Large Animal Diagnostic Imaging

Large Animal Diagnostic Imaging: Comprehensive Study Notes

Chapter Overview

  • Contains chapters focusing on diagnostic imaging techniques used in large animals, particularly horses.

  • Emphasizes the importance of positioning, preparation, and safety for effective radiographic studies.

Learning Objectives

  • Understand large animal positioning aids

  • Prepare large animal patients for radiographic studies

  • Recognize commonly performed imaging techniques of equine limbs

  • Familiarize with other radiographic views for large animal patients

Current Imaging Techniques

  • MRI, CT, and nuclear scintigraphy have largely replaced traditional radiographic methods in larger animal diagnostics.

  • In many rural areas, conventional film and digital x-ray still remain prevalent due to equipment availability.

Common Radiographic Views in Large Animals

  1. Coffin Bone

    • Lateral

    • 45º Dorsopalmar

  2. Navicular

    • Lateral

    • Skyline

    • Palmar proximal

  3. Pastern

    • Lateral

    • Dorsopalmar

  4. Fetlock

    • Flexed lateral

  5. Metacarpal

    • Lateral

  6. Carpus

    • Flexed lateral

    • Extended lateral

    • Dorsopalmar

  7. Tarsus

    • Lateral

    • Dorsoplantar

    • DLPM oblique

Patient Positioning

  • Key differences between large and small animal imaging include:

    • Need for specialized physical restraint

    • Use of different equipment

    • Specific preparation protocols

    • Adherence to radiographic safety guidelines

    • Utilization of positioning devices

Large Animal Radiographic Safety

  • Large imaging facilities often utilize ceiling-mounted units on tracks for optimal positioning.

  • Most radiographs are conducted using portable units, which present higher risks of radiation exposure.

    • Caution is necessary as machines can be aimed in multiple directions, risking exposure to personnel.

    • Machines often have limited power and necessitate longer exposure times for images.

  • All personnel involved must wear appropriate PPE (Personal Protective Equipment) and dosimeters for safety.

  • Additional safety practices include:

    • Never manually hold image receptors; always utilize a cassette holder.

    • Maintain distance from the radiographic machine during exposure.

    • Collimate the primary beam to the specific area of interest to reduce scatter.

Patient Preparation

  • Adequate preparation is crucial for obtaining high-quality images while minimizing radiation exposure.

  • Consideration of patient temperament is vital as horses can startle easily; thus, minimizing sudden movements and loud sounds around them is essential.

    • Sedation may be needed to reduce potential movement which could blur images.

  • Bovine patients typically do not require sedation but are restrained using stocks.

Equine Foot Preparation

  • Preparation steps include:

    • Removing the horse's shoe and trimming excess hoof material.

    • Thoroughly cleaning the shoe and clefts using appropriate methods.

    • Packing the sulci adjacent to and within the frog with radiolucent material (e.g., Play-Doh or softened soap) to prevent gas shadowing in radiographs.

Patient Positioning Techniques

  • Radiographic machines' designs generally do not allow the primary beam to be centered within 10 cm of the ground.

    • Positioning blocks are recommended to elevate the affected foot for additional views, specifically the lateromedial view.

    • Cassette tunnels are utilized when radiographing digits to protect the image receptors for dorsopalmar, dorsoplantar, and oblique views.

    • These tunnels can be constructed from radiolucent wood or durable hard plastic, ensuring no nails are used to avoid interference with imaging.

Key Radiographic Considerations

  • The primary beam must be centered on the specific bone or joint under examination, and measurements taken accordingly.

  • Image receptors should be positioned as closely to the anatomical location as possible, ensuring they remain parallel to prevent distortion or magnification from altered object-film distances.

  • Certain views, such as pelvic and dental arcade views, typically require ceiling-mounted machinery and may involve anesthesia.

Common Radiographs of the Carpus

  • For effective carpal imaging, six views are typically utilized:

    • Dorso-palmar

    • Latero-medial

    • Flexed lateral

    • Two oblique views

    • Skyline view

Dorsopalmar View (D-P)

  • Positioning:

    • X-ray machine is positioned dorsally relative to the carpus, with the plate situated palmar.

  • Anatomy Identified:

    • A - Radius

    • B - Third metacarpal bone

    • C - Radial carpal bone

    • D - Ulnar carpal bone

    • E - Accessory carpal bone

    • F - Second carpal bone

    • G - Third carpal bone

    • H - Fourth carpal bone

    • I - Antebrachiocarpal joint

    • J - Middle carpal joint

    • K - Carpometacarpal joint

    • L - Second metacarpal bone

    • M - Fourth metacarpal bone

    • Int - Intermediate carpal bone

Lateromedial View (L-M)

  • Positioning:

    • X-ray machine is positioned laterally to the carpus, while the plate is placed medially.

  • Anatomy Identified:

    • A - Radius

    • B - Third metacarpal bone

    • C - Radial carpal bone

    • D - Ulnar carpal bone

    • E - Accessory carpal bone

    • F - Second carpal bone

    • G - Third carpal bone

    • H - Fourth carpal bone

    • I - Antebrachiocarpal joint

    • J - Middle carpal joint

    • K - Carpometacarpal joint

    • L - Second metacarpal bone

    • M - Fourth metacarpal bone

    • Int - Intermediate carpal bone

Flexed Lateral View

  • Positioning:

    • The carpus is flexed, with the x-ray machine positioned laterally and the plate placed medially.

  • Anatomy Identified:

    • A - Radius

    • B - Third metacarpal bone

    • C - Radial carpal bone

    • D - Ulnar carpal bone

    • E - Accessory carpal bone

    • F - Second carpal bone

    • G - Third carpal bone

    • H - Fourth carpal bone

    • I - Antebrachiocarpal joint

    • J - Middle carpal joint

    • K - Carpometacarpal joint

    • L - Second metacarpal bone

    • M - Fourth metacarpal bone

    • Int - Intermediate carpal bone

Additional Oblique Views

  • Dorsoproximal-Dorsodistal Oblique (Skyline View)

    • Positioning: Flex the carpus, placing the x-ray machine dorsally and proximally, with the plate parallel to the cannon bone.

Oblique View Positions

  • Notable oblique view angles include North-West, East-South orientations, and specific anatomical positioning (dorsal, lateral, palmar, medial).

Conclusion

  • The comprehensive manual covers significant aspects necessary for understanding and performing large animal radiographic procedures, focusing on various viewpoints, safety, and patient features.