Fetlock fractures in spotlight as vets work on early detection

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PET is the most recent advance in diagnostic imaging. It is being developed in California and, when combined with CT, provides information on bone activity and structure. In these three images of the same fetlock from different aspects, the orange spots indicate increased activity in the proximal sesamoid bone, which is a potential precursor to more serious injury.
PET is the most recent advance in diagnostic imaging. It is being developed in California and, when combined with CT, provides information on bone activity and structure. In these three images of the same fetlock from different aspects, the orange spots indicate increased activity in the proximal sesamoid bone, which is a potential precursor to more serious injury. © Dr M Spriet, University of California, Davis

Veterinary experts from around the world have explored how diagnostic imaging before racing can contribute to risk reduction, particularly of fetlock fractures in racehorses.

A two-day workshop in Britain hosted by the Jockey Club Estates, Newmarket, considered the value of radiography, which is the most widely available tool used to identify tiny fractures which will heal effectively, providing exercise is reduced. Technological progress in advanced imaging such as standing MRI, standing CT (Computed Tomography) and PET (Positron Emission Tomography) scanning, have the potential to identify pathology even earlier. At the workshop, the expert panel reviewed existing knowledge and discussed how to generate the research evidence, which is essential if these novel technologies are to gain a place in effective pre-race risk assessment programmes.

Pete Ramzan, Partner at Rossdales LLP, who co-ordinated the workshop said there was a great need to get some of the key experts leading these new technologies together in the same room to correlate their findings and work out how to translate them into tangible reductions in serious injury rates.

A radiograph showing a racing Thoroughbred’s fetlock joint. The arrow points to linear radiolucency in the parasagittal groove of the lower cannon bone, a finding that is frequently detectable before progression to serious injury.
A radiograph showing a racing Thoroughbred’s fetlock joint. The arrow points to linear radiolucency in the parasagittal groove of the lower cannon bone, a finding that is frequently detectable before progression to serious injury. © Dr P Ramzan, Rossdales LLP, Newmarket

“One of the somewhat unexpected outcomes of the discussions was that despite the fact that we are riding the crest of a wave of technological advances, basic radiography still has much to offer; better education around the application and interpretation of radiographs has real potential to allow vets like myself at the coal face to detect injuries at an early and recoverable stage,” Ramzan said.

Fetlock injury is one of several racecourse musculoskeletal injuries that collectively are estimated to occur in about 8 of every 10,000 race starts in the UK. Serious musculoskeletal injuries are slightly more common in the US and Canada, yet despite recent concerns, research shows 99.8% of starts in those jurisdictions are free of serious musculoskeletal injury. Nevertheless, fetlock injury can be extremely impactful and can be career-ending in some injured horses.

On the second day, a larger group of stakeholders reviewed the expert panel’s conclusions and discussed the need for greater transparency, education and communication amongst the racing industry stakeholders, all of whom share responsibility for ensuring racing continues to collaborate and enhance racehorse safety and welfare.

Standing CT has recently been developed in the US and Australia. This allows exquisite detail of bone structure to be imaged in the standing horse. In this image, the arrow points to a defect in the sesamoid bone indicating the bone is at risk of further injury.
Standing CT has recently been developed in the US and Australia. This allows exquisite detail of bone structure to be imaged in the standing horse. In this image, the arrow points to a defect in the sesamoid bone indicating the bone is at risk of further injury. © Professor Chris Whitton, University of Melbourne

The event was chaired by Equine Veterinary Journal editor Professor Celia Marr, who said racing has an excellent safety record and the injuries discussed were extremely rare.

“The low prevalence of fetlock injury makes it very difficult to pinpoint the affected individuals. But it is essential that we continue our efforts to do so ever more effectively because if silent injury is not detected it can progress to become much more serious.”

Fred Barrelet, Trustee of Beaufort Cottage Educational Trust, said the social licence which supports racing places responsibility for promoting animal welfare in the hands of the veterinary profession. “These are exciting times, and as new technologies come on board and information from these modalities is slotted into existing knowledge of risk factors, we can expect to see more effective risk assessment for individual races.”

The collaborative workshop was sponsored by The Gerald Leigh Charitable Trust and the Beaufort Cottage Educational Trust, together with several other industry contributors. The Beaufort Cottage Educational Trust is a small charity that aims to support educational projects and events for those involved in the care of horses and disseminate knowledge of the best veterinary and management practices and thereby enhance horse welfare. It works with the Gerald Leigh Charitable Trust to support projects focusing on racing and the Thoroughbred.

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