Diagnostic Imaging Flashcards
In this image from 2014 Buhler paper “Computed tomographic features of apical infection of equine maxillary cheek teeth: A retrospective study of 49 horses” what is #3 indicating?
EVJ 2014
Alveolar bone sclerosis
In Buhler’s 2014 paper “Computed tomographic features of apical infection of equine maxillary cheek teeth: A retrospective study of 49 horses” what sign was significantly associated with computed tomographic abnormalities of the pulp, root, periapical bone and periodontal space?
EVJ 2014
Tooth fracture
Infundibular changes were NOT associated with other CT signs of apical infection.
In Buhler’s 2014 paper “Computed tomographic features of apical infection of equine maxillary cheek teeth: A retrospective study of 49 horses”, what structure is indicated by the #1?
EVJ 2014
Lamina dura
Non detectable lamina dura present in all teeth and 76% roots. A nondetectable lamina dura should be interpreted cautiously and may even be considered normal due to its minor thickness and/or too low resolution of the imaging modality.
In Casey’s 2014 study “Gross, computed tomographic and histological findings in mandibular cheek teeth extracted from horses with clinical signs of pulpitis due to apical infection,” what were the Hounsfield units of 1.) cementum, dentin, bone, 2.) pulp, 3.) enamel?
Tremaine. EVJ 2014
1.) cementum, dentin, bone: 550-2000 HU
2.) pulp 400-500 HU
3.) enamel > 2500 HU
In Casey’s 2014 study “Gross, computed tomographic and histological findings in mandibular cheek teeth extracted from horses with clinical signs of pulpitis due to apical infection,” changes in the dentinopulpar area were located in what location for cases and controls?
Tremaine. EVJ 2014
Cases: apical third
Controls: occlusal and middle third
In Casey’s 2014 study “Gross, computed tomographic and histological findings in mandibular cheek teeth extracted from horses with clinical signs of pulpitis due to apical infection,” CT was most useful for detecting what type of defects?
Tremaine. EVJ 2014
Enamel and cemental
In Casey’s 2014 study “Gross, computed tomographic and histological findings in mandibular cheek teeth extracted from horses with clinical signs of pulpitis due to apical infection,” what histologic changes associated with pulpitis had not previously been documented in the horse?
Tremaine. EVJ 2014
Pulpar mineralization and osteodentin
In Carmalt’s 2016 study “Computed Tomographic Appearance of the Temporomandibular Joint in 1018 Asymptomatic Horses: A Multi-Institution Study,” what muscle inserts where the white arrows are pointing?
Vet Rad US 2016
Lateral pterygoid
In Carmalt’s 2016 study “Computed Tomographic Appearance of the Temporomandibular Joint in 1018 Asymptomatic Horses: A Multi-Institution Study,” CT anatomatical variations were detected in what percent of all horses and what percent of all joints studied?
40% all horses
29% all joints
In Carmalt’s 2016 study “Computed Tomographic Appearance of the Temporomandibular Joint in 1018 Asymptomatic Horses: A Multi-Institution Study,” what was the association with age on increased CT anatomical variations?
TMJs were sig more likely to have CT anatomic variations as horse age categories increased
In Carmalt’s 2016 study “Computed Tomographic Appearance of the Temporomandibular Joint in 1018 Asymptomatic Horses: A Multi-Institution Study,” what was the association with sex and CT anatomical variation?
Odds of geldings having normal TMJs sig lower than mares but not sig lower than stallions with no sig differences between mares and stallions
In Carmalt’s 2016 study “Computed Tomographic Appearance of the Temporomandibular Joint in 1018 Asymptomatic Horses: A Multi-Institution Study,” the odds of having TMJ anatomical variations were not stat sig associated with which factors?
reason for undergoing CT, horse breed or the presence of concurrent pathology in the region of the TMJ
In Carmalt’s 2016 study “Computed Tomographic Appearance of the Temporomandibular Joint in 1018 Asymptomatic Horses: A Multi-Institution Study,” what percent of horses over the age of 1 year had discrete focal hypodense regions?
57.4%
but not stat sig associated with age
In Carmalt’s 2016 study “Computed Tomographic Appearance of the Temporomandibular Joint in 1018 Asymptomatic Horses: A Multi-Institution Study,” what factors were not stat sig associated with the presence of regions of well defined hypodensity?
Age
right vs left
In Carmalt’s 2016 study “Computed Tomographic Appearance of the Temporomandibular Joint in 1018 Asymptomatic Horses: A Multi-Institution Study,” thin, linear hyperdense regions immediately ventral and parallel to mandibular fossa in region of disc in transverse plane were stat sig associated with what factor?
Age: Never occurred in horses < 1yr and increased dramatically in
horses > 10yrs
In Carmalt’s 2015 study “Intraarterial injection of iodinated contrast medium for contrast enhanced computed tomography of the equine head”, what was the outcome comparing low-dose intra-arterial and high-dose IV administration of contrast media?
Vet Rad US 2015
Findings indicated that low-dose intraarterial administration of contrast material in the equine head resulted in comparable soft tissue enhancement vs. high volume intravenous administration
What pathology is documented via oral endoscope of this 109 tooth in Doztel’s 2017 Step by Step paper on how to build an endoscope?
JVD 2017 issue 1
Oral endoscopic image of the occlusal surface of an apically infected right maxillary first molar (109). There is feed impaction of defects over all 5 pulp horns in addition to the mesial infundibulum.
What has metaplastic calcification in the sinus been associated with in this and previous reports?
Nottrott et al. Successful Treatment of a Persistent Oroantral Fistula via Transbuccal and Transnasal Endoscopic Debridement in a Horse. JVD 2018 issue 1
Dental fractures
In this mini sinuscopic image, “d” is the infraorbital canal of the right frontal sinus. What is “c”?
Pouyet, Vet Surg 2019, Validation of a 2-mm videoendoscope for the evaluation of the paranasal sinuses with a minimally invasive technique
Maxillary septal bullae
In this mini sinuscopic image of the right caudal maxillary sinus, “a” is the ethmoid and “c” is the infraorbital canal. What is “b”?
Pouyet, Vet Surg 2019, Validation of a 2-mm videoendoscope for the evaluation of the paranasal sinuses with a minimally invasive technique
The entrance to the sphenopalatine sinus
In this mini sinuscopic image of the right rostral maxillary sinus, what are “c” and “d”?
Pouyet, Vet Surg 2019, Validation of a 2-mm videoendoscope for the evaluation of the paranasal sinuses with a minimally invasive technique
Roots of 108 (d) and 109 (c)
From this frontal trephine location, what structure is shown with the black box over it?
Bach et al. Vet Surg 2019. Surgical enlargement of the nasomaxillary aperture and transnasal conchotomy of the ventral conchal sinus: Two surgical techniques to improve sinus drainage in horses
Maxillary septal bullae
30 mm trephine used
In Limone’s 2018 paper “Dental Radiography of the Horse,” what do A, B, C, D and E represent?
JVD 2018, Barratt
A. Conchofrontal sinus
B. Caudal maxillary sinus
C. Infraorbital canal
D. Rostral maxillary sinus
E. Common dorsal compartment (bulla) of the ventral conchal sinus
In Limone’s 2018 paper “Dental Radiography of the Horse,” what do A, B, C represent?
JVD 2018, Baratt
A. Caudal maxillary sinus
B. Rostral maxillary sinus
C. Ventral conchal sinus
Dorsoventral view
In Limone’s 2018 paper “Dental Radiography of the Horse,” what radiographic view is shown?
JVD 2018, Baratt
Right dorsal to left ventral lateral oblique view of maxillary cheek teeth (Rt30D-LeVO)
In Limone’s 2018 paper “Dental Radiography of the Horse,” what radiographic view is shown?
JVD 2018, Barrat
Open mouth right dorsal to left ventral lateral oblique view of left mandibular cheek teeth (Rt10D-LeVO)
In Limone’s 2018 paper “Dental Radiography of the Horse,” what radiographic view is shown?
JVD 2018, Barrat
Open mouth right ventral to left dorsal lateral oblique view (Rt45V-LeDO)
Isolates apices of maxillary cheek teeth, steeper angles 60 degrees needed in younger horses
In Limone’s 2018 paper “Dental Radiography of the Horse,” what radiographic view is shown?
JVD 2018, Barrat.
Open mouth right ventral to left dorsal lateral oblique view (Rt45V-LeDO)
In Luiti’s 2018 article “A Comparison of Computed Tomographic, Radiographic, Gross and Histological, Dental, and Alveolar Findings in 30 Abnormal Cheek Teeth from Equine Cadavers”, what % of apically infected teeth had strong evidence of disease on CT and rads respectively?
Liuti et al Frontiers 2018
96% on CT
50% on rads
What imaging sign of apical infection is noted by the red arrow?
Liuti et al Frontiers 2018
Erosion of alveolar bone
What % of apically infected teeth had intrapulpar gas in Liuti’s 2018 Frontiers study (ex vivo study)?
Liuti et al Frontiers 2018
68%
In comparison to in vivo 2017 study of 100%
What type of occlusal fissure is noted in e) and f)?
EVJ 2018 Pollaris et al
e) Type 2 - enamel only
f) Type 2 - primary dentin only
What type of occlusal fissure is noted in a) and c)?
EVJ 2018 Pollaris et al
a) Type 1a
c) Type 1b
In Pollaris et al 2018 “Equine cheek teeth occlusal fissures: Prevalence, association with dental wear abnormalities and occlusal angles” what was the prevalence of occlusal fissures?
EVJ 2018 Pollaris et al
72%
Males > females
More common > 13 yo
In Pollaris et al 2018 “Equine cheek teeth occlusal fissures: Prevalence, association with dental wear abnormalities and occlusal angles” what pulp horns were most commonly involved with OFs?
EVJ 2018 Pollaris et al
pulp horn 4 (59.2%) in maxillary cheek teeth,
pulp horns 1 (47.4%) and 2 (26.0%) in mandibular teeth
In Horbal et al’s 2019 paper “A Computed Tomographic (CT) and Pathological Study of Equine Cheek Teeth Infundibulae Extracted From Asymptomatic Horses. Part 1: Prevalence, Type and Location of Infundibular Lesions on CT Imaging”, this image shows caudal to the left and rostral to the right. What grade infundibular caries is noted for both infundibulae?
Frontiers 2019
Caudal: grade 2 (cementum and enamel)
Rostral: Grade 3 (cementum, enamel and dentin)
In Horbal et al’s 2019 paper “A Computed Tomographic (CT) and Pathological Study of Equine Cheek Teeth Infundibulae Extracted From Asymptomatic Horses. Part 1: Prevalence, Type and Location of Infundibular Lesions on CT Imaging”, this image shows what pattern of cemental hypoplasia?
Frontiers 2019
combined central
linear defect and apical cemental hypoplasia
green line indicates short distance from INF to pulp horn through thin enamel and dentin
In Horbal’s 2019 paper “A Computed Tomographic and Pathological Study of Equine Cheek Teeth Infundibulae Extracted From Asymptomatic Horses. Part 2: MicroCT, Gross, and Histological Findings” what were the reported median density microCT HU for normal cementum vs hypoplastic?
Frontiers 2019
Normal: 3,438 HU
Hypoplastic: 501 HU
What type of occlusal fissure is depicted here by the arrows on this microCT image?
Pollaris The Vet Journal 2020
Type 1a
What occlusal fissure type is depicted by the red arrowhead and green arrowhead in this microCT image, respectively?
Pollaris The Vet Journal 2020
Red: Type 1a
Green: Type 1b
In Pollaris’ 2020 study, “Occlusal fissures in equine cheek teeth: mCT and histological findings” what was the most common type of OF noted?
The Vet Journal 2020
type 1a (35/43 OFs)
In Pollaris’ 2020 study, “Occlusal fissures in equine cheek teeth: mCT and histological findings” what was significantly associated with fissure depth?
The Vet Journal 2020
Location (buccal OFs deeper than lingual OFs) and Triadan # (09s were deepest)
In Dixon’s 2020 study “A Computed Tomographic Assessment of Osteitis of Sinus Bony Structures in Horses with Sinonasal Disorders,” bone was significantly thicker in affected sides vs controls at all measured areas except which two?
Frontiers 2020
Frontal bone (FB)
Nasolacrimal duct maximal bony wall thickness (NLDB)
In Dixon’s 2020 study “A Computed Tomographic Assessment of Osteitis of Sinus Bony Structures in Horses with Sinonasal Disorders,” canal diameters were significantly wider for which canals?
Frontiers 2020
infraorbital
nasolacrimal duct
but nasolacrimal duct maximum bone thickness was not sig thicker
In Dixon’s 2020 study “A Computed Tomographic Assessment of Osteitis of Sinus Bony Structures in Horses with Sinonasal Disorders,” what was the relationship between bone density in HU between affected and non-affected sides?
Frontiers 2020
Bone density (HU) did not differ significantly between affected and control sides
In Dixon’s 2020 paper “Computed Tomographic Assessment of Individual Paranasal Sinus Compartment and Nasal Conchal Bulla Involvement in 300 Cases of Equine Sinonasal Disease,” the rostral maxillary and ventral conchal sinus were involved in what percent of cases overall respectively?
Frontiers 2020
Rostral maxillary sinus 94.7%
Ventral conchal sinus 87%
Most commonly involved compartments
In Dixon’s 2020 paper “Computed Tomographic Assessment of Individual Paranasal Sinus Compartment and Nasal Conchal Bulla Involvement in 300 Cases of Equine Sinonasal Disease,” what was the most common cause of sinus disease?
Frontiers 2020
Dental sinusitis 53%
Primary sinusitis 26%, sinus cyst 8%
In Dixon’s 2020 paper “Computed Tomographic Assessment of Individual Paranasal Sinus Compartment and Nasal Conchal Bulla Involvement in 300 Cases of Equine Sinonasal Disease,” what sinus compartment(s) was significantly more frequently involved in dental vs non-dental sinusitis, and what sinus compartment(s) was significantly less frequently invovled in dental vs non dental sinusitis?
Frontiers 2020
sig higher frequency of RMS involvement
Sig lower frequency of dorsal conchal sinus and sphenopalatine involvement
In Dixon’s 2020 paper “Computed Tomographic Assessment of Individual Paranasal Sinus Compartment and Nasal Conchal Bulla Involvement in 300 Cases of Equine Sinonasal Disease,” there was infection or destruction of the ipsilateral NCBs in what percent of horses?
Frontiers 2020
56% ipsilateral NCB involvement
Examination of contralateral NCBs showed fluid attenuating material in 3.3% cases
What bone is fractured as indicated by the arrowheads in this CT image?
EVE 2019 Crijns
Basisphenoid bone
In Crijn’s 2019 paper comparing CT and rads for skull fractures, what features of the fractures differed when evaluated radiographically vs on CT?
EVE 2019 Crijns
Extent of fracture underestimated by rads
Number of Fragments underestimated by rads
Single vs comminuted underestimated by rads
What bone is fractured indicated by the arrowhead?
EVE 2019 Crijns
Frontal bone
What bone is fractured, indicated by the arrow?
EVE 2019 Crijns
Temporal bone
What differential diagnosis would you have for this mass noted on the radiograph on the left side?
Platt JVD 2021 issue 1
Heterotopic polyodontia
In Zadelhoff’s paper “Multidetector CT and cone-beam CT have substantial agreement in detecting dental and sinus abnormalities in equine cadaver heads”, what categories of pathology were identified well on both modalities, and which were not?
Vet Rad US 2021
The agreement between CBCT and MDCT was almost perfect for overall detection of dental abnormalities (k = 0.90) with k = 1 for diastema k = 0.95 for clinical crown abnormalities, and k = 0.93 for infundibular abnormalities
The detection of pulp changes by CBCT was only moderate k = 0.44 - often missed gas in pulp chamber on CBCT but well diagnosed on MDCT
Increased scatter radiation, non-calibrated Hounsfield Unit and artifacts in CBCT images made accurate identification of the pulp density difficult.
In Carmalt’s 2017 study “The association between oral examination findings and computed tomographic appearance of the equine temporomandibular joint,” what percent of horses had TMJ variation?
EVJ 2017 Rawlinson
36%
all horses had no clinical signs of TMJ pathology
Carmalt 2016 40% horses had TMJ abnormalties
In Carmalt’s 2017 study “The association between oral examination findings and computed tomographic appearance of the equine temporomandibular joint,” what risk factors or conditions were significantly associated with a TMJ abnormality?
EVJ 2017, Rawlinson
age, periodontal and infundibular disease
horses with abnormal TMJs sig older than those with normal TMjs
Horses with periodontal disease were sig less likely to have abnormal TMJ findings
Horses with infundibular disease sig more likely to have TMJ abnormalities
In Carmalt’s 2017 study “The association between oral examination findings and computed tomographic appearance of the equine temporomandibular joint,” what oral exam findings were less likely to have an abnormal TMJ finding?
EVJ 2017, Rawlinson
Horses with periodontal disease were less likely to have abnormal TMJ findings compared with horses with no oral pathology
In Carmalt’s 2017 study “The association between oral examination findings and computed tomographic appearance of the equine temporomandibular joint,” what oral examination findings were not statistically significantly associated with TMJ pathology?
EVJ 2017, Rawlinson
No association with TMJ pathology for stepped teeth, incisor malocclusions or wave mouths
In Carmalt’s 2017 study “The association between oral examination findings and computed tomographic appearance of the equine temporomandibular joint,” what percent of horses had circular hypoattenuating regions within the temporal or mandibular condyles suggestive of subchondral bone cysts and what risk factors were significantly associated with their development?
EVJ 2017, Rawlinson
19% of horses
No significant risk factors
In Carmalt’s 2017 study “The association between oral examination findings and computed tomographic appearance of the equine temporomandibular joint,” what percent of horses had intra-articular disc mineralization and what risk factor was statistically significantly associated with it?
EVJ 2017, Rawlinson
11% of horses
Age was the only sig risk factor
Why are MRIs more time consuming to obtain than CTs?
Manso-Diaz. Application and indications of magnetic resonance imaging and computed tomography of the equine head. EVE 2017.
A separate acquisition is needed for each different sequence as well as for each different plane
What type of contrast media are used for CT and MRI respectively?
Manso-Diaz. Application and indications of magnetic resonance imaging and computed tomography of the equine head. EVE 2017.
CT → iodinated nonionic
MRI → organic chelates of gadolinium
What MRI sequences are represented in a, b, c and d below?
Manso-Diaz. Application and indications of magnetic resonance imaging and computed tomography of the equine head. EVE 2017.
a.) T2 weighted
b.) T1 weighted
c.) FLAIR
d.) T2 weighted gradient recalled echo
What imaging modality is the gold standard for imaging the temporo-hyoid apparatus?
Manso-Diaz. Application and indications of magnetic resonance imaging and computed tomography of the equine head. EVE 2017.
CT
What type of imaging modality and sequences are shown in a, b,c and d below?
Manso-Diaz. Application and indications of magnetic resonance imaging and computed tomography of the equine head. EVE 2017.
A.) T2-weighted MRI
B.) T1 weighted MRI
C.) bone window CT
D.) soft tissue window CT
According to Manso-Diaz’s 2021 paper “Application and indications of magnetic resonance imaging and computed tomography of the equine head,” MRI and CT are the gold standard for imaging what structures respectively?
EVE 2017
MRI: central nervous system (brain and cranial nerves), extracranial soft tissues
CT: bones of the skull, temporomandibular joint, temporo-hyoid articulation and teeth
both CT and MRI can adequately image the nasal passages and paranasal sinuses but CT has the advantage for subtle nasal and sinus osseous wall lesions
In Rowley’s 2021 study “A computed tomographic study of endodontic and apical changes in 81 equine cheek teeth with sagittal fractures,” what percent of horses were symptomatic and what was the association between the presence of clinical signs and likelihood of apical infection?
Frontiers 2021
63% symptomatic
No significant association between clinical signs and likelihood of apical infection or CT changes
In Rowley’s 2021 study “A computed tomographic study of endodontic and apical changes in 81 equine cheek teeth with sagittal fractures,” apical infection was diagnosed in what percent of teeth overall and were maxillary or mandibular cheek teeth more commonly affected?
77% apical infection
fractures occurred in maxillary teeth 91%, mandibular 9%
In Rowley’s 2021 study “A computed tomographic study of endodontic and apical changes in 81 equine cheek teeth with sagittal fractures,” what percent of maxillary buccal fractures were apically infected?
Frontiers 2021
71%
In Rowley’s 2021 study “A computed tomographic study of endodontic and apical changes in 81 equine cheek teeth with sagittal fractures,” what type of fractures were significantly associated sinusitis or apical infection respectively?
Frontiers 2021
Midline maxillary sagittal fractures significantly associated with sinusitis
infundibular involvement significantly associated with apical infection
All solitary midline sagittal maxillary teeth fractures apically infected (13/13)
96% of teeth with fractures involving infundibula apically infected
In Albers’ article “Early incisor lesions and Equine Odontoclastic Tooth Resorption and Hypercementosis: Reliability of radiographic findings” what % of teeth deemed “healthy” on rads had lesions detected on uCT?
EVJ 2022
83.7% of those noted “healthy” on rads were categorized as having some form of lesions on uCT – 52.7% moderate, 5.4% severe
In Albers’ article “Early incisor lesions and Equine Odontoclastic Tooth Resorption and Hypercementosis: Reliability of radiographic findings” where did they note early signs to be located on uCT evaluation?
EVJ 2022
palatal/lingual side
In Giavitto’s case series “Congenital hypodontia in three horses diagnosed by computed tomography,” what factors were suspected to contribute to maintance of good alignment of teeth next to agenesis sites?
EVE 2021
bone attenuating tissue filling space left by undeveloped teeth and persistence of retained deciduous caps
In Giavitto’s case series “Congenital hypodontia in three horses diagnosed by computed tomography,” the HU of the sites of dental agenesis ranged between what values which is a sign of what type of tissue?
EVE 2012
+1000 and -100 (one case -50)
represented a mixture of fat tissue and bone trabeculae
What disease is depicted in this image?
Verwilghen Vet Sciences 2022
bilateral idiopathic suture exostosis involving both nasolacrimal ducts. Reactions of sinus mucosa and skin are only mild.
What disease is depicted in this image?
severe suture exostosis with sequester formation
In this image, what pathology is the white arrow indicating, and what clinical sign would you suspect in the horse?
Perrier EVJ 2022
Enlarged left infraorbital nerve
Head Shaking
What are 1 and 2 in this image if this scope is placed in the discotemporal joint (DTJ) and facing medially?
Carmalt Frontiers 2022
1 - articular eminence of temporal bone
2 - intra-articular disk
If this scope is placed in the discomandibular joint (DMJ) and facing caudally, what do 1 and 2 depict?
Carmalt Frontiers 2022
1 - intra-articular disk
2 - condylar process of the mandible
What dental abnormalitiyis evident on this RtD30-LeVO radiograph of a 4.5 years-old miniature horse?
Tinsley Frontiers 2023
Missing 208 and persistent 608
Identify the pathology in these radiographs as presented by Arnbjerg in 2014.
Hypercementosis
Identify the type of resorption (white arrowhead) as described by Henry et al. in 2016
External replacement resorption
Identify the type of resorption as described by Henry et al. in 2016
External inflammatory resorption
In Norvall’s 2020 article “Ultrasound-guided arthrocentesis of the temporomandibular joint in healthy adult horses is equivalent to blind arthrocentesis” what structures are visualized when the ultrasound is placed with dorsal to the left of the image?
Norvall 2020 Vet Rad US
mandibular fossa of the temporal bone visualized dorsally (left), the disc centrally, and the mandibular condyle ventrally (right)
The caudal compartment of the dorsal pouch of the joint was identified as a triangular hypoechoic to anechoic structure (dotted line)
What anatomy is identified by the red and yellow arrows respectively?
Eduardo de Lima Vet Rad US 2024
Red: max septal bullae
Yellow: max septum
Image obtained after barium painted on structures via a bone flap
In Fairburn’s 2022 study “Computed tomographic findings in 101 horses presented for the investigation of headshaking,” fracture of what bone shown below was identified as one of the 4 cases that had CT findings consistent with headshaking?
EVE 2022
Paracondylar process of the occipital bone
What pathology is present in this apically infected 209?
Liuti EVJ 2018 “Radiographic, computed tomographic, gross pathological and histological findings with suspected apical infection in 32 equine maxillary cheek teeth (2012–2015)”
distorted apex
intrapulpar gas (arrow) and a round cemental structure (‘pearl’) in periodontium.
What are the red and white arrows indicating in this young horse?
Liuti Vet Rec 2017 “Computed tomographic assessment of equine maxillary cheek teeth anatomical relationships, and paranasal sinus volumes”
White arrow: mediodorsal location of infraorbital canal
Red arrow: restricted conchomaxillary drainage angle
What pathology is present in this image and what do the arrows indicate?
Dixon EVJ 2021
Left-sided (dental) sinusitis
The maxillary septal bulla thickened and sclerotic due to osteitis and with swollen mucosa on both sides (vertical arrow)
Grossly thickened maxillary bones (horizontal arrow)
What pathology is noted by the arrow?
Dixon EVJ 2021
Maxillary bone osteitis and soft tissue swelling secondary to the sinusitis of the RMS
What pathology is indicated by this arrow in this horse diagnosed with fungal sinusitis? What clinical sign would you expect from it?
Fiske-Jackson EVE 2012
Erosion into the IOC
Headshaking from trigeminal neuropathy
What post-op complications are shown in this radiograph in a 16 yo mare after repulsion of a 108 (red arrows and green arrows respectively)?
Earley 2013 JVD
Red arrows: sinusitis persisting
Green arrows: retained root of 108
What are the blue arrows indicating and where?
Earley 2013 JVD
Fluid line in caudal max sinus
What form of resorption is noted by the arrowhead and arrow respectively?
VCNA 2020 Baratt
Arrowhead: replacement resortion
Arrow: Inflammatory resorption
What change in angle should be performed for a lateral oblique radiograph of a TMJ
VCNA 2020 Baratt
Ventral - dorsal and caudal - rostral
LeV15Cd15-RtDRO
CT still the best though
What imaging modality is noted to have higher sensitivity for TR lesions?
VCNA 2020 Baratt
CT
Image of EOTRH in cheek teeth
What anatomy of the TMJ is noted by the asterisk on this ventral to dorsal tangential view?
VCNA 2020 Baratt
Mandibular condyle
What are the reported HU ranges for enamel, cementum, dentin, pulp, and bone
VCNA 2020 Epperly
Note: differs from values in Arnbjerg 2014
What are the black and white arrows indicating in this post-contrast scane?
VCNA 2020 Epperly
Black arrow: contrast enhancing rim around the soft tissue attenuating mass
White arrow: blood vessel
Given the HU (AV=average), what do you suspect of pathology #3?
VCNA 2020 Epperly
The caudal aspect of the tongue contains a large (5.3-cm 4.1-cm 3.5-cm) well-defined, precontrast hyperattenuating (average 98 HUs; range 89–126 HUs), non–contrast-enhancing (average 92 HUs; range 67–113 HUs) mass; consistent with an incidental melanoma.
Melanin HU = 100
Given the HU pre- and post- contrast in this scan, what do you suspect is happening with this sinus mass (#1)?
AV=average HU
VCNA 2020 Epperly
The (1) fibroma is mildly hyperattenuating (average 62 HUs; range 43–82 HUs)
and non–contrast enhancing (average 66 HUs; range 47–83 HUs), indicative of hemorrhage.
Hemorrhage HU = 60-100
Describe how to endoscopically access the ventral conchal bullae
VCNA 2020 Claffey
The endoscope is passed 10 to 15 cm caudal to the nares where the middle meatus is clearly visible.
Scope passed laterally around the ventral conchal scroll into the ventral conchal recess.
The endoscope has been advanced caudally within the ventral conchal recess until the VCB is visible (starred)
The thin septum separating the ventral conchal recess from the ventral conchal sinus is visible (arrowhead).
What is this image showing the instrument break through anatomically in the nasal passage?
VCNA 2020 Claffey
The membrane separating the VCS from the ventral conchal recess
The asterisk is the VCB
What is your diagnosis in this case of a 14-year-old Warmblood gelding referred because of facial swelling between the eyes, which appeared to cause discomfort to the patient and cause epiphora?
Sacks EVE 2013
Chronic suture exostosis
“Fixation of chronic suture exostosis in a mature horse” EVE 2013
What structure is noted by the arrowhead?
Sack EVE 2013
Nasolacrimal duct
Loss of definition here in this chronic suture exostosis case
What is your diagnosis?
Esselman EVE 2019
Nasofrontal suture exostosis
“Visual evidence of progression and eventual resolution of nasofrontal suture exostosis over 27 months in a gelding” EVE 2019
What condition is consistent with these irregular margins of the condyle and temporal bone?
Nagy Vet Surg 2006
Septic TMJ OA
What findings on this US of the R TMJ is consistent with septic OA?
Barnett EVE 2014
Hyperechoic at normal location of meniscus – like hypermineralized disc on CT
Hypoechoic tract - consistent with the clinical draining tract to the joint
What are the white arrows indicating?
Giavitto EVE 2017
Fluid lines in the dorsal and ventral nasal conchal bullae
What are the blue arrowheads indicating?
Giavitto EVE 2017
the mucosal folds that delineate the rostral limit of both bullae
What structure is indicated by the yellow arrowheads?
Pineros. Radiographic anatomy of the nasal conchal bullae and conchal sinuses in mature horses. Vet Radiol Ultrasound 2024.
Ventral conchal sinus
What structure is indicated by the yellow arrowheads?
Pineros. Radiographic anatomy of the nasal conchal bullae and conchal sinuses in mature horses. Vet Radiol Ultrasound 2024.
Dorsal conchal sinus
What structure is indicated by the red arrow heads?
Pineros. Radiographic anatomy of the nasal conchal bullae and conchal sinuses in mature horses. Vet Radiol Ultrasound 2024.
Dorsal conchal bulla
What structure is indicated by the blue arrow heads?
Pineros. Radiographic anatomy of the nasal conchal bullae and conchal sinuses in mature horses. Vet Radiol Ultrasound 2024.
Ventral conchal bulla
What age group were these hypodense regions surroundewd by hyperdense rims most associated with?
Carmalt Vet Rad US 2016 “Computed Tomographic Appearance of the Temporomandibular Joint in 1018 Asymptomatic Horses: A Multi-Institution Study “
Discrete focal hypodense regions present in 57.4% horses over 1 year of age
89.% hypodense regions in mandibular condyle, 10.5% in mandibular fossa (all in mandibular fossa had obvious communication with the joint)
No effect of age on the presence of regions of well-defined hypodensity and no left vs right side effect
Males more likely than females to have the region of hypodensity
Where did linear hyperdense regions of the articular disk tend to occur, and what age group were they associated with?
Carmalt Vet Rad US 2016 “Computed Tomographic Appearance of the Temporomandibular Joint in 1018 Asymptomatic Horses: A Multi-Institution Study “
Almost exclusively occurred in lateral to mid region of dorsorostral portion of disc
Never occurred in horses < 1yr and increased dramatically in horses > 10yrs
In the image below from Luiti’s 2018 article “A Comparison of Computed Tomographic, Radiographic, Gross and Histological, Dental, and Alveolar Findings in 30 Abnormal Cheek Teeth from Equine Cadavers”, what do the Hounsfield units within the common pulp chamber of this tooth indicate?
Frontiers 2018
That there is intrapulpar gas which is a sign of endodontic disease
Intrapulpar gas: 900 to 1,000 Hu
68% infected cadaver teeth had signs of intrapulpar gas in this study, 100% had intrapulpar gas in Luit’s 2018 in vivo study.
What anatomy is indicated by the white arrow and white arrowhead on this CT?
Tucker 2016 EVJ
the sphenoidal (arrows) and palatine (arrowheads) portions of the sphenopalatine sinus
How do sinus cysts appear on T1 weighted vs T2 weighted MRI?
Easley ch 21
T1W - hypointense
T2W - hyperintense
STIR also shows it hyperintense
What MRI sequences are shown of this left sided sinusitis? Slice at level of 10s
Easley ch 21
A is a T1W pre-contrast image
B is a T1W post-contrast image
C is a digital subtraction image
What MRI sequences are shown of this left sided sinusitis? Slice at level of 10s
Easley ch 21
A is T1W
B is T2W
In the image below from Pimentel’s 2021 study, “The Frequency of Communication Between the Synovial Compartments of the Equine Temporomandibular Joint: A Contrast-Enhanced Computed Tomographic Assessment,” what do the yellow, blue and white arrows indicate?
Carmalt Frontiers 2021
Yellow: discotemporal joint
Blue: discomandibular joint
White: extravasation/leadkage of contrast outside the joint
Does figure A or B have a wider window length (WL) and window width (WW), and what are the advantages of using a wider WW and WL vs narrower WW and WL?
Easley textbook 2022, chp 20
B is wider
Advantages of wider WW are more gray scale being visible which is better able to visualize structures with different attenuation (air filled sinus, dental tissue, bone)
Narrower is better for looking at tissues with similar attentuation
When WL is decreased CT image will be brighter
