Tomlinson J E, Sage A M, Turner T A
Department of Clinical and Population Sciences, University of Minnesota, 225k Veterinary Teaching Hospitals, 1365 Gortner Ave, St. Paul, Minnesota 55108, USA.
Equine Vet J. 2003 Jan;35(1):48-54. doi: 10.2746/042516403775467540.
The pelvis is covered with extensive musculature and often presents a challenge in diagnostic imaging. Ultrasonography provides diagnostic information about soft tissue, articular cartilage and bone surfaces, although little information exists about the normal ultrasonographic appearance of the equine sacroiliac region.
To determine the clinical applicability of ultrasonographic examination in horses with sacroiliac pain.
Horses presented to the University of Minnesota Veterinary Teaching Hospital for hindlimb lameness were evaluated and lower limb lameness was ruled out with examination and local anaesthesia. Twenty cases were diagnosed with sacroiliac pain, characterised by response to palpation over the tuber sacrale. Seven of the 20 had visible asymmetry of the tuber sacrale. Ultrasonography was performed percutaneously and per rectum. Structures imaged were measured and compared to normal reference measurements. Other methods used to confirm diagnoses included thermography, scintigraphy and radiology.
All 20 cases with sacroiliac pain showed ultrasonographic abnormalities of the sacroiliac area. Abnormalities were detected in the dorsal sacroiliac ligaments. Ligament size was significantly different from the normal ranges (P < 0.01). Malalignment of the sacroiliac area and sacral fractures were also imaged.
Ultrasonography of the sacroiliac region aided diagnosis of ligament damage and displacement of bone surfaces; and may aid in monitoring the progression of healing.
Diagnostic ultrasound is readily available to most practitioners. Therefore the findings of this study show that diagnosis of sacroiliac injuries is possible in the field.
骨盆被广泛的肌肉组织覆盖,在诊断成像中常常具有挑战性。超声检查可提供有关软组织、关节软骨和骨表面的诊断信息,尽管关于马骶髂区域正常超声表现的信息较少。
确定超声检查在患有骶髂部疼痛马匹中的临床适用性。
对送至明尼苏达大学兽医学院教学医院的后肢跛行马匹进行评估,并通过检查和局部麻醉排除下肢跛行。20例被诊断为骶髂部疼痛,其特征为对骶结节处触诊有反应。20例中有7例骶结节可见不对称。经皮和经直肠进行超声检查。对成像的结构进行测量,并与正常参考测量值进行比较。用于确诊的其他方法包括热成像、闪烁扫描和放射学检查。
所有20例骶髂部疼痛病例均显示骶髂区域存在超声异常。在背侧骶髂韧带中检测到异常。韧带大小与正常范围有显著差异(P < 0.01)。还对骶髂区域的排列不齐和骶骨骨折进行了成像。
骶髂区域的超声检查有助于诊断韧带损伤和骨表面移位;并可能有助于监测愈合进程。
大多数从业者都可轻易获得诊断超声。因此,本研究结果表明在现场即可对骶髂部损伤进行诊断。