What does it mean? The significance of MRI findings in the distal limb

The availability of standing magnetic resonance imaging (MRI) has spread worldwide and this, in combination with the highfield pioneers of equine MRI in the 1990s, means over 40,000 horses of all breeds, ages, disciplines and clinical presentations have undergone an MRI scan. With such a weapon added to our armoury for around 2 decades, has our understanding of orthopaedic disease been revolutionised? Are our rehabilitation regimes tailored with exquisite precision? Has this led to a wealth of evidence-based medicine generated from follow-up from thousands of horses with specific diagnoses? For those not comforted by self-delusion the answer is, unfortunately, no. For the optimists, not yet.
The reality is that we’re a long way from reaching these goals. Most facilities like ours which scan hundreds of horses a year rarely, unfortunately, get the time to reflect in a meaningful way on the findings and a feeling is often mooted that more questions have been raised than answered. We now have what is essentially a simplistic ability to rule in or out a small proportion of the potential causes of distal limb lameness, which were previously difficult to image, but progress is slow in forming greater understanding of disease progression and, importantly, prevention. But the equine distal limb, orthopaedic disease and the mechanism and perception of pain are anything but simplistic and, if the answers are contained in the data generated from those 40,000 horses, the signal is being drowned out by the noise. […]