Ultrasound use in orthopaedics: what’s new? - Veterinary Practice
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InFocus

Ultrasound use in orthopaedics: what’s new?

Professor PIETER BRAMA offers a final preview of next month’s BEVA congress in Birmingham

THE Saturday morning programme at the BEVA congress in September will include an update on ultrasound use in orthopaedics.

Presented by experts in the field from a practical “How to!” perspective, the session promises that the latest “tips and tricks” in orthopaedic ultrasound usage will be discussed.

It is clear that ultrasound deserves a place in every equine practice and that advances in technology have improved ultrasound’s ability to diagnose a myriad of musculoskeletal problems. Tendon, muscle, nerve, joint and some osseous pathology can all be visualised with excellent resolution.

Portability allows examination not only in the clinic but also under field conditions. Relatively low costs, real time imaging, and its additional ability to be used as a guide for interventional procedures make this an excellent imaging modality. This session is, therefore, an absolute must for equine clinicians with an interest in orthopaedics and ultrasound.

Although MRI is often seen as superior to ultrasound, both of these imaging modalities have advantages and disadvantages and can be viewed as complementary rather than adversarial. Ultrasound is generally regarded as less expensive than MRI.

Additionally, ultrasound is seen as more patient friendly, as general anaesthesia or more heavy sedation may be needed with MRI. MRI scans do have the advantage of examining a large area but may detect several “abnormalities” that may be clinically unrelated to the patient’s complaints.

Complex

The acquisition of ultrasound images is, however, difficult and their interpretation, particularly when moving parts are involved, is very complex.

Once the technique and variations in normal anatomy have been mastered, the very dynamic nature of the modality becomes, paradoxically, its main attraction. For example, the affected part can be imaged in real time, observing for pathologic movement in tendon, bursa, muscles, or joints.

Unfortunately, MRI does not offer this luxury, as there would be movement artifact distorting image quality.

This session aims at helping delegates to overcome the difficulties they may encounter and to update their knowledge on recent advancements in ultrasound use in orthopaedics. Both the benefits as well as limitations of this unique imaging modality will be highlighted by experts in the field.

First, Heather Chalmers (USA) will explore possibilities and impossibilities of ultrasound use in assessing joints; followed by Florent David (Ireland) presenting the “ins and outs” of the use of ultrasound in assisting during surgical procedures – a technique largely underutilised and having great potential for the equine surgeon.

Assessing muscle injuries

In the next session, Jean Marie Denoix (France) will step up onto the stage. Known as the “godfather” of equine orthopaedic ultrasound, he will present on the use of ultrasound in assessing muscle injuries. Finally, Florent David will present on ultrasound guided injections providing a “How to” experience to directly avail of these techniques in day to day practice.

Finally, all speakers in the session will join each other on stage to provide an interactive and open discussion with the audience on ultrasound usage in equine orthopaedics.

Delegates are invited to bring specific problems, imaging difficulties and technical questions to give to the expert panel. Take advantage of this option to get your problems solved or lift yourself to a higher level by getting acquainted with the pitfalls experienced by your peers.

In conclusion, this session promises to provide you with tools that have an immediate potential to be utilised in your day to day practice.

■ For full details of the congress, including registration, see www.beva.org.uk.

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