Meet Ruby, a 10 year old mare who was referred for IR imaging due to head shaking/ tossing and increased bronking. Ruby is a general purpose horse, ridden both on the flat and jumping 5 times per week.

When she was first purchased her new owner found that a poorly fitting saddle was potentially to blame for bronking behaviour when mounted. All was going well when Ruby started to head shake/ toss which progressed into bronking.  Over time issues settled and bronking stopped but headshaking significantly increased which led to a full clinical & behavioural investigation.

IR imaging was used in the early stages to help guide the investigation and a number of physiological abnormalities were detected. There were two key areas that were identified as primary concerns (directly related to the clinical signs/ behaviour) and correlated with further investigation.

IR findings: Hyperthermic patterns observed in the caudal thoracic spinal region warrant further clinical correlation as this may represent inflammation secondary to muscular tightness through this region, spinal ligamentous sprain, or in more serious cases – vertebral facet joint dysfunction or dorsal overriding of the
spinous processes.


Ruby was sensitive to palpation over sciatic groove and poll to lumbar xrays in March 2020 found some crowding in the thoracic area and one touching in the lumbar area. Changes were initially considered to be incidental findings, confirmed by a second opinion.

Scintigraphy evaluation at Oakham vets June 2020 evaluated head, neck, back, ribs, pelvis and hindlimbs.
A single area of moderate focal increased radiopharmaceutical uptake (IRU) corresponding with a single dorsal spinous process in the mid thoracic spine was detected and was consistent across lateral and dorsal views. This  was the most significant finding and likely to represent a focal area of overriding dorsal spinous processes.

Radiographs followed and showed a focal kissing spine lesion affecting one dorsal spinous process and 2 interspinous spaces in the mid thoracic spine consistent with the changes on the bone scan. This lead to a diagnosis of kissing spine syndrome and a direct correlation with infrared imaging.


IR findings: Diffuse hypothermic asymmetry of the left paralumbar region was suggestive of neuropathy, this correlated with thermal findings of thoracic spinal/lumbosacral inflammation and was suggestive of sacroiliac disease (focal inflammation of the sacroiliac regions and linear hypothermia of the sciatic regions).

A pelvic assessment was advised as (thermal findings as seen below) in the back and pelvis may have correlated with a history of behavioural changes.

Ruby was described as looking ‘uncomfortable’ behind and ‘sore all over her back and hind end’. SI dysfunction was suspected it was decided to medicate the SI at the same time as the diagnosed kissing spines. A noticeable improvement was seen and a confirmed correlation for infrared imaging.


Infrared imaging successfully identified kissing spine syndrome and flagged SI pathology. A combined approach of further investigation/ diagnostic imaging and treatment helped to diagnose/manage Ruby’s condition. Thank you to Ruby’s owner Jessica Lees for allowing us to share this case study and highlight the importance or IR imaging and a collaborative veterinary approach. Jessica kindly wrote a testimonial for Vet-IR that provide an insight into her experience. You can read the full article HERE!

“I believe that, if I hadn’t had the thermography report done, Ruby’s diagnoses would have taken much longer to pin down, at the expense of her comfort and wellbeing.”
Owner, Jessica Lees

Cases such as these are common and are normally always start with concerns over performance or behaviour. Full body infrared imaging is a superb place to start to gain a full perspective before honing in on regional areas. Sacroiliac (SI) pathology is often seen on cases relating to long term spinal/ back pathology so it is important that we consider and treat the horse as a whole otherwise we can treat the primary concern and not consider the impact of secondary issues.

For more information on imaging services contact our team.