Equine Imaging: Hallmarq's Standing MRI Expertise Accessible Through Hoof Blog Alliance

This video, produced by Hallmarq Veterinary Imaging, details the procedure involved in preparing for and executing a standing MRI as practiced by Sarah E. Powell, MA, VetMB, MRCVS in the Hallmarq suite at Rossdales Equine Diagnostic Centre in Newmarket, England.

Get ready for some exciting new additions to the Hoof Blog. Over the next few weeks, the H-Blog will present information for and with the assistance of Hallmarq Veterinary Imaging, a company that is recognized as the worldwide leader in standing-MRI imaging of the horse's lower limb.

Now that 14 leading North American university and private equine hospitals are equipped with specialized Hallmarq magnetic resonance imaging (MRI) units for hoof imaging, there is a "need to know" in the horse owner, trainer, technician, therapist and farrier sectors about what this type of veterinary diagnostic imaging involves and what its value to the horse can be. Worldwide, almost 50 Hallmarq lower limb imaging suites are in use; images of almost 20,000 equine lameness cases have been archived in the company's central database. But what does that mean to a horse in my care, or in yours?

Why does a veterinarian need an MRI if a radiograph has already been taken? An MRI looks literally "into the foot" from different angles and reveals the condition of soft tissue structures, such as tendons, ligaments, and hard-to-view points like the navicular bursa. A radiograph's weaknesses are an MRI's strengths. MRI results are especially valuable for making a prognosis for a performance-related injury. (Hallmarq image)

With Hallmarq's expertise and vast database of images, we will be helping to de-mystify where, when and how MRI fits into the bigger picture of horse foot injury imaging and explaining specific foot problems that are especially well-suited for detailed soft-tissue analysis using MRI technology. Hallmarq's unit, as you will see in this video, also allows the horse to be imaged while standing, so that only sedation is required rather than subjecting the horse to the risks of general anesthesia.

That's the process, and while we all are interested in the end results, it's important to know what can be done to best prepare horses for an MRI appointment and to appreciate the valuable information that MRI might provide. Information from leading clinics and lameness specialists will provide insights and perhaps give insight to what the future may hold.

Watch for more in the Hallmarq-sponsored article series this summer, and check their social media system and especially their info-deep web site for lots more information.

To learn more about Hallmarq Veterinary Imaging and standing MRI technology for horses:

• Become a fan  of the new Hallmarq Equine MRI Facebook page;
• Follow @HallmarqMRI on Twitter;
• Subscribe to the hallmarqvetimaging channel on YouTube.com;
• Watch for a growing equine distal limb Hallmarq MRI image gallery on Flickr.com;
• Visit the Hallmarq.net web site. (Plan to spend some time there!)

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About Hoof Blog sponsored articles: From time to time, the HOOF BLOG publishes articles made possible by the sponsorship of industry partners and advertisers. These articles will always be clearly marked as sponsored content. They are developed and created by Hoofcare Publishing in collaboration with the sponsor. Only articles clearly marked as sponsored content have commercial affiliations. Sponsored content opportunities are available to companies whose programs, events or products are relevant to the educational mission of Hoofcare Publishing and the interests of its subscribers. Please email Hoofcare more information on sponsorship opportunities.

Google Ocean and the Animated MRI of a Horse's Foot

by Fran Jurga | 4 August 2009 | Fran Jurga's Hoof Blog

This blog post is comprised of three "aha!" moments.

It began back in February when I was intrigued by the launch of Google Oceans, an enhancement of Google Earth that allows us to look at the ocean floor, go inside the hull of a sunken ship, or explore the base of an iceberg in Antarctica. I imagine one day soon that the lobstermen around here won't have to go out and check their traps anymore; they will simply get on Google Ocean, type in the GPS coordinates of each trap, and see what they've caught. Then they would have to haul only those traps.

The image (above) that Google Ocean served up to promote its new program made me think of the horse's hoof, of course. The hoof has a lot in common with an iceberg. Everything is going on where we can't see it. Things are larger than they appear on the surface. And there's more to it than meets the eye. And as the history of the Titanic will tell you, a problem with an iceberg can ruin your day, or even end it. The same goes for a hoof.

Fast forward a couple of months and I'm lying inside an MRI unit in Massachusetts General Hospital. I'm determined to understand and appreciate this uncomfortable and deafening experience and use whatever I can get out of it to enhance my comprehension of magnetic imaging of the horse's foot.

Except no one on the staff wants to talk to me and the noise is too loud for conversation anyway.
I appreciate MRI images of the horse's foot because it is a new way to see inside the foot but I'm never sure what I'm looking at because I am trying to keep in mind that that is just a slice, unlike a radiograph. The MRI is like a strip of film negatives of a sequence of images in an old-fashioned filmstrip (albeit in 3D). When the radiologist looks at the MRI, he or she views the series mounted together on a sheet, not a single isolated image. Together, they make up the whole, but the isolated view reveals the injury.

MRI should be a collective noun, not a singular. That's what I brought out of that clanging tube that day at the hospital.

Fast forward again. Now it's the end of July and I'm in Columbus, Ohio, sitting in the back row at the AAEP's Focus on the Foot summer meeting. I'm really enjoying the speakers, taking notes like mad, and regretting missing the first day.

A change in the schedule brings North Carolina State University's Dr Rich Redding to the stage; he had been the victim of media glitches the day before, so his lecture was rescheduled. What a bonus for me! His lecture offers a hybrid approach to examining the foot and selecting the imaging modality for an injury diagnosis. All his images of the foot are lovely and explained very clearly but it all comes together for me when he compares four cases of foot injuries--puncture wound, two collateral ligament strains, and navicular zone pain by showing their MRIs.

The first thing that caught my attention was the should-be standard technique of showing a dissected foot cut at a specific point, and positioning an MRI "slice" at the same point next to it. That helped visualize the level in the foot where the injury was, and all the structures seen in the MRI, since the navicular bone can be viewed on so many different slices through the coffin joint.

Then, instead of showing an isolated MRI slice that showed the lesion site, he animated the slices into a fly-through of the entire MRI series.

Dr. Redding writes: "This was a horse that had a puncture to the navicular bone that damaged the Deep Digital Flexor (DDF) Tendon with a flap of tendinous tissue on the dorsal tendon proximal to the navicular bone. There is hemosiderin in the digital cushion where the nail penetrated the frog into the DDF and navicular bone." (Rough translation: the nail was in the back part of the foot so it grazed the upper surface of the navicular bone, which is at the level of the short pastern bone in the coffin joint. Watch the video and when the black square of P2 appears, you will see the injured area very briefly.)

It was Google Ocean all over again. You're beneath the surface, flying through; stop where you like and have a look around.

When they decide to do Google Hoof, I'm ready. Or maybe we're already doing it.

Thanks to Dr. Redding for the loan of this animation.


© Fran Jurga and Hoofcare Publishing. No use without permission. You only need to ask. Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.