Case Study 
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History: Subchondral Bone Cyst
Patient is a five year old bay Trakhener mare that presented to Animal Imaging for a full bone scan for an acute left front lameness.  Lower limb blocks up through the carpus were unsuccessful in alleviating the lameness.  The severity of the lameness fluctuates from a grade I to a grade III.  On presentation to Animal Imaging, a grade II left front lameness was noted.  Pain was noted on deep palpation of the shoulder.  Abduction of the shoulder exacerbated the lameness. 
  Subchondral Bone Cyst                                                       Scintigraphic Findings: 
Reagan was administered 160 millicuries of Technetium and multiple images were acquried.  Areas of increased radiopharmaceutical uptake included:
-A focal intense uptake was noted in the glenoid region of the distal scapula of the left fore limb.  Radiographs confirmed an osseous cyst like lesion that may have an articular component.  The cyst like lesion was surrounded by extremely sclerotic bone.   
Subchondral Bone Cyst 
Impressions and Recommendations:
True subchondral bone cysts often occur in the middle of the glenoid cavity of the scalpula.  Trauma is often an inciting cause.  It is not an uncommon finding to have the degree of lameness vary between any given examination.  True subchondral bone cysts are associated with active bone remodeling, therefore, scintigraphic evaluation can be useful in determining the extent of the pathology.  Surgical debridement has been successfull in some cases.  If the patient responds to intra articular therapy, a more conservative approach with intra articular medication may be an appropriate initial course of treatment.  Other intra articular treatment options include platelet rich plasma or cultured stem cells as well as intra lesional corticosteriod therapy.  Please email us with any of your comments or suggestions.
Animal Imaging 
Animal Imaging is a veterinary referral diagnostic center in Irving offering MRI, Scintigraphy, Radiology, Fluoroscopy and Ultrasound for companion animals and equine patients. 

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Jake Hersman, DVM            Robert Cole, DVM, DACVR           Susan Willenbrock
Managing Partner                 Imaging Director                           Office Manager
(972) 869-2180                     (972) 869-2180                             (972) 869-2180