Clinical orthopedic examination (lameness examination)

The importance of a good clinical examination is often underestimated. During the clinical examination, the horse gets an in depth inspection, palpation and dynamic examination. Often additional (flexion) tests are incorporated into this examination. SMDC has developed the perfect facility to do this optimally. Patients are examined dynamically on different footings. To confirm the location of a possible problem,
local anaesthetic blocks can be performed. With a local anaesthetic block, pain at a specific region will be blocked and the horse will be re-examined afterwards to see if there are changes in movement patterns.  These local anaesthetic blocks include nerve blocks and/or joint blocks. After a thorough clinical examination, additional diagnostic imaging may be performed.

Radiographic Examination

X-rays are generated in the x-ray tube and focused on an object (for example a joint). This radiation will pass through soft tissue (tendons and muscles) and get stopped by dense tissues (bone). The remaining radiation waves finally expose the plate that is behind the object (for example a joint). On this plate and with the help of computer software this remaining radiation is converted to an image: the radiograph.

At SMDC, we have the most up to date (digital) and powerful equipment. In our radiology room we have three generators: two fixed generators that are suspended from the ceiling – one for legs and one for imaging the entire vertebral column. The third generator is a mobile one that is used for nervous horses.

  • As mentioned, we work with “state of the art” equipment. This results in high quality images of the limbs and the vertebral column. We have a lot of experience and knowledge in acquiring high quality images as well as interpreting them. We can send all studies easily throughout the world by sharing a link through Antech-technologies.

  • Radiation exposure can be hazardous (especially people that are exposed frequently such as our staff).  Because of this we do everything to limit the exposure – this includes wearing lead aprons, lead gloves, dosimeters (measures radiation exposure) as well as being aware of the technique used (distance, cassette holders).  We comply with all radiation safety rules and we even have a radiation safety expert on staff.

  • traumatic bone injuries, like fractures
  • further evaluation of lameness examinations: suspected arthritis, fissures (a crack in the bone), bone cysts and/or ligament or tendon attachment pathology (like high suspensory attachment pathology)
  • (Pre) Purchase Examinations

Ultrasonographic Examination

With the use of ultrasonography we can examine in detail soft tissue (skin, muscle, ligaments, tendons, cartilage and nerves) as well as the outline of bone-surfaces. We have multiple high quality ultrasounds in our clinic with multiple transducers. We use specific transducers to examine specific regions. SMDC has ISELP trained and certified specialists: this is worldwide considered the highest achievement with respect to ultrasound knowledge and experience. Ultrasonographic examinations of tendons and the axial skeleton, including trans rectal examination of the SI-joints, are performed on a daily basis at SMDC.

  • Ultrasound makes use of sound waves. The frequency of these waves is too high for humans to hear (ultrasonographic sound, on which the name is based). Via a transducer (probe) the sound waves are sent into tissues. These sound waves are reflected back at the interface between different tissues. The reflected sound waves are picked up by the transducer (probe) and, in the computer, converted to an image. Ultrasonography is used to image various tissues in high detail (bone, cartilage, ligaments, tendons, muscle, and nerves). At SMDC ultrasonographic examinations are performed on various regions of the horse’s body. Beside tendons, ligaments and joints of the limbs, at SMDC the entire vertebral column, including facet joints of neck and back and trans rectal ultrasound of the sacroiliac areas are visualized with this technique on a daily basis.

  •  lesions in ligaments and tendons
  • attachment problems of ligaments and tendons
  • vertebral column problems (neck and back)
  • pelvic problems (trans rectal ultrasound) gives us the ability to image the sacroiliac regions and lumbosacral joint. In case of a suspected pelvic fracture, these can often be diagnosed with a combined internal and external examination.
  • (pre)purchase examinations: to check the current quality of the tendons and ligaments.

Tissue Characterization (UTC)

UTC Imaging is a new diagnostic scanning modality for imaging tendons and ligaments whereby the results are analyzed by a computer program. With this technique four different echo-types can be discriminated and related to the architecture and integrity of tendons and ligaments. This ultra-structural information is visualized tomographically in 3 planes of view and quantified by means of the calculation of respective percentages of echo-types. The ratios of these 4 echo-types are highly correlated with histo-morphological characteristics of tendon tissue, showing the discriminative power of UTC for tissue characterization. UTC appeared to be very sensitive which allowsUTC-imaging_logo_smdc_advanced-imaging not only discrimination but also staging of extensive disintegration. Already minimal load induced changes in the tendon matrix, whether physiological or pathological, can be monitored with excellent inter- and intra- observer reliability.

SMDC uses this technique not only on tendon and ligament lesions but also as a tool for monitoring high-performance horses aiming at injury prevention.

Scintigraphy

Equine scintigraphy (bone scan) involves injection of a radioisotope, (technetium-99m) which is linked to a compound called bisphosphonate-MDP. Within a couple of hours…

The result of the examination (made by imaging specialists) can be expected the day after the examination (so NOT the same day). The report wil be directly mailed to client and referral veterinarian(s). Together with third parties a (treatment)plan will be discussed.

read more about Scintigraphic Examination

MRI (Magnetic Resonance Imaging)

MRI stands for Magnetic Resonance Imaging. SMDC Advanced Imaging has a high quality standing MRI for horses. MRI produces highly detailed quality images that can show…

The result of the examination (made by imaging specialists) can be expected the day after the examination (so NOT the same day). The report wil be directly mailed to client and referral veterinarian(s). Together with third parties a (treatment)plan will be discussed.

read more about MRI

Endoscopy

During laryngoscopy and bronchoscopy, a small tube with an integrated camera is passed down the airways for a thorough exam. This same principle can be applied to examine the esophagus and stomach (gastroscopy). For gastroscopy it is important that the horse is fasted with no access to food for 12 hours and no water for 6 hours.