title: Close, impinging and overriding spinous processes in the thoracolumbar spine: the relationship between radiological and scintigraphic findings and clinical signs.
abstract: BACKGROUND
  There has been no objective study comparing radiological features of spinous processes (SPs) in the thoracolumbar region and/or scintigraphic findings with clinical signs.
  
  
  OBJECTIVE
  To investigate the relationship between the presence or absence of clinical signs of back pain and: 1) radiological findings of close, impinging or overriding SPs; 2) increased radiopharmaceutical uptake (IRU) in the SPs; and 3) the combination of radiological findings and IRU. Also to determine the prevalence of concurrent osseous pathology.
  
  
  METHODS
  Five-hundred and eighty-two horses, presented for perceived back pain and poor performance, underwent comprehensive clinical investigation including diagnostic analgesia of the forelimbs, hindlimbs, back and sacroiliac joints, and radiographic and scintigraphic evaluation of the thoracolumbar spine. Radiological and scintigraphic grades were determined subjectively. Statistical analysis was performed to determine the relationships between clinical signs of back pain, radiological and scintigraphic features, age, breed, gender, discipline, height and weight.
  
  
  RESULTS
  Thoroughbreds (TBs) were over-represented with thoracolumbar pain compared with Warmbloods and TB cross breeds. There was a significant association between maximum and total radiological grades of the SPs and thoracolumbar pain, between maximum and total grades of IRU and thoracolumbar pain, and between a combination of radiological and scintigraphic abnormalities and thoracolumbar pain. Horses with osteoarthritis (OA) of the synovial intervertebral articulations (SIAs) were more likely to have thoracolumbar pain than horses with lesions of the SPs alone, but the presence of OA of the SIAs and lesions of the SPs was associated with the highest likelihood of thoracolumbar pain.
  
  
  CONCLUSIONS
  Fore- or hindlimb lameness and/or pain associated with the sacroiliac joints could mimic primary thoracolumbar pain. A combination of radiology and scintigraphy gives the most accurate prediction of thoracolumbar pain, but diagnostic analgesia is crucial for accurate diagnosis.
authors: Centre for Equine Studies, Animal Health Trust, Newmarket, UK.
authors: M
authors: M
authors: Zimmerman
authors: S
authors: S
authors: Dyson
authors: R
authors: R
authors: Murray
mesh_terms: D000818:Animals; D001416:Back Pain / Q000000981:diagnostic imaging / Q000662:veterinary*; D005260:Female; D006734:Horse Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006736:Horses; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D011859:Radiography; D011877:Radionuclide Imaging / Q000662:veterinary*; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000662:veterinary*; D013131:Spine / Q000000981:diagnostic imaging; D013904:Thoracic Vertebrae / Q000473:pathology