The use of radionuclide bone scanning in the diagnosis of tibial 'stress' fractures in the horse: a review of five cases.

Five horses, all two year old Thoroughbreds, presented with acute onset hindlimb lameness following moderate to fast exercise. The use of a hand-held scintillation detector after Tc99 MDP injection greatly aided the diagnosis of tibial stress fractures in these horses. Radiological findings were subtle, involving only periosteal new bone and callus at the fracture site. In two cases this took several weeks to develop but in three others was present at the onset of lameness, indicating insidious pre-fracture bone pathology. The site of the most obvious radiological signs was constant in all five cases, being the proximal lateral tibia some 8 to 9 cm from the femoro-tibial joint surface. The diagnosis of five cases of tibial fracture in one racing season suggests that this condition has been underdiagnosed in the past in this clinic, prior to the availability of bone scanning.