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The angle contrast ultrasound technique in the flexed limb improves assessment of proximal suspensory ligament injuries in the equine pelvic limb
Open to download resource.
Open to download resource.
Diagnosis of proximal suspensory ligament (PSL, third interosseous muscle) injuries in equine hindlimbs can be challenging because of the complex anatomy of the proximal metatarsal region. Ultrasonographic examination of the PSL using the angle contrast ultrasound technique in the flexed limb facilitates assessment of PSL desmopathies and enthesopathies, with subjectively improved sensitivity compared with the standard approach. The main limitation of ultrasonography is identification of deep osseous injuries, but combined with other imaging procedures, ultrasonography provides valuable diagnostic information of the injured structures. Ultrasonography also helps to specify the stage of a lesion. The repair process can be monitored, helping the clinician to adapt the rehabilitation programme and establish a prognosis for the horse to return to its previous level.
An optimised injection technique for the navicular bursa that avoids the deep digital flexor tendon
Open to download resource.
Open to download resource.
Palmar foot pain represents a major cause of poor performance and lost time from exercise in horses. Diagnostic imaging of this region is most commonly performed using radiographs and magnetic resonance imaging (MRI). Using these imaging modalities, it has been shown that pathological change can occur in multiple sites in the foot, including the navicular bone, navicular bursa, deep digital flexor tendon (DDFT),
distal sesamoidean impar ligament, collateral distal sesamoidean ligaments and distal interphalangeal (DIP) joint.
An ultrasound-guided, tendon-sparing, lateral approach to injection of the navicular bursa
Open to download resource.
Open to download resource.
Local treatment of diseases of the podotrochlear apparatus may be indicated in deep digital flexor tendon (DDFT) tendinopathy, collateral and distal sesamoidean desmopathy, and in degenerative bone disease of the navicular bone. These conditions are generally accompanied by synovitis of the navicular bursa, which may benefit directly from intrabursal medication. Patients with such injuries have been shown to respond better to medication of the navicular bursa than of the distal interphalangeal (DIP) joint.
A Review of Normal Anatomy and Variants Commonly Mistaken for Pathology in Equine Musculoskeletal Ultrasound
Open to download resource.
Open to download resource.
Variability in appearance of some normal ultrasonographic anatomy is commonly confused for pathology. Anisotropy artifact of normal anatomic structures can mimic the appearance of lesions. This paper reviews common errors in interpretation of equine musculoskeletal ultrasound exams.
A review of radiographic interpretation of the navicular bone
Open to download resource.
Open to download resource.
Navicular syndrome (also called navicular disease) plays a major role in the equine industry as a chronic, degenerative and often career-limiting disease process which affects a variety of breeds of horses. In addition to clinical signs and diagnostic analgesia, diagnostic imaging plays a key role in identification of this disease process – radiography is the most used imaging modality. In addition to their clinical utility, foot radiographs are a standard element of most pre-purchase examinations. Good radiographic quality and positioning are necessary for accurate interpretation. Radiographic lesions of the navicular bone such as sclerosis, enlarged synovial invaginations, distal border fragments and flexor cortical erosions are important to identify and understand because of their potential role in the disease process. This article reviews an approach to radiological evaluation and interpretation of lesions affecting the navicular bone.
High field magnetic resonance imaging contributes to diagnosis of equine distal tarsus and proximal metatarsus lesions: 103 horses
Open to download resource.
Open to download resource.
Injury of the distal tarsus and proximal metatarsus commonly causes lameness. Magnetic resonance imaging (MRI) allows concurrent assessment of both the distal tarsal joints and suspensory ligament origin, and aids identification of lesions that may otherwise go undetected by other modalities. In this retrospective observational study, the medical records of a veterinary imaging center were searched for MRI exams of the distal tarsus and proximal metatarsus for the years 2012 through 2014. Studies for 125 limbs of 103 horses were identified and retrospectively evaluated by two board-certified veterinary radiologists. Soft tissue and osseous changes were characterized and graded by degree of severity. The patients’ signalment, lameness severity, and results of diagnostic analgesia were recorded. Osteoarthritic changes of the distal intertarsal and tarsometatarsal jointswere the most common findings. Other findings included bone marrow lesions, degenerative changes of the small cuboidal bones, subchondral cystic lesions, and intertarsal desmopathy. Suspensory ligament desmopathy was found in 53% of limbs. Fourty-seven percent of limbs that responded to analgesia of the proximal suspensory ligament had more severe lesions in the distal tarsus. Bone marrow lesions of the third tarsal bone were the onlyMRI finding that correlated with grade of lameness in patients for which lameness grade was reported. The grade of lameness has a poor correlation with the severity of lesions found on MRI. The findings support the use of MRI for simultaneous evaluation of the proximal metatarsus and distal tarsus, particularly given the difficulty of lesion localization with diagnostic analgesia.
Equine Ultrasound of the Hind Suspensory (YouTube Video)
Select the "View On-Demand Recording" button to begin. | 8 minutes
Select the "View On-Demand Recording" button to begin. | 8 minutes
Learn Dr. Carrie Schlachter's best practices for scanning the equine hind suspensory ligament with ultrasound. Learn which adjustments and products help to provide the clearest images throughout the veterinary exam.
