Ultrasonographic and histopathological findings in equine superficial digital flexor tendon injury

Ultrasonographic examination of the proximal scutum in the horse

Normal and abnormal ultrasonographic images are presented of the proximal scutum (proximal sesamoid bones and palmar ligament) in the horse. Comparison between anatomical sections, MRI (magnetic resonance imaging) and ultrasound scans enabled the authors to establish the normal ultrasonographic anatomy of the palmar fetlock. Nine cases of proximal scutum injuries were identified ultrasonographically, of which 4 are illustrated. On normal limbs, the facies flexoria of the proximal sesamoid bones appeared as a thin and regular hyperechoic line and the palmar ligament was regularly echogenic. Lesions of the proximal scutum, that could be documented ultrasonographically, included rupture of the palmar ligament, avulsion fractures of the proximal sesamoid bones and palmar ligament desmopathy. Thinning or degeneration of the palmar ligament, concurrent with osteolysis of the proximal sesamoid bones, were indicative of palmar ligament enthesopathy. Ultrasonographic examination provided essential information for an accurate diagnosis of proximal scutum damage.

The role of computed tomography in evaluation of subchondral osseous lesions in seven horses with chronic synovitis

Seven horses with severe, persistent lameness of sudden onset were evaluated with scintigraphy and/or computed tomography. The lameness was localised to the front fetlock joint in 2 horses and to the tibiotarsal joint in 5 horses. Five of the horses had a history of intra-articular injections of the involved joint prior to presentation. All horses had effusion of the affected joint and were positive to flexion tests. Intraarticular anaesthesia eliminated or improved the lameness in 4 cases and a nerve conduction block proximal to the affected joint improved the lameness in another. Cytology examination of fluid from affected joints identified normal joint fluid (one horse) or elevations in nucleated cell counts of 0.9 x 10(9)/l-36.8 x 10(9)/l and total protein 20-42 g/l (6 horses). The joint fluid of 2 of these horses cultured positive for bacteria. Initial radiographs were either normal (4 cases) or the changes seen were not sufficient to explain the degree of lameness. In the 6 cases where scintigraphy was performed, intense focal isotope uptake was found in the suspected region, which corresponded to the proximal portion of the first phalanx (2 cases), distal tibia (2 cases), or talus (3 cases). Computed tomography (CT) was performed because occult fracture or osteomyelitis was suspected; and knowledge of the precise anatomical location of the lesion was considered necessary to assess the need for surgery and to plan the surgical approach. Hypodense focal lesions with hyperdense haloes were found in the subchondral bone deep to the sagittal groove of the first phalanx (P1) (2 cases) in the cochlea of the distal tibia (2 cases), and in the intertrochlear portion of the talus (3 cases). Communication between the lesion and the joint space was demonstrated by CT in 5 cases. Post mortem examination of one case revealed synovitis and a chronic bone abscess (Brodie's abscess) communicating with the joint space.

Factors affecting the ultrasonic properties of equine digital flexor tendons

The velocity, attenuation and apparent backscattering coefficient of 6-11-MHz ultrasound were measured in three orthogonal directions in equine deep digital flexor (DDF) and superficial digital flexor (SDF) tendons at 0 degree C. Ultrasonic measurements were examined for correlation with tendon water, collagen, DNA and glycosaminoglycans contents, determined by chemical analyses and with structure observed by scanning electron microscopy. The SDF tendon contained more water, more DNA (i.e., more cells), less collagen and less glycosaminoglycans and exhibited lower velocities and attenuations than the DDF tendon. Velocities were governed primarily by the adiabatic bulk modulus and density, perturbed by a highly direction-dependent rigidity. Ultrasound propagating across tendon generated frequency-independent backscattering which appeared to derive from the large interfaces between the fascicles, while along the fibres backscattering varied as f3.62 +/- 0.88 and appeared to derive from small structures such as collagen fibres. The mechanisms by which ultrasound is attenuated by tendon remain unknown.

The cross-sectional areas of normal equine digital flexor tendons determined ultrasonographically

Fifty-two animals, comprising 22 Irish Draught crosses (Group A), 15 Thoroughbreds (Group B) and 15 ponies (Group C) were examined ultrasonographically using a 7.5 mHz linear array probe and stand-off pad. All animals were free of tendon disease as determined from clinical and ultrasonographical examination. The superficial (SDFT) and deep (DDFT) digital flexor tendons were scanned at 7 transverse (axial) levels between the carpus and metacarpophalangeal joint. Each transverse image was digitised using a commercially available frame grabber and the cross-sectional areas of each tendon at each level measured using a dedicated software application. Excellent accuracy (averaging less than 5%) was demonstrated between the ultrasound generated areas and those measured from the tendons post mortem in 12 limbs. The mean, s.d. and tolerance intervals of both SDFT and DDFT cross-sectional areas at each level were determined for each group of horses. There was no statistically significant difference between Groups A and B and these 2 groups were, therefore, combined for further analysis. The cross-sectional areas of both tendons were statistically smaller for Group C when compared to Groups A and B. The ratio of SDFT to DDFT cross-sectional areas was calculated for each level and this demonstrated less variation between groups. The difference in measurements between limbs of the same horse was analysed. The mean differences for all groups were 9.13 mm2 for the SDFT and 11.64 mm2 for the DDFT. Upper limits (95% of the population) were 22.67 mm2 (SDFT) and 29.22 mm2 (DDFT).(ABSTRACT TRUNCATED AT 250 WORDS)