An obese 17-year-old Shetland pony mare with a history of recurrent colic episodes was presented for investigation of colic signs of a few hours' duration associated with marked tachycardia. Transabdominal ultrasonography identified a large amount of multilobulated tissue that was hypoechoic to the adjacent retroperitoneal fat within the caudal and ventral abdomen; this could be seen extending dorsally into the mid-abdomen between intestinal structures. At exploratory laparotomy, a lipoma at the mesenteric attachment of the mid-jejunum (considered likely to have caused intermittent extraluminal compression) as well as excessively thick layers of fat in the mesentery of both small and large intestine (compatible with lipomatosis) were identified. The lipoma was removed. Post-operative recovery was uneventful. A strict diet was enforced, resulting in marked weight loss over the 12-week post-surgery period. Follow-up abdominal ultrasound examination identified a reduction in the thickness of the retroperitoneal fat layer and the abnormal multilobulated tissue. This is the first case report detailing the ultrasonographic findings in a case of extensive mesenteric lipomatosis in a pony and describing the ultrasonographic improvement following a weight loss programme.
Damage to the subchondral bone has been associated with a number of orthopaedic diseases. Diagnostic imaging is, therefore, critical in identifying disease and damage of the subchondral bone, not only for the diagnosis of joint and subchondral bone disease causing lameness, but also for identifying early/pre-symptomatic damage. The aims of this Critically Appraised Topic (CAT) were to assess the published evidence for the use of advanced imaging techniques (magnetic resonance imaging [MRI] and computed tomography [CT]) in the diagnosis of subchondral bone disease in the distal limb joints (metacarpo/ metatarsophalangeal and interphalangeal joints) of the adult horse, and to compare the diagnostic value of these techniques with radiography. In the studies reviewed in this CAT, advanced imaging modalities (MRI and CT) were superior to routine radiography for the diagnosis of subchondral bone injury of the distal limb joints. In a small percentage of horses, post-MRI reevaluation of the initial radiographs or acquiring further lesion-orientated radiographs allowed the identification of the subchondral bone injury. Extended radiographic examinations, including non-standard views, might increase the sensitivity of radiography to detect subchondral bone injuries, however, currently CT and MRI may be considered the "gold standard" imaging modalities. More studies comparing the identification of subchondral bone lesions on imaging and by histopathological/gross examination would be useful to assess more precisely the sensitivity and specificity of the different modalities.
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