Multimodal Diagnostic Imaging to Identify Septic Apophysitis of the Proximal Humerus in a Thoroughbred Foal

• Published in: Journal of equine veterinary science 2021-06, Vol.101, p.103448, Article 103448
• Main Authors: Scilimati, Nicola, Pepe, Marco, Pressanto, Maria Chiara, Angeli, Giovanni, Beccati, Francesca
• Format: Article
• Language: English
• Subjects: Computed tomography; Foal; Radiography; Septic physitis; Ultrasound
• ISSN: 0737-0806; 1542-7412
• DOI: 10.1016/j.jevs.2021.103448

•The use of CT examination to identify a septic apophysitis in a Thoroughbred foal.•Sterile ultrasound-guided needle aspiration from the growth plate of the proximal humerus to isolate streptococcus equi zooepidemicus.•Early recognition of infection and targeted therapy application were essential for the resolution of the septic process. A 4-month-old Thoroughbred filly was referred for evaluation of severe left forelimb lameness of 24 hours duration. Radiographic projections of the shoulder revealed mild irregularity and sclerosis of the proximal humeral apophysis. Ultrasonographic examination showed a moderate increase in the amount of anechogenic synovial fluid within the intertubercular bursa and scapulohumeral joint, and irregularity of the ossifying bone surface of the intermediate tubercle of the humerus. Computed tomographic (CT) examination revealed a circular hypoattenuating area at the level of the proximal apophysis of the humerus. CT imaging in this case was essential for an early identification of the septic foci and it allowed ultrasound-guided sample from the lesion for the selection of targeted antibiotic therapy.