Page 60 - Barrel Stallion Register 2017

“Our study looked at sensitivity and specificity of MRI and CT scans compared to arthroscopy and ultrasound. MRI was
not as good as ultrasound. The problem
with ultrasound, however, is that success is somewhat dependent on the equipment but extremely dependent on the ability and expe- rience of the operator. With an experienced person, the sensitivity (ability to say there is or isn’t something wrong, but not necessarily determine what is wrong) is relatively high. The specificity involves pinpointing what the problem is after you’ve made the deci- sion that there is a problem. Those are the two numbers that we look at in comparing these modalities. The one that came out the best for the non-invasive techniques was the ultrasound—with an experienced operator,” says Frisbie.
“The standing stifle arthroscopy was next, even though an MRI would probably be the same. The problem with MRI, however, is that not everyone can afford this (usually about $2,500) and the horse has to go through gen- eral anesthesia. This is a big downside and also drives the cost up,” he says.
There is a dedicated imaging center in Dallas, Texas, called Animal Imaging that has a high field MRI. “It’s state-of-the-art for humans, being a 3.0 Tesla magnet. They can also get small to medium-size horses’ stifles in this one. So, we are starting to do more stifles partly because of the location of that magnet, and a lot of those horses are western perfor- mance horses,” he explains.
“Myra Barrett is a radiologist who specializes in MRIs, and there are fancy words for it such as planer imaging—which means it’s more three- dimensional, looking at things in various planes. We are starting to see more people who special- ize in that type of imaging, whether it’s reading MRIs or doing the ultrasound. There are some people who do more sport horses and warm- bloods, and some who have more expertise in western performance horses. These groups end up being a bit different in how their stifles look. There are definitely some nuances that exist in the various breeds, as well as the disciplines in which they perform,” he says. Those joints are subjected to different stresses and strains.
“The stifle has been a challenging joint in that we’ve had to figure things out via the
school of hard knocks because we were so ham- strung in earlier years in our diagnostics. The important thing to do first if you think the horse might have a stifle problem is to have the veterinarian do a thorough lameness exam and get the stifle blocked out, to determine for sure that this is where the pain is coming from.” Once you have a diagnosis, then it’s good to try to figure out what it is (what part of the joint and what the damage is), but that’s not always possible, especially if you live a long way from diagnostic experts.
“In those cases, your veterinarian prob- ably goes ahead and treats the stifle with a steroid injection, and maybe it does great for about 6 weeks. If the horse goes lame again, typically this means there is a more serious problem that needs to be addressed. Most
of the time this is when I get involved, and there are multiple things that can be done. It is important to get with someone who does
a lot of these cases and knows how to treat them. A lot depends on the horse owners and how much they want to put into this.” When there is a serious problem, it’s wise to involve a good specialist.
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