“Baxter” was a 2 year-old Golden Retriever. Baxter had a draining tract in his paw that had been surgically explored on three different occasions. Small pieces of wood were found, but there had been no resolution of the fistulous tracts. Dr. Haburjak, a veterinary surgeon, requested a magnetic resonance imaging study of the paw to better plan any further surgical intervention. The previous surgeries would have distorted the normal architecture severely and would make subsequent surgery difficult without an accurate “roadmap.” The magnetic resonance imaging study was carried out with a high field super-conducting magnet.
Sequences included STIR sequences in all three planes and T1-weighted images before and after contrast. The T1-weighted images were also performed with fat-saturation toreduce the fat signal and allow better visualization of the contrast enhancement.
An abnormality was seen that was within the soft tissues of the paw. The abnormality was between the deep digital flexor tendons and the metacarpal bones of the left paw. There was a hyperintense lesion that was seen on the STIR sequences from a fluid collection. The draining fistulous tracts were readily identified. At the center of the fluid was a hypointense structure that measured approximately 3.5 cm in length by 0.5 cm in width. There was a center to this material, which was compatible to a stick with a soft core or medullary cavity that was soaking up the fluid.
The lesion was midline between the third and fourth metacarpal regions and was deep to the flexor tendons. Surgery was performed and a stick of the size diagnosed by magnetic resonance was readily removed with the accurate roadmap for the surgeon. The images depict the abnormalities. There is also a post-operative image of the removed wood foreign body.
The use of magnetic resonance imaging provided the information needed for the proper and corrective surgery. MRI exams are costly, but if one calculates the direct and indirect cost of the previous 3 surgeries there was obviously a value to this examination. When we think of the pain and suffering, the value of a proper procedure often trumps the initial cost.