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Bone Islands

November 14, 2022

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Polly is an eight-year-old warmblood performance horse; she has been a patient at CEC under Dr Nicolle Symonds and Dr Robin Bell for three years. Polly had a history of intermittent mild lameness that was not significant enough to block. Multiple assessments and treatments were trialled, but improvement was only ever temporary. Given the chronic and mild nature of her lameness, at Polly’s recent trot up nuclear scintigraphy, also known as a bone scan, was recommended.

Nuclear scintigraphy is often used in non-specific lameness cases like Polly. The horse is given a radioactive isotope, T99M, via a catheter, and a large camera is used to identify areas of increased pharmaceutical uptake or ‘hot spots’. ‘Hot spots’ are indicative of increased bony turn over which, in most cases, are areas of abnormal bony change.

In Polly’s case, a full body bone scan was performed and identified marked, focal regions of increased radiopharmaceutical uptakes in the tibia and the radius. This is a highly unusual finding, but our specialist team of sports medicine vets efficiently diagnosed Polly with enostosis-like lesions or ‘bone islands’.  Bone islands are defined as single or multiple regions of new bone in the medulla of long bones near nutrient foramens and are highly uncommon; The exact cause of this phenomenon is unknown but it can affect many bones simultaneously.

Polly was treated with rest and drugs that help regulate bone turnover. Three months on and after three years of ongoing lameness, Polly is finally sound as a bell and will be hitting the competition ring again soon!

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