Computed tomographic evaluation of the distal limb in the standing sedated horse: Technique, imaging diagnoses, feasibility, and artifacts

Nicoli Mathee, Mickaël Robert, Sheelagh Margaret Higgerty, Geoffrey T. Fosgate, Angela L Rogers, Xavier d'Ablon, Ann Carstens

Background: Computed tomographic (CT) imaging has become an accepted imaging modality in the veterinary world and has become routine practice at certain institutions. The distal limb of the horse is often injured and several conditions can be challenging to visualize with standard imaging techniques.

Study: This retrospective study aimed to evaluate the technique, imaging diagnoses, feasibility, and image artifacts of multi-slice helical CT of 250 horses’ distal limbs, over a three-year period, acquired under standing sedation.

Methods: The CT images of 250 horses of various breeds, aged 3–23 years, that underwent standing distal limb CT were evaluated. Three observers assessed the CT images for artifacts and inter-observer agreement was calculated.

Results: Sixty-five percent (163/250; 95% confidence interval (CI), 59–71) of the horses had a single imaging diagnosis. The most common imaging diagnosis for horses that underwent standing CT was a tendinopathy in 20.3% (33/163; 95% CI, 15–27) of cases. The mean number of acquired scans per horse was 1.7 scans (range = 1–4 scans). No complications before, during, or after the CT procedure were recorded.

Limitations: Limitations of the study include the lack of signalment information for some of the patients and some of the CT reports identifying several abnormal imaging findings per limb.

Conclusions: Standing examination of the distal limb using a multi-slice helical scanner mounted on a hydraulic lever system achieved diagnostic image quality with minimal acquisition attempts and within a reasonable time frame. This technique is easy to perform and provides a safe, convenient alternative to CT examination under general anesthesia.

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