Imaging of Thoracic Trauma

Presentation Description / Summary: Chest trauma in horses is commonly associated with emergency situations. On first examination, the clinician must quickly determine whether traumatic injuries involving only superficial structures, or if the damage extends to deeper tissue planes, disrupting vital structures and compromising respiratory and cardiac function. Therefore, a rapid but thorough examination is required in order to establish a precise diagnosis and initiate possibly life-saving treatment. Radiography and ultrasonography are indispensable first-line diagnostic tool for trauma patients, and should be considered an essential part of a comprehensive examination at admission. Both techniques complement each other for the assessment of the thorax. Ultrasonography has the advantage of providing a rapid, point-of-care and sensitive assessment the superficial structures, whereas radiography is only available in referral centers, but provides a more detailed evaluation of the lung parenchyma and mediastinum. Currently, in small animal medicine an abbreviated ultrasonographic examination technique called focused assessment with sonography for trauma (FAST) has been described in critically patients. A similar modified protocol can be adapted for evaluating the equine thorax in emergency situations such as traumatic injuries. Moreover, the development of wide-bore computed tomography scanners is allowing unparalleled visualization of the thorax of foals and small horses. In this lecture the use of diagnostic imaging modalities for assessing traumatic injuries of the equine thorax is discussed, providing a practical approach that can be introduced in the diagnostic work-up of these cases.

Learner Outcomes: • Recognizing diagnostic features of common and less common traumatic injuries of the thorax. • To describe a rapid and focused combined radiographic and ultrasonographic protocol to comprehensively assess the equine thorax. • To develop a decision tree for reaching a diagnosis and initiating treatment based on the imaging findings in emergency situations.