Bone Scans (Scintigraphy) & SI

Spangles

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I have read from other owners that a bone scan is not useful for identifying SI issues but not sure if this is correct ?

Horse has been bucking in arena and vet found sacroilliac area to be tight and tender. History of hind suspensory injury but has been sound for 2yrs and doesn't present as being lame now - although maybe 1/10th on one rein of lunge. Hocks also medicated about 18mths ago so likely to have won off now.

Question is could the hocks/ suspensories be the cause of SI pain or is SI a totally separate issue ? Bone scan is an option and would be useful for hind end but possibly not SI ?

Or do I go with blocking/ medicating SI and possibly hocks again ? Agh !!! what order do I look at first ???
 

Wheels

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It's always such a conundrum. SI issues can be picked up by a bonescan. Often horses who have any other issues in the hind limbs can also have issues with the SI joints - which comes first? I dont think that's easy to work out and not always necessary to know which was first if you can get the right treatment plan.
 

clairefeekerry1

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We went round the houses, but in our case it was hocks that were the root of the problem and the bone scan picked that up. Previous nerve blocks of the hocks had been negative so we had thought SI issue but in hindsight the wrong hock joint was being nerve blocked. After the bone scan the correct part of the hock joint was blocked and the horse was instantly sound. We had 12 months of diagnostic hell though.
 

PaintPonies

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Bone scan will pick up any 'hot spots' this will then lead the way for further diagnostics such as x-rays etc on the affected area. In my experience a bone scan is helpful in locating the problem areas but not the exact nature of the problem hence the need for further investigations but at least you then know where to look.
 

SarahM

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I've had 2 horses go for bone scans. The first one it picked up SI joint disease, KS and hock arthritis so was a huge help in making a diagnosis. The second one was inconclusive and flagged a few little things which were then invested. They are usually very beneficial but just be prepared that It may well be inconsistent. Best of luck, all very stressful x
 

FinkleyAlex

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Mine is waiting to have a bone scan to explore back pain - x Rays didn’t flag anything so we’re thinking possibly an SI issue. Bizarrely has no issues when ridden, just unhappy being saddled and mounted on occasion. We’ve ruled out most other things (KS, ulcers, not lame) so have no idea how we’d go forward if bone scan doesn’t pick it up!
 

ITPersonnage

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My girl had bone scan to investigate pelvic/stifle issues. Luckily they found a stifle injury that we could treat. Best of luck with yours.
 

ihatework

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Bone scans are just one piece in a large jigsaw puzzle when you are investigating multiple issues.

They flag up areas where there is active bone remodelling. Thing is, bone remodels a lot of the time - so it’s a bit of an art interpreting bone scans and isolating what may be clinically significant and worth investigating further.

Definitely a useful tool, but not the holy grail.

If I had a horse with hock issues and presenting sore over SI, I’d save the bone scan ££, and use it to medicate hocks and SI and then embark on a physio led rehab program. I’d also scan & block high suspensory to rule that in/out
 

Ceriann

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Bone scan on mine picked up mild hot spot in SI, which was followed up with a suspensory scan, which then identified a medial branch injury/tear. SI considered to be secondary. It was useful to clear up a load of questions too - ks, hocks, stifles.
 

Nudibranch

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Hock issues often go hand in hand with SI. Bone scans *can* find SI problems, but there's no guarantee so you may still end up not finding anything, even if it is there.
That said, if your insurance will cover it then you may as well give it a go. Then remedicate hocks if nothing obvious is found. That's what I'd probably do.
I hope you get to the bottom of it. I had 5 years of trying to resolve SI and hocks and it was pretty frustrating!
 
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