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  1. 1. F e b r u a r y 2 0 1 0 V e t s c a n L t d • G u a r d s H a l l • G u a r d s A v e • C a t e r h a m • S u r r e y C R 3 5 Z D t e l • 0 1 8 8 3 3 4 5 2 3 4 F a x • 0 1 8 8 3 3 4 5 9 5 1 E m a i l • i n f o @ v e t s c a n . e u X-RAY ULTRASOUND CT MRI TELERADIOLOGY YOUR PARTNER IN PRACTICE NEUROLOGY CONSULTS What is Your Diagnosis? A 6 month old female Bernese Mountain Dog presented with a vague history of pain/discomfort for a few weeks which difficult to isolate to any particular region. Gradually it got worse to where she was yelping in pain 2-3 times daily especially when getting up from a lying position. Pain was then isolated to the neck. No neurological deficits were noted. Haematology and biochemistry results were unremarkable. Radiography of the neck was performed. Neurology and MRI Consultants! Thank you to all who attended our successful MRI seminar with Dr. Pat Gavin at the Coulsdon Manor Hotel on Jan 12th. We are delighted to announce that Pat Gavin has joined us as MRI Consultant and Sue Fitzmaurice will also join the team in March offering a Neurology service. Now you and your clients can also benefit from Pat and Sue’s wealth of clinical MRI and neurology experience. Have the real experts on YOUR team! And don’t forget our 2010 Film Reading Sessions and One Day Radiology Courses! - See inside for details.
  2. 2. F e b r u a r y 2 0 1 0 V e t s c a n L t d • G u a r d s H a l l • G u a r d s A v e • C a t e r h a m • S u r r e y C R 3 5 Z D t e l • 0 1 8 8 3 3 4 5 2 3 4 F a x • 0 1 8 8 3 3 4 5 9 5 1 E m a i l • i n f o @ v e t s c a n . e u CASE STUDY Radiographic Findings • The radiograph shows a palisade-like periosteal reaction along the ventral body of the atlas • MRI shows that the suture between the right neural arch and the intercentrum or body of the atlas has ossified normally. The suture between the right and left neural arches has not ossified but the arches retain their normal shape dorsally. The suture between the left neural arch and the intercentrum is wide and irregular with a large buttress of new bone extending ventrolaterally for approx 1.5cm from the left neural arch and a wedge shaped periosteal reaction on the left ventral aspect of the body of the atlas. • There is no evidence of atlantoaxial subluxation but there is moderate to marked hyperintensity on STIR and post contrast images in the soft tissue surrounding the lesion including the cleft between the left neural arch and the body of the atlas. There are however no such changes between the incompletely ossified left and right neural arches themselves dorsally. Importantly, the spinal cord is normal. Diagnosis • Incomplete ossification of the atlas with surrounding soft tissue inflammation This is an uncommonly recognised lesion that has only been recently described in the veterinary literature1. The atlas develops from the fusion of three separate centres of ossification; the right and left neural arches dorsally and on either side and the body ventrally2. Failure of the sutures to ossify normally may result in instability between the separate centres of ossification and inflammation of the surrounding tissues may ensue. Indeed concurrent anomalies of the surrounding ligaments may predispose to atlantoaxial subluxation. Some dogs have may present with neurological deficits referable to C1-C5. Treatment may be conservative or surgical depending on the degree of structural changes present and the severity of clinical signs. 1. Warren-Smith C et al. Incomplete ossification of the atlas in dogs with cervical signs. Vet Radiol Ultrasound 2009;50:635-638 2. Evans HE. Miller’s anatomy of the dog, 3rd ed. Philadelphia: W.B.Saunders, 1993;166-170 3. Thanks to Penny Birchall at Toachim House Veterinary Surgery for the referral and the radiographs! T1 Pre Contrast T1 Post Contrast Dorsal FLAIR
  3. 3. F e b r u a r y 2 0 1 0 V e t s c a n L t d • G u a r d s H a l l • G u a r d s A v e • C a t e r h a m • S u r r e y C R 3 5 Z D t e l • 0 1 8 8 3 3 4 5 2 3 4 F a x • 0 1 8 8 3 3 4 5 9 5 1 E m a i l • i n f o @ v e t s c a n . e u Vetscan CPD Imagine the Future.... We can! 10 x Film Reading Sessions Our popular film reading sessions will continue this year at our offices in the Village, Caterham. They will be held every month from March to December on the first Tuesday of the month starting on March 2nd. Cost is £20 + VAT per session. Or get all 10 sessions for the price of 8! If you sign up before March 2nd, you get all 10 evenings for £160 + VAT. These sessions are interactive and you are encouraged to bring your own films. So you can get free film interpretations for your clients on the night - What a bargain! Radiology CPD - One Day Courses (Caterham, Surrey) Course Tutor: Bernard A. Walsh, MVB, MRCVS, CVR, DACVR Six one day radiology courses will be held this year in Caterham, Surrey. There will be two days each devoted to the chest, abdomen and skeleton. Cost is £350 + VAT for each course. If you sign up before March 23rd for the full course you get all 6 days for the price of 5! i.e. £1750 + VAT for the year. These one day courses will cover the major areas of importance in practice: positioning the patient, getting good films, interpreting them properly including recognising normal anatomy and the variations thereof, artifacts and how NOT to be fooled by them, contrast studies, digital radiography and much, much more. Didactic and practical sessions will be included. 23 March 2010 Neck and Thorax: What is normal? Larynx, Pharynx, Trachea, Oesophagus, Pleura, Mediastinum, Diaphragm 20 April 2010 Heart and Pulmonary Vessels, Lung Disease and Lung Patterns 24 June 2010 Abdominal Masses, Peritoneal Space, Liver, Spleen, Uterus, Ovaries, Prostate and Testes 27 July 2010 Kidneys, Ureters, Bladder, Urethra, Stomach, Small Intestine, Large Intestine 16 September 2010 Axial Skeleton: Skull, Nasal Cavity, Sinuses, Brain, Vertebrae, Intervertebral Discs and Spinal Cord 14 October 2010 Appendicular Skeleton: Disease of Immature Bone, Fracture Classification, Healing & Complications, Bone Tumours and Osteomyelitis, Joint disease
  4. 4. F e b r u a r y 2 0 1 0 V e t s c a n L t d • G u a r d s H a l l • G u a r d s A v e • C a t e r h a m • S u r r e y C R 3 5 Z D t e l • 0 1 8 8 3 3 4 5 2 3 4 F a x • 0 1 8 8 3 3 4 5 9 5 1 E m a i l • i n f o @ v e t s c a n . e u Vetscan is a referral diagnostic imaging practice that works closely with veterinary practices in London and the Southeast of the UK. We deal with about 3000 referred cases a year for X-ray, Ultrasound, CT and MRI examinations making us one of the leading referral imaging practices in the country. Once we receive the information from the referring vet we will contact the pet owner directly, usually within 30 minutes, to schedule an appointment at their convenience. We will confirm the appointment with the referring vet’s office to keep you completely informed at every stage of the process. Bernard A. Walsh Diplomate of the American College of Veterinary Radiology and Vetscan MD. We Have To Look Before We See Vetscan is located within easy access of London and the South- East. Vetscan’s main clinic is only 10 minutes off Junction 6 or 7 of the M25. We also have excellent parking facilities for your clients. In addition, we also operate mobile ultrasound clinics at • Henderson & Keywood, Surbiton, Surrey • Warren House Vets, Rochester, Kent Sue Fitzmaurice Diplomate of the ACVIM (Neurology) and European College of Veterinary Neurology. Dr. Patrick Gavin Professor Emeritus in Veterinary Radiology at Washington State University and a Diplomate of the American College of Veterinary Radiology 1. Book online at 2. Call us on 01883 345 234 3. Fax us on 01883 345 951 4. e-mail us at