During our positioning week on Radiology, my rotation partner and I had taken radiographs (x-rays) of everything from Pomerians in heart failure to Labradors that had eaten rocks to cats with pelvic fractures. Most of our patients were dogs and cats, though I did help a technician take full body radiographs of a sedated rabbit with the softest brown fur I’d ever felt. We also helped the exotics department take radiographs of a pregnant chinchilla and a sick hedgehog. We even watched the technicians set up an elaborate horizontal beam array to take radiographs of a betta fish that had trouble swimming straight. They used a similar array to radiograph a leopard gecko, whose crooked bones were evidence of severe metabolic bone disease.
Unless we had a strong interest in equine medicine, we weren’t required to help the technicians with the horses, although I could never resist the temptation to peek through the window. One day I spied one of the sports medicine doctors pushing on a horse’s shoulder as if trying to push it back into place. My interest piqued, I slipped through the door. I quickly learned that the doctor was trying to palpate the shoulder joint to feel if it was out of place. A rapid-fire discussion by three doctors and four technicians sought to determine how best to image the shoulder joint to highlight the suspected subluxation. A shoulder subluxation (partial dislocation) is rare, and so the staff didn’t have a memorized set of standard views to use. After a quick discussion, a few different ideas were tried. The best radiographic view was obtained with the horse’s leg extended forwards, then moved laterally about 18 inches, with the x-ray beam traveling from the front of the horse to form an image on the plate placed just behind the armpit. I learned the next day from the sports medicine student that the shoulder subluxation was successfully reduced under anesthesia. The horse was anesthetized, and once asleep was hoisted into the air by all four feet by the motorized hoist apparatus. After a few minutes hanging in the hoist, the horse was lowered onto the padded gurney. Luckily the muscles had stretched enough to allow the doctors to push the displaced joint back into place. The horse recovered uneventfully, and post-op radiographs showed that the shoulder joint was indeed back in place.
I really enjoyed my positioning week on Radiology, because even though we didn’t get much practice interpreting the radiographs we took, it was still a great experience to practice problem-solving how to image so many different species.