Plus-Hex CLINICAL
Ischium | 45 ° – caudal – cranial
As with most pelvic injuries , the horse may be unwilling to stand square or to bear weight on the injured limb . To obtain good-quality views of the ischium , the horse should be straight through the body ; using a set of stocks is helpful . The horse can be standing with the limb positioned well underneath the body , as long as it is not resting a hindlimb . This angle helps with plate positioning as the plate needs to be held on the caudal aspect of the gaskin , with the generator tube head angled 10 – 15 ° towards the tail , centred just off the midline , on the very caudal aspect of the buttock .
REFERENCES
1 Barrett EL , Talbot AM , Driver AJ , Barr FJ , Barr ARS . A technique for pelvic radiography in the standing horse . Equine Veterinary Journal . 2010 ; 38 ( 3 ): 266 – 270 . Available from : https :// doi . org / 10.2746 / 042516406776866435 .
2 Geburek F , Rötting AK , Stadler PM . Comparison of the diagnostic value of ultrasonography and standing radiography for pelvic – femoral disorders in horses . Veterinary Surgery . 2009 ; 38 ( 3 ): 310 – 317 . Available from : https :// doi . org / 10.1111 / j . 1532-950X . 2009.00508 . x .
3 Sales J , Caine A , Dennis R , Lhermette P . Diagnostic imaging . In : Cooper B , Mullineaux E , Turner L . ( eds .) BSAVA Textbook of Veterinary Nursing . 6th ed . Gloucester : BSAVA ; 2020 . p . 428 – 491 .
4 Walker WT , Werpy NM , Goodrich LR . Procedure for the transrectal and transcutaneous ultrasonographic diagnosis of pelvic fractures in the horse . Journal of Equine Veterinary Science . 2012 ; 32 ( 4 ): 222 – 230 . Available from : https :// doi . org / 10.1016 / j . jevs . 2011.09.067 .
Ilial wing
As described by Geburek et al . [ 2 ] , it is not currently possible to image the ilial wing in an adult horse using radiography , with the exception of injury to the tuber sacrale , which can be seen on a lateral projection . It may be possible in a foal or a small , slim pony .
Ultrasonography
Due to their size , most equine patients will require the use of both radiography and ultrasound techniques to diagnose an injury . Although all veterinary nurses ( VNs ) can perform radiographs and interpretation is straightforward , there are limitations when it comes to performing ultrasound scans , and interpretation from saved images can be difficult .
As Walker et al . [ 4 ] describe , the most useful techniques include transrectal ultrasonography , which VNs are not able to perform . However , due to the skin thickness and muscle density of the horse , there are images that cannot be acquired via ultrasonography .
Summary
It is possible to perform radiographs of the pelvis without the need to use general anaesthesia , which reduces the associated risks and the time taken to identify the fracture . Although radiography is not always the best modality to use – especially with some referral practices having access to computed tomography , scintigraphy and ultrasonography – it is still considered a useful tool . A VN is able to position the horse to gain a diagnostic image , helping to save the veterinary surgeon ' s time .
Volume 39 ( 2 ) • April 2024
39