Page 283 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

258 CHAPTER 1

VetBooks.ir 1.487

Fig. 1.487 Transverse
parasagittal ultrasound images
of the lumbar facet joints at
L2 using a 4 MHz curvilinear
TP J J TP
probe. J = facet joint space;
TP = transverse process.
Note that the joint is in line
with the arrow.

1.488

Fig. 1.488 Bone scan of the
thoracolumbar spine and pelvis
of a horse presenting with acute
back pain. Note the intense focal
radiopharmaceutical uptake
between T15 and 16 in all views,
suggesting acute bone pathology.
Radiographs confirmed a
fracture of the dorsal spinous
process. (Photo courtesy
Graham Munroe)

Scintigraphy and thermography both have poor Management
specificity for chronic conditions, increasing the Symptomatic treatment coupled with active reha-
risk of false-negative results. Both require special- bilitation is the cornerstone of the management of
ist execution and interpretation in order to obtain back pain. Although pasture or box rest was previ-
useful diagnostic information and are rarely useful ously recommended, active rehabilitation through
when used in isolation. specific strengthening exercises and stretching is
Pressure algometry can be used to study the increasingly recognised as beneficial. Time off rid-
dynamic interaction between the horse’s back, rider den work is often needed, depending on the cause
and tack. Many thoracolumbar problems manifest- of the back pain. Physiotherapy can reduce local
ing in back pain have an important iatrogenic com- muscle spasm and compensatory tension elsewhere
ponent through the complex interaction of back and in the core. Rehabilitation is increasingly popular,
tack. As well as their use in research, pressure mats but many owners lack the skills and time required
are increasingly used to investigate clinical problems to carry it out properly. The use of postural train-
and provide novel treatment solutions. ing aids is widespread, encouraging the horse to