A 4 year old thoroughbred stallion was used for steeple jumping He struck one of the jumps with his right knee and was immediately lame Radiographs were made of the affected knee A lame 4 year old with a routine 5 views of the carpus Radiographic diagnosis
- A fracture of the right radius extended into the radiocarpal joint laterally with severe injury to both bone and articular surface
- A pattern of soft tissue calcification/ ossification seen adjacent to the fracture site was not expected with an acute trauma patient
- Surgery was performed with an incomplete reduction of the fractures - a secondary infection complicated the healing - the horse was discharged lame 11 days after the injury
Comments concerning the soft tissue opacification/ossification
- A pattern of soft tissue calcification can be superficial and the result of a skin lesion
- Use of an iodine solution on the skin can give this type of indistinct linear radiopaque shadows
- Soft tissue calcification can appear following injections of steroids but this would be result of a chronic treatment and not be evident immediately following a trauma
- A pattern of periosteal new bone causing a pattern of ossification is not expected immediately post trauma and the pattern in this horse is not attached to the underlying periosteum
- A superficial artifact causing a radiodense pattern was considered
- What ever the cause, the pattern of calcification/ossification was not seen on subsequent pre-op studies made after the radiographs shown above and was not seen on the post-op studies
- A discussion with the technicians did indicate that the knee was tightly wrapped with a gauze bandage at the time of admission – this was discarded immediately after making the radiographic study and was not available for examination – the possibility that the bandage contained iodine was considered the most likely explanation for the artifacts
- Preparation of the skin within the radiation field is important – this is usually accomplished by removing all bandages and brushing or scrubbing the limb – this removes radiopaque material from the radiation field due to rocks or dirt or opaque medicaments - this is especially important when a penetrating foreign body is considered in the injury
