How to Ultrasound the Normal Pelvis for Aiding Diagnosis of Pelvic Fractures Using Rectal and Transcutaneous Ultrasound Examination

Pelvic fractures do not occur frequently in horses, and reports of incidence range from 0.9% to 4.4%. Despite this low incidence, many equine practitioners will, at some point in time, be faced with determining a diagnosis, a prognosis, or formulating a treatment regimen based on their impressions of fracture severity. Because the equine pelvis is a complex anatomic structure, the diagnosis of pelvic fractures is often one of suspicion because of the extensive musculature coupled with size of the horse. Furthermore, swelling and crepitus that may be appreciated in long-bone fractures may be more difficult to recognize. Diagnosis often involves ventrodorsal pelvic radiographs that require that the horse be placed under general anesthesia. However, this method of diagnosis has inherent risks because of the potential of fracture displacement and/or internal hemorrhage caused by laceration of the iliac arteries on recovery. More recently, a detailed description of the pelvicultrasound anatomy has been reported in normal horses, and two studies incorporate the use of ultrasound to help diagnose pelvic-bone abnormalities. The purpose of this abstract is to describe our approach to the ultrasonic evaluation of the equine pelvic region and its use in determining whether or not fractures have occurred in the pelvis or associated structures such as the head and/or neck of the femur. Examples of clinical cases in which fractures were diagnosed will also be presented.