 navicular bones. There was no association between IRU in the navicular bone and MR lesions of either the DSIL origin or the CSL insertion, however there was an association between IRU in the navicular bone and combined lesions of the CSL, DSIL and navicular bursa. In limbs with a DDFT lesion, navicular bone scintigraphic Grades 2 and 3 were over-represented.
  
  
  CONCLUSIONS
  Scintigraphy and MRI provide complementary information about the pathogenesis of lesions of the podotrochlear apparatus. Further understanding of these disease processes may eventually permit more targeted treatments.
authors.affiliation: Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK.
authors.forename: S
authors.initials: S
authors.lastname: Dyson
authors.forename: R
authors.initials: R
authors.lastname: Murray
mesh_terms: D000818:Animals; D003937:Diagnosis, Differential; D006734:Horse Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D006736:Horses; D007794:Lameness, Animal / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000662:veterinary*; D011877:Radionuclide Imaging / Q000379:methods / Q000662:veterinary*; D012680:Sensitivity and Specificity; D012716:Sesamoid Bones / Q000000981:diagnostic imaging* / Q000473:pathology*; D018709:Statistics, Nonparametric; D013639:Tarsal Bones / Q000000981:diagnostic imaging* / Q000473:pathology; D013708:Tendon Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000662:veterinary*; D013710:Tendons / Q000000981:diagnostic imaging / Q000473:pathology