Diagnostic Imaging

Digital Radiography

An 800 mA X-ray generator in the radiology suite provides imaging for standing, adult large animals; covering head, neck, chest, shoulders, elbows, and stifles. This generator can be used to image regions of the horse that can be difficult to image in the field, including the caudal cervical spine, thoracolumbar spine, pelvis, and abdomen. Myelograms can also be performed on the cervical spine under general anesthesia.

Computed Tomography (CT)

Computed tomography (CT) can be used to evaluate bony and soft tissue lesions in 3-D, helping to identify abnormalities that are incompletely seen or even missed on standard radiographs. CT is most useful for evaluating bone.

What We Offer

• Robotic imaging of the head, cervical spine and distal limb (mid-radius to foot and distal tibia to foot)
• Esophagrams / TVEC fluoroscopy

The Use of CT Scans During Surgery

At New Bolton Center, the integration of intra-operative computed tomography (CT) has transformed the way we approach orthopedic surgery. This advanced imaging technology allows our surgical team to visualize fractures and other abnormalities in precise detail and in three dimensions, before, during, and after surgery. By accurately identifying the full extent of an injury, CT enhances surgical planning and improves outcomes.

Many of these procedures are now performed using minimally invasive techniques, which rely on small incisions rather than fully opening the limb. Intraoperative CT, along with real-time fluoroscopy (continuous X-ray imaging), plays a critical role in guiding these delicate interventions with accuracy and confidence.

Robotic CT Imaging

Penn Vet was the world’s first veterinary teaching hospital to use a robotics-controlled imaging system for computed tomography, which can be used to image the horse without general anesthesia. 

This system has proven value for both clinical and research applications.

Nuclear Medicine

Nuclear medicine, commonly referred to as nuclear or bone scintigraphy, involves the administration of a radiopharmaceutical that binds to bone where there is injury, or at sites of active bone formation. Used in conjunction with lameness examination and diagnostic analgesia, this modality can assist in identifying the cause of lameness.

Potential Candidates for Nuclear Scintigraphy

Horses that might benefit from nuclear scintigraphy include:

• Horses with suspected stress related bone injury
• Horses in which radiographic images are negative or confusing
• Horses in which pain causing lameness can be localized using nerve blocks but the cause of pain cannot be determined on radiography and ultrasonography
• Horses with high-speed lameness, or poor performance
• Horses with numerous, subtle lameness abnormalities 
• Horses with neck, back, or pelvic problems
• Horses with suspected soft tissue injury such as suspensory ligament, skeletal muscle, or soft tissue structures in the navicular region

Bone scans should be performed in conjunction with a thorough lameness examination, which can be performed by your veterinarian or here at New Bolton Center. The results are then interpreted along with all other clinical and diagnostic information. Horses must remain in the hospital for 24 hours after radiopharmaceutical administration to allow the radioactivity to subside.

Positron Emission Tomography (PET)

Positron Emission Tomography (PET) is a form of nuclear medicine imaging, similar to scintigraphy, that allows veterinarians to detect subtle changes in bone and soft tissue metabolism. While PET scans originally required general anesthesia, advances in technology now allow the procedure to be performed safely with standing sedation.

Both PET and scintigraphy are used to identify areas of increased activity—or “hot spots”—that may signal early or microscopic injury, often before structural damage becomes visible on other imaging modalities. This is especially important in the detection and prevention of limb fractures, which can be life-threatening in horses. Early diagnosis through PET plays a critical role in protecting equine athletes and improving outcomes.

What to Expect

A small dose of a radioactive agent is injected approximately 30 minutes prior to imaging. This agent distributes through the body and accumulates in regions with increased bone turnover. Once the horse is sedated, the procedure takes between 3-5 minutes to image each site. In less than 30 minutes, both front feet and both front fetlocks can be imaged.

Results

(Top row) CT/PET fused images of a fetlock in a horse demonstrate many sites of uptake of the radioactive agent in the fetlock indicating multiple sites of bone injury

(Bottom row) CT/PET fused images of a carpus (knee) in a horse demonstrate significant uptake of the radioactive agent in the third carpal bone indicating bone injury

Clinical Applications

Specialists at New Bolton Center use imaging to enhance their diagnostic work-up. Applications include:

Soft Tissue Surgery and Dentistry

• Evaluation of the head, including the teeth and paranasal sinuses.
• Learn more about dentistry.

Orthopedic Surgery

• Evaluation of trauma and wounds
• Lameness work-up
• Surgical planning
• Find out more about surgery.

Sports Medicine

• Lameness and poor performance work-up
• Learn more about the sports medicine service.

Neurology

• Cervical spine imaging
• Learn more about neurology.

Cardiovascular Medicine

• Evaluating the heart and lungs in patients with cardiac disease
• Find out more about cardiology.

Internal Medicine

• Evaluating the lungs in horses with respiratory illness
• Screening the abdomen for colonic sand or intestinal stone formation in horses with colic
• Read about internal medicine.

Translational Opportunities

Penn Vet researchers and clinicians collaborate with colleagues at Penn Medicine, Nemours Children’s Health System, and other human medical centers about possible applications of new imaging systems.

Translational applications include:

• Motion correction technology used to image standing, sedated horses is similar to what is used to image infants and pediatric patients
• Diagnosis and serial monitoring of naturally-occurring musculoskeletal disease including injuries that affect tendons, ligaments, and bone
• Intra-operative imaging techniques that can be performed during surgery

Ultrasonography

Ultrasound is an excellent method to evaluate soft tissue structures and the surface of bone.  Ultrasound is known as a “user dependent modality” and our faculty have advanced training in musculoskeletal ultrasound and general ultrasound imaging. We have several state of the art “console” or hospital units in addition to portable capabilities. In our clinic, ultrasound is routinely but not exclusively used for evaluation for soft tissue injury in the lame horse, causes of acute or chronic colic, weight loss, thoracic disease, neonatal foals, high risk pregnant mares and our farm animal species.  It is used to perform ultrasound guided injections, biopsies and intra-operative procedures, thus improving the accuracy and safety of these procedures over ‘blind’ techniques.

For information or to schedule an appointment, please call (610) 444-5800. Appointments may be made by the owner, trainer, or referring veterinarian.