Vet Comp Orthop Traumatol 2009; 22(02): 113-118
DOI: 10.3415/VCOT-08-04-0037
Original Research
Schattauer GmbH

Effects of radial extracorporeal shock wave therapy on radiographic and scintigraphic outcomes in horses with palmar heel pain

C. Byron
1   Department of Veterinary Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana, Illinois, USA
,
A. Stewart
1   Department of Veterinary Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana, Illinois, USA
,
B. Benson
1   Department of Veterinary Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana, Illinois, USA
,
B. Tennent-Brown
1   Department of Veterinary Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana, Illinois, USA
,
J. Foreman
1   Department of Veterinary Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana, Illinois, USA
› Author Affiliations
Further Information

Publication History

Received 18 April 2008

Accepted 02 March 2008

Publication Date:
17 December 2017 (online)

Summary

Objective: To investigate the effects of radial extracorporeal shock wave therapy (RESWT) on radiographic and scintigraphic variables in horses with clinical pain referable to the palmar heel.

Methods: Eight client-owner horses with palmar heel pain were treated with RESWT for a total of three treatments. Nuclear scintigraphy and radiography were repeated at the beginning and completion of the study. Scintigram region of interest (ROI) density ratios were calculated and compared between treated limbs, untreated limbs, and a population of comparison limbs from eight horses free of lameness. Radiographs were scored for whole navicular bone appearance as well as distal border synovial fossae number and severity.

Results: There was not any preversus post-treatment difference in scintigraphic navicular pool phase or delayed phase ROI density ratios in treated limbs, or between treated and untreated limbs. Delayed phase ROI density was increased in the central navicular region in treated limbs compared to comparison limbs from non-lame horses at both time points. Radiographic scores remained unchanged.

Clinical significance: RESWT as applied in the present study has no effect on acute palmar heel region scintigraphic or radiographic parameters. Any acute clinical benefit may be due to analgesic effects rather than stimulation of local tissue metabolism.

 
  • References

  • 1 Sturtevant B. Shock wave physics of lithotriptors. In: Smith’s textbook of endourology, vol 1. Smith AD, Badlani GH, Bagley DH. et al. (eds) St. Louis: Quality Medical Publishing 1996; 5: 29-552.
  • 2 Haupt G. Use of extracorporeal shock waves in the treatment of pseudarthrosis, tendinopathy and other orthopedic diseases. J Urol 1997; 158: 4-11.
  • 3 Wang C. An overview of shock wave therapy in musculoskeletal disorders. Chang Gung Med J 2003; 26: 220-232.
  • 4 Wilner JM, Strash WWL. Extracorporeal shock-wave therapy for plantar fasciitis and other musculoskeletal conditions utilizing the Ossatron: an update. Clin Podiatr Med Surg 2004; 21: 441-447.
  • 5 Harniman E, Carette S, Kennedy C. et al. Extracorporeal shock wave therapy for calcific and noncalcific tendonitis of the rotator cuff: a systematic review. J Hand Ther 2004; 17: 132-151.
  • 6 Seil R, Wilmes P, Nührenbörger C. Extracorporeal shock wave therapy for tendinopathies. Expert Rev Med Devices 2006; 3: 463-470.
  • 7 Stoltny T, Koczy B, Wawrzynek W. et al. Hetero-topic ossification in patients after total hip replacement. Ortop Traumatol Rehabil 2007; 9: 264-272.
  • 8 Wang CJ, Wang FS, Huang CC. et al. Treatment for osteonecrosis of the femoral head: a comparison of extracorporeal shock waves with core decompression and bone grafting. J Bone Joint Surg Am 2005; 87: 2380-2387.
  • 9 Schaden W, Fischer A, Sailler A. Extracorporeal shock wave therapy of nonunion or delayed osseous union. Clin Orthop Relat Res 2001; 387: 90-94.
  • 10 Dahlberg JA, McClure SR, Evans RB. et al. Force platform evaluation of lameness severity following extracorporeal shock wave therapy in horses with unilateral forelimb lameness. J Am Vet Med Assoc 2006; 229: 100-103.
  • 11 Revenaugh MS. Extracorporeal shock wave therapy for treatment of osteoarthritis in the horse: clinical applications. Vet Clin North Am Equine Pract 2005; 21: 609-625.
  • 12 McClure S, Evans RB, Miles KG. et al. Extracorporeal Shock Wave Therapy for Treatment of Navicular Syndrome. In: AAEP Proceedings 2004; 50: 316-319.
  • 13 McClure SR, VanSickle D, Evans R. et al. The effects of extracorporeal shock-wave therapy on the ultrasonographic and histologic appearance of collagenase-induced equine forelimb suspensory ligament desmitis. Ultrasound Med Biol 2004; 30: 461-467.
  • 14 Cleveland RO, Chitnis PU. Comparison of the acoustic and cavitation fields produced by SWT devices with different generating principles. In: Proceedings 5th Surg Int Soc Muskuloskelet Shockwave Ther. 2002: 2.
  • 15 Bonder D, Boening JK. Extracorporeal shock wave therapy. In: Diagnosis and management of lameness in the horse. Ross MW, Dyson SJ. (eds) Philadelphia: W.B. Saunders; 2003: 825-826.
  • 16 Byron CR, Benson BM, Stewart AA. et al. Effects of radial shock waves on equine cartilage explants integrity, chondrocyte membrane permeability, and chondrocyte viability. Am J Vet Res 2005; 66: 1757-1763.
  • 17 Benson BM, Byron CR, Pondenis H. et al. The effects of radial shock waves on the metabolism of equine cartilage explants in vitro. NZ Vet J 2007; 55: 40-44.
  • 18 Da Costa Gómez TM, Radtke CL, Kalscheur VL. et al. Effect of focused and radial extracorporeal shock wave therapy on equine bone microdamage. Vet Surg 2004; 33: 49-55.
  • 19 Crowe OM, Dyson SJ, Wright IM. et al. Treatment of chronic or recurrent proximal suspensory desmitis using radial pressure wave therapy in the horse. Equine Vet J 2004; 36: 313-316.
  • 20 Bolt DM, Burba DJ, Hubert JD. et al. Determination of functional and morphologic changes in palmar digital nerves after nonfocused extracorporeal shock wave treatment in horses. Am J Vet Res 2004; 65: 1714-1718.
  • 21 Pauwels FE, McClure SR, Amin V. et al. Effects of extracorporeal shock wave therapy and radial pressure wave therapy on elasticity and microstructure of equine cortical bone. Am J Vet Res 2004; 65: 207-212.
  • 22 Schoonover MJ, Jann HW, Blaik MA. Quantitative comparison of three commonly used treatments for navicular syndrome in horses. Am J Vet Res 2005; 66: 1247-1251.
  • 23 Lizarraga I, Castillo F, Valderrama ME. An analgesic evaluation of isoxsuprine in horses. J Vet Med A Physiol Pathol Clin Med 2004; 51: 370-374.
  • 24 Dabareiner RM, Carter GK, Honnas CM. Injection of corticosteroids, hyaluronate, and amikacin into the navicular bursa in horses with signs of navicular area pain unresponsive to other treatments: 25 cases (1999–2002). J Am Vet Med Assoc 2003; 223: 1469-1474.
  • 25 Denoix JM, Thibaud D, Riccio B. Tiludronate as a new therapeutic agent in the treatment of navicular disease; a double-blind placebo-controlled trial. Equine Vet J 2003; 35: 407-413.
  • 26 Wright IM. A study of 118 cases of navicular disease; treatment by navicular suspensory desmotomy. Equine Vet J 1993; 25: 501-509.
  • 27 Matthews S, Dart AJ, Dowling BA. Palmar digital neurectomy in 24 horses using the guillotine technique. Aust Vet J 2003; 81: 402-405.
  • 28 Brown KE, Nickels FA, Caron JP. et al. Investigation of the immediate analgesic effects of extracorporeal shock wave therapy for treatment of navicular disease in horses. Vet Surg 2005; 34: 554-558.
  • 29 Dyson SJ. Navicular disease and other soft tissue causes of palmar foot pain. In: Diagnosis and management of lameness in the horse. Ross MW, Dyson SJ. (eds) Philadelphia: W.B. Saunders; 2003: 286-299.
  • 30 Butler JA, Colles CM, Dyson SJ. et al. Foot, pastern and fetlock. In: Clinical radiology of the horse. Butler JA, Colles CM, Dyson SJ. et al. (eds) London: Blackwell; 2000: 27-130.
  • 31 Keegan KG, Wilson DA, Lattimer JC. et al. Scinti-graphic evaluation of 99mTc-methylene diphosphonate uptake in the navicular area of horses with lameness isolated to the foot by anesthesia of the palmar digital nerves. Am J Vet Res 1996; 57: 415-421.
  • 32 Dyson SJ. Subjective and quantitative scinti-graphic assessment of the equine foot and its relationship with foot pain. Equine Vet J 2002; 34: 164-170.
  • 33 Foreman JH, Kneller SK, Twardock AR. et al. Forelimb skeletal scintigraphy responses in previously untrained Thoroughbreds undergoing initial treadmill examination. Equine Vet J Suppl 2002; 34: 230-235.
  • 34 Verna M, Turner TA, Anderson KL. Scintigraphic, radiographic, and thermographic apperance of the metacarpal and metatarsal regions of adult healthy horses treated with nonfocused extracorporeal shock wave therapy- a pilot study. Vet Ther 2005; 6: 268-276.
  • 35 Murray RC, Schramme MC, Dyson SJ. et al. Magnetic resonance imaging characteristics of the foot in horses with palmar foot pain and control horses. Vet Radiol Ultrasound 2006; 47: 1-16.
  • 36 Schumacher J, Steiger R, Schumacher J. et al. Effects of analgesia of the distal interphalangeal joint or palmar digital nerves on lameness caused by solar pain in horses. Vet Surg 2000; 29: 54-58.
  • 37 Schumacher J, Schumacher J, de Graves F. et al. A comparison of the effects of local analgesic solution in the navicular bursa of horses with lameness caused by solar toe or solar heel pain. Equine Vet J 2001; 33: 386-389.
  • 38 Schumacher J, Schumacher J, Gillette R. et al. The effects of local anaesthetic solution in the navicular bursa of horses with lameness caused by distal interphalangeal joint pain. Equine Vet J 2003; 35: 502-505.
  • 39 Schumacher J, Livesey L, de Graves FJ. et al. Effect of anaesthesia of the palmar digital nerves on proximal interphalangeal joint pain in the horse. Equine Vet J 2004; 36: 409-414.
  • 40 Whitton RC, Buckley C, Donovan T. et al. The diagnosis of lameness associated with distal limb pathology in a horse: a comparison of radiography, computed tomography and magnetic resonance imaging. Vet J 1998; 155: 223-229.