title: Radiographic, scintigraphic and magnetic resonance imaging findings in the palmar processes of the distal phalanx.
abstract: BACKGROUND
  Increased radiopharmaceutical uptake (IRU) in the palmar processes of the distal phalanx is recognised but its clinical significance has not been established.
  
  
  OBJECTIVE
  To investigate the relationship between radiographic, scintigraphic and MRI findings in the palmar processes of the distal phalanx.
  
  
  OBJECTIVE
  Increased radiopharmaceutical uptake in the palmar processes of the distal phalanx is associated with MRI abnormalities; IRU and MRI abnormalities are over-represented in lame limbs.
  
  
  METHODS
  Clinical data, radiographic, scintigraphic and MRI findings of 258 horses with unilateral or bilateral foot pain were recorded. Scintigraphic images were assessed subjectively and using region of interest and profile analysis, and intensity of IRU graded. Alteration in signal intensity in T1 and T2 weighted and short tau inversion recovery (STIR) MR images was documented, and MRI abnormalities graded. Relationships between scintigraphic, MRI, radiographic and clinical findings were assessed.
  
  
  RESULTS
  Focal IRU was over-represented in palmar processes with most MRI abnormalities. There was a significant correlation between IRU and MRI grades and IRU was over-represented in palmar processes with MRI Grades 2 and 3. Both IRU and MRI abnormalities occurred most frequently in the medial palmar process. MRI abnormalities were generally over-represented in lame limbs. The most common MRI abnormality was mild diffuse decreased signal intensity in T1 and T2 weighted images, which was associated with mild generalised IRU.
  
  
  CONCLUSIONS
  There was considerable variation in the radiographic, scintigraphic and MRI appearance of palmar processes of the distal phalanx. Focal IRU in a palmar process was seen in association with MRI abnormalities and lameness or as an incidental finding. Magnetic resonance imaging abnormalities occurred more frequently in lame limbs, either contributing to lameness or as a consequence of lameness.
  
  
  CONCLUSIONS
  Further investigation is needed to establish the clinical significance of MRI abnormalities in the palmar processes of the distal phalanx and their relationship with lesions in adjacent structures.
authors: Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk, UK.
authors: A
authors: A
authors: Nagy
authors: S J
authors: SJ
authors: Dyson
authors: R M
authors: RM
authors: Murray
mesh_terms: D000818:Animals; D003937:Diagnosis, Differential; D005260:Female; D005534:Foot Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000662:veterinary*; 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; D008297:Male; D010146:Pain / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000662:veterinary; D011859:Radiography / Q000379:methods / Q000662:veterinary; D011877:Radionuclide Imaging / Q000379:methods / Q000662:veterinary*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index