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DLPMO • Weight bearing • Foot of interest placed slightly cranial • Centered at middle carpal joint • Beam is 60 degrees lateral off a straight dorsalpalmar DMPLO • Same as previous, BUT, beam comes from 60° MEDIAL from a straight DP • Since beam comes across the front of the horse, have a cooperative horse Sedation if needed A Review… DORSAL LATERAL MEDIAL PALMAR CT or CAT Scan • Computed tomography has just recently become available for large animal patients. • This equipment is very expensive and limited to specialized facilities. • Use is restricted in adult horses to the examination of the head, cranial cervical spine and distal limbs. • Patient must be under anesthesia. • Must be injected with radioisotope and is absorbed by bony areas • Used as a last resort in diagnosing. CT scan of the horse’s nasal passages This is the CT control room. The animal patient must be anesthetized because you can not remain in the room with them. There can be no motion or movement involved. “By scanning foals as they mature, one is able to directly quantify the rate of bone development in the distal limb. At this stage the foal must be anesthetized for a short time so there is no movement artifact.” MRI • Magnetic Resonance Imaging; the area being imaged is placed within a strong magnetic field and stimulated by radio-frequency pulses. These radio-frequency signals are collected and analyzed by computers to form the image. • Very, very costly and not widely available • Anesthesia is required • MRI tend to be superior to CT for soft tissue imaging • The head, cervical spinal cord and lower legs can be imaged in an adult animal • Precise and focal imaging tool that produces images of all tissue types; bone, tendons, ligaments, and fluid. Mainly utilized in equine lameness. Thermography • Uses a heat camera to scan the body surface temperature of the patient. • Very popular because it is noninvasive, equipment is affordable and portable. • Primarily used to locate “hot spots” which may indicate inflammation near the body surface. Deeper locations can not be detected, such as within the thorax or abdomen. Stifles: the right stifle shows a “hot spot” over the medial femorotibial joint. IR PROx Thermal Infrared Camera Ultrasound • Operates on high frequency sound waves beyond our hearing. • Uses sound waves to detect differences in tissue density • Generally superior to standard radiographs for visualizing soft tissues. • Radiographs are superior for imaging bony structures. Common uses of Ultrasound • Visualize kidneys and capable of ultrasound guided biopsy • Lungs for pneumonia diagnosis and treatment • GI for colics - small intestinal distension, large colon wall thickness, peritoneal fluid, diagnosis of abcesses and tumors • Foals - GI disease, umbilical structures (diagnose umbilical infections), ruptured bladder • Liver - ultrasound guided biopsy • Assist with lameness diagnosis, including the extent of tendon and ligament damage • Eyes Common uses of Ultrasound cont… • Monitor the mare's reproductive tract and optimize the time for breeding • The genital tract in stallions • Early detection of pregnancy • Early detection of problem pregnancies, including fetal abnormalities • Cardiovascular • Ultrasound can be used to image the heart, lungs, kidneys, liver, spleen, and intestines, even during colic episodes. Portable veterinary ultrasound Brief Introduction to Ultrasound • Transducer produces sound waves and also receives reflected sound waves. • Sound waves travel in a plane through tissue. • Sound waves are transmitted, absorbed or reflected by tissues. • Computer forms image – in shades of gray. • Bone appears white, fluids appear black From: Zagzebski, JA; Essentials of Ultrasound Physics, Mosby, © 1996 Musculoskeletal Palmar distal extremity Infected umbilicus Reproduction Uterine cysts Echocardiography Pericardial effusion Abdomen Liver - cholelithiasis Thorax Pleuropneumonia Patient Preparation Clip the area Clean area Coupling medium alcohol commercial gel Imaging technique Systematic organized approach – must be familiar with normal Scan from proximal to distal Evaluate structures individually Transducer perpendicular to structure Limb should be weight bearing Imaging Techniques Label images - patient info, directions and location Two methods for location 1. Zones 2. Reference points - cm distal to standard point accessory carpal bone point of hock point of ergot Transverse images Palmar (skin surface) Lateral Medial Dorsal Rectal ultrasound examination of a fetus A 16-day pregnancy, visualized rectally with a 5-mHz probe. Video.. Endoscopy Endoscopy • Endoscopes come in two basic varieties; rigid and flexible. • A thin tube that contains a fiberoptic camera and a tool at the end allowing samples to be taken from various locations in the body. It is passed through virtually any open cavity on the body. • Usually takes 2-3 people to operate Control handpieces Air/Water channel Illumination lens Instrument channel Viewing lens Illumination lens Control handpiece and insertion tube of the flexible endoscope. Endoscope examination of the male urethra. Notice how many people are involved. Maintenance of the Equipment • You will be utilizing some if not all of the previously mentioned equipment. • Take care of the equipment and it will take care of you in the long run. • Please follow ALL procedures in your hospital/clinical pertaining maintenance and trouble shooting equipment. • Follow ALL cleaning procedures as The End