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  Discussion on Skeletal scintigraphy in the horse
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DrO

Posted on Friday, Jan 6, 2006 - 11:46 am:

This group also calls to account skeletal scintigraphy. Examining past studies it finds problems with earlier research leaving open the question of its use. I must say I have seen lameness with lesions diagnosed using scintigraphy and then confirmed with regional anesthesia or necropsy. Often these were greenstick and nondisplaced partial fractures and some bone cancers, but overall I do often find scintigraphy minimally helpful in lameness diagnosis. Sometimes it seems like the only tool left to diagnose a difficult to localize lameness. I think this group is calling to task the use of subtle changes commonly seen in bone scintigraphy as a diagnostic tool.
DrO

Vet J. 2005 Dec 13;
Skeletal scintigraphy in the horse: Current indications and validity as a diagnostic test.

Archer DC, Boswell JC, Voute LC, Clegg PD.
Department of Clinical Studies, Philip Leverhulme Large Animal Hospital, University of Liverpool, Leahurst, Neston, The Wirral CH64 7TE, UK.

Gamma scintigraphy is a well established imaging modality, which in equine practice is predominantly used in the investigation of lameness and suspected musculoskeletal problems. Whilst there is a growing literature on the indications for scintigraphy in the horse, there has been little emphasis so far on identifying the validity of scintigraphy as a diagnostic test. In particular, to what extent can the results of a scintigraphic examination be trusted? In this opinionated review the current indications for skeletal scintigraphy in the horse are considered and its validity as a diagnostic test reviewed. It is concluded that in the majority of published studies, inherent biases in study design make it difficult to assess accurately the validity of skeletal scintigraphy in the horse. Further well designed, prospective studies are required to assess the validity of skeletal scintigraphy as a diagnostic tool, particularly in horses with subtle alterations in radiopharmaceutical uptake.


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