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Horne CR, Tufts S. Advances in Imaging Techniques to Guide Therapies and Monitor Response to the Treatment of Musculoskeletal Injuries. Vet Clin North Am Equine Pract 2023; 39:489-501. [PMID: 37482520 DOI: 10.1016/j.cveq.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Continual advancements in diagnostic imaging have allowed for more accurate and complete diagnoses of injuries in the performance horse. The use of several different imaging tools has further allowed the equine sports medicine clinician to more carefully direct treatment options, monitor response to therapy and guide rehabilitation recommendations. The advancements in diagnostic imaging and novel treatment options have led to the improvement in the overall prognosis of many injuries that affect the horse and their performance. The purpose of this section is to review the advancements made in diagnostic imaging of the horse and to aid the practitioner in the selection of the appropriate modality and how best to use them to guide treatment and monitoring decisions.
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Affiliation(s)
- Caitlyn R Horne
- North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, NC 27607, USA.
| | - Sara Tufts
- North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, NC 27607, USA
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Fjordbakk CT, Marques-Smith P. The equine patellar ligaments and the infrapatellar fat pad - a microanatomical study. BMC Vet Res 2023; 19:20. [PMID: 36691004 PMCID: PMC9869593 DOI: 10.1186/s12917-023-03579-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Interpretation of patellar ligament (PL) ultrasonography may be difficult, as hypoechoic or heterogenous echogenicity are common findings. Verifying suspected disease of equine PLs by histopathology is also problematic as descriptions of normal PL vascularity and histology are scarce. The current study describes the PL and infrapatellar fat pad (IFP) vascular pattern from computed tomography scans of barium perfused normal equine specimens (n = 8; age 10 days to 18 years), as well as routine histology to serve as a reference for future investigations into PL pathology and IFP disease. RESULTS The PLs received a bipolar blood supply. Vascular architecture consisted of numerous distinct longitudinal vessels with several horizontal connections, which branched into extensive latticeworks of smaller vessels throughout the ligaments. Several vascular connections between the PLs and the IFP were identified. One distinct longitudinal vessel was seen entering each of the IFP lobes at the distocranial aspect, branching extensively into lobar vascular networks which anastomosed by several horizontal branches at the mid portion of the IFP where the two lobes merge. Histologically, there were large variations in PL interfascicular endotenon thickness, vascularity and fatty infiltration; these parameters increased with age for the intermediate and medial PL. Areas of metaplastic tenocytes / chondroid metaplasia were identified in all investigated adult medial PLs; in 2/7 in the intermediate PL and in 4/7 in the lateral PL. The adult IFP consisted of white unilocular adipose tissue, organized in lobules separated by thin connective tissue septa increasing in thickness towards the periphery and the distocentral aspect. CONCLUSIONS The equine PLs and IFP are highly vascularized structures with ample vascular connections suggestive of crosstalk. This, together with the large variation in PL endotenon thickness, vascularity and fatty infiltration, should be taken into consideration when assessing potential PL histopathology as these changes increase with age and are found in horses without clinical signs of stifle disease. Metaplastic tenocytes / chondroid metaplasia should be considered a normal finding throughout the medial PL and is not age dependent. The role of the equine IFP in stifle disease has yet to be elucidated.
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Affiliation(s)
- Cathrine Taule Fjordbakk
- grid.19477.3c0000 0004 0607 975XFaculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Equine Teaching Hospital, Oluf Thesens Vei 24, 1432 Ås, Norway
| | - Patrick Marques-Smith
- grid.19477.3c0000 0004 0607 975XFaculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Equine Teaching Hospital, Oluf Thesens Vei 24, 1432 Ås, Norway
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Wright L, Hernlund E, Fjordbakk C, Ytrehus B, Law E, Uhlhorn M, Rhodin M. Patellar ligament desmopathy in the horse – a review and comparison to human patellar tendinopathy (‘Jumper’s knee’). COMPARATIVE EXERCISE PHYSIOLOGY 2022. [DOI: 10.3920/cep220011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patellar ligament desmopathy in horses is regarded as an uncommon condition with unclear aetiology. Of the three patellar ligaments in the horse, the intermediate is the one most often diagnosed with desmopathy in horses presenting with chronic lameness. This structure corresponds to the patellar tendon in humans. As diagnostic imaging modalities continuously improve, changes in echogenicity of the patellar ligaments are identified ultrasonographically with increasing frequency. However, disruption of the normal fibre pattern may be present also in patellar ligaments in horses that show no signs of lameness. Similarly, there is a poor correlation between pain and diagnostic imaging findings in human patellar tendinopathy. Consequently, there appears to be a knowledge gap pertaining to normal ultrasonographic variation and diagnostic criteria for disease of the patellar ligaments in horses. Furthermore, local anaesthetic techniques to verify the diagnosis are poorly described, and due to the low number of treated cases, no specific treatment modality can be recommended on a scientific basis. The aim of this paper is to review the current knowledge regarding the pathogenesis, diagnosis and management of patellar ligament desmopathy in horses, compare this condition with patellar tendinopathy in humans, and identify areas for further research to increase the diagnostic accuracy in horses. We conclude that there is a profound need for better descriptions of ultrasonographic variation and pathological changes of the equine patellar ligaments. Identification of areas of maximal ligament strain and descriptions of early histopathological changes could render more information on the possible aetiology, preventive measurements and treatment options of desmopathy. Description of regional innervation could aid in development of methods for diagnostic anaesthesia to verify pain originating from the ligaments.
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Affiliation(s)
- L. Wright
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, P.O. Box 7011, 750 07 Uppsala, Sweden
| | - E. Hernlund
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, P.O. Box 7011, 750 07 Uppsala, Sweden
| | - C.T. Fjordbakk
- Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Oluf Thesens vei 24, 1432 Ås, Norway
| | - B. Ytrehus
- Department of Biomedicine and Veterinary Public Health, Swedish University of Agricultural Sciences, P.O. Box 7028, 750 07 Uppsala, Sweden
| | - E. Law
- University Animal Hospital, P.O. Box 7040, 750 07 Uppsala, Sweden
| | - M. Uhlhorn
- University Animal Hospital, P.O. Box 7040, 750 07 Uppsala, Sweden
| | - M. Rhodin
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, P.O. Box 7011, 750 07 Uppsala, Sweden
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Equine flexor tendon imaging part 1: Recent developments in ultrasonography, with focus on the superficial digital flexor tendon. Vet J 2021; 278:105764. [PMID: 34678500 DOI: 10.1016/j.tvjl.2021.105764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 09/14/2021] [Accepted: 10/15/2021] [Indexed: 12/15/2022]
Abstract
Flexor tendon injuries are a major cause of lameness in performance horses and have considerable impact on equine welfare and the wider horse industry. Ageing and repetitive strain frequently cause varying degrees of tendon micro-damage prior to the recognition of clinical tendinopathy. Whilst B-mode ultrasonography is most commonly utilised for detection and monitoring of tendon lesions at the metacarpal/metatarsal level, the emphasis of recent research has focused on the identification of subclinical tendon damage in order to prevent further tendon injury and improve outcomes. The introduction of elastography, acoustoelastography and ultrasound tissue characterisation in the field of equine orthopaedics shows promising results and might find wider use in equine practice as clinical development continues. Based on the substantial number of research studies on tendon imaging published over the past decade this literature review aims to examine the currently used ultrasonographic imaging techniques and their limitations, and to introduce and critically appraise new modalities that could potentially change the clinical approach to equine flexor tendon imaging.
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Evrard L, Joostens Z, Vandersmissen M, Audigié F, Busoni V. Comparison Between Ultrasonographic and Standing Magnetic Resonance Imaging Findings in the Podotrochlear Apparatus of Horses With Foot Pain. Front Vet Sci 2021; 8:675180. [PMID: 34291100 PMCID: PMC8287171 DOI: 10.3389/fvets.2021.675180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
This prospective study aimed to blindly compare the ultrasonographic and standing magnetic resonance imaging (sMRI) findings in deep digital flexor tendon (DDFT), navicular bone, and navicular bursa in horses with foot pain, positive digital analgesia, and without definitive radiographic diagnosis. Ultrasonography detected more DDFT abnormalities (32/34 feet vs. 27/34 with sMRI) but identified less palmar navicular abnormalities (23/34 feet vs. 30/34 with sMRI). In suprasesamoidean DDFT lesions, which were mainly dorsally located, changes in echogenicity did not correspond to a particular pattern of sMRI signal change. Transcuneal ultrasonography did not allow assessment of morphology and extent of distal DDFT lesions, and sporadically discriminated the affected lobe compared to sMRI. Defects of the palmar compact bone were identified with both modalities except a parasagittal defect, which was only seen at sMRI.
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Affiliation(s)
- Laurence Evrard
- Department of Clinical Sciences of Companion Animals and Equids, Equine Division, Diagnostic Imaging Section, University of Liège, Liège, Belgium
| | - Zoë Joostens
- Medical Imaging Department, Equitom Equine Clinic, Lummen, Belgium
| | - Maxime Vandersmissen
- Department of Clinical Sciences of Companion Animals and Equids, Equine Division, Diagnostic Imaging Section, University of Liège, Liège, Belgium
| | - Fabrice Audigié
- Centre d'Imagerie et de Recherche sur les Affections Locomotrices Equines, Ecole Nationale Vétérinaire d'Alfort, Goustranville, France
| | - Valeria Busoni
- Department of Clinical Sciences of Companion Animals and Equids, Equine Division, Diagnostic Imaging Section, University of Liège, Liège, Belgium
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Rabba S, Petrucci V, Petrizzi L, Giommi DW, Busoni V. B-Mode Ultrasonographic Abnormalities and Power Doppler Signal in Suspensory Ligament Branches of Nonlame Working Quarter Horses. J Equine Vet Sci 2020; 94:103254. [PMID: 33077065 DOI: 10.1016/j.jevs.2020.103254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 11/18/2022]
Abstract
Information concerning B-mode ultrasonographic abnormalities and power Doppler (PD) signal in suspensory ligament branches of nonlame working Quarter Horses are not reported. The aims of this study were to investigate the prevalence of B-mode ultrasonographic abnormalities and PD signal in suspensory ligament branches in a group of nonlame working Quarter Horses and to compare B-mode findings with PD findings of horses in two different training (barrel racing and team roping). Twenty-one Quarter Horses in training, 14 barrel racing (Group B) and seven team roping horses (Group R), were assessed by ultrasound for screening purpose. A total of 168 suspensory ligament branches were examined (B-mode and PD examinations). B-mode lesions were seen more frequently in forelimbs (25 branches) than in hindlimbs (10 branches). Power Doppler signal was not detected in suspensory ligament branches that were normal at B-mode, whereas it was visible in 22 of the 35 branches abnormal at B-mode. Horses of Group R showed more B-mode abnormalities and more PD signal in branches abnormal in B-mode.
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Affiliation(s)
- Silvia Rabba
- Diagnostic Imaging Section, Department of Clinical Sciences of Companion Animals and Equids, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium; Department of Diagnostic Imaging, Istituto Veterinario di Novara, Granozzo con Monticello (NO), Italy.
| | | | - Lucio Petrizzi
- Veterinary Teaching Hospital, University of Teramo, Teramo, Italy
| | | | - Valeria Busoni
- Diagnostic Imaging Section, Department of Clinical Sciences of Companion Animals and Equids, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
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Pluim M, Martens A, Vanderperren K, van Weeren R, Oosterlinck M, Dewulf J, Kichouh M, Van Thielen B, Koene MHW, Luciani A, Plancke L, Delesalle C. High-Power Laser Therapy Improves Healing of the Equine Suspensory Branch in a Standardized Lesion Model. Front Vet Sci 2020; 7:600. [PMID: 33102552 PMCID: PMC7494822 DOI: 10.3389/fvets.2020.00600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 07/27/2020] [Indexed: 11/13/2022] Open
Abstract
High-power laser therapy is often used as a treatment for human sport injuries but controlled standardized studies on its efficacy are lacking. The technique has also been introduced in the equine field and recently promising results were reported in a retrospective study focusing on 150 sporthorses suffering from tendinopathy and desmopathy of the SDFT, DDFT, suspensory ligament, and suspensory branches. The goal of the present study was to evaluate the effect of high-power laser in a standardized lesion model in horses. Lesions were created in all lateral suspensory branches of 12 warmblood horses. In each horse, 2 of the 4 lesioned branches were treated daily with a multi-frequency high-power laser for 4 weeks. Color Doppler ultrasonography was performed during and after the treatment period. Six horses were euthanized 4 weeks post-surgery (short-term) and 6 were further rehabilitated until 6 months and then euthanized (long-term). High-field MRI evaluation was performed on all cadaver limbs. On ultrasound, transverse size of the lesion was significantly smaller after 2- and 3 months (p = 0.026 and p = 0.015) in the treated branches. The expected post-surgery enlargement of the lesion circumference and cross-sectional area (CSA) over time, was significantly lower in the short-term laser treated group (p = 0.016 and p = 0.010). Treated lesions showed a significantly increased Doppler signal during treatment (p < 0.001) compared with control. On MRI, in the short and long-term group, the CSA of the lesions was significantly smaller (p = 0.002), and the mean signal significantly lower in the treatment groups (p = 0.006). This standardized controlled study shows that multi-frequency high-power laser therapy significantly improves healing of a suspensory branch ligament lesion.
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Affiliation(s)
- Mathilde Pluim
- Department of Virology, Parasitology and Immunology, Research Group of Comparative Physiology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.,Tierklinik Lüsche GmbH, Bakum, Germany
| | - Ann Martens
- Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Katrien Vanderperren
- Department of Veterinary Medical Imaging and Small Animal Orthopedics, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - René van Weeren
- Department of Clinical Sciences, Utrecht University, Utrecht, Netherlands
| | - Maarten Oosterlinck
- Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Jeroen Dewulf
- Unit of Veterinary Epidemiology, Department of Obstetrics, Reproduction and Herd Health, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Mimoun Kichouh
- Radiology Department, Brussels University Hospital, Brussels, Belgium
| | - Bert Van Thielen
- Radiology Department, Brussels University Hospital, Brussels, Belgium.,Odisee Hogeschool, Campus Terranova, Training Center for Imaging Technologists, Brussels, Belgium
| | | | | | - Lukas Plancke
- Department of Virology, Parasitology and Immunology, Research Group of Comparative Physiology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Cathérine Delesalle
- Department of Virology, Parasitology and Immunology, Research Group of Comparative Physiology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.,Department of Clinical Sciences, Utrecht University, Utrecht, Netherlands
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Read RM, Boys-Smith S, Bathe AP. Subclinical Ultrasonographic Abnormalities of the Suspensory Ligament Branches Are Common in Elite Showjumping Warmblood Horses. Front Vet Sci 2020; 7:117. [PMID: 32258068 PMCID: PMC7092662 DOI: 10.3389/fvets.2020.00117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 02/17/2020] [Indexed: 11/24/2022] Open
Abstract
Background: There is limited information concerning the ultrasonographic appearance of suspensory ligament branches (SLB) in sports horses. Publications exist on clinical injuries that lead to loss of training days and retirement, but not on the appearance of SLBs in high level showjumping Warmbloods. Objectives: To demonstrate the prevalence of subclinical SLB abnormalities in regularly competing high-level showjumpers; to grade each branch 0–3; compare forelimb vs. hindlimb and medial vs. lateral SLBs; subjectively assess periligamentous fibrosis; measure cross sectional area (CSA) and to gather competition follow-up data. Study Design: Prospective cross-sectional study using ultrasonograms. Methods: Sixty elite showjumping Warmbloods without recent history or clinical signs of SLB desmopathy were examined ultrasonographically. Eight static images of each SLB were acquired in transverse and longitudinal sections, anonymised and stored. Images were then assessed and graded by two experienced blinded clinicians based on a published ordinal scale (grade 0–3). A branch score was assigned based on the most severe grade of any image slice in each branch series. SLB cross-sectional area measurement was obtained from each SLB using the transverse image proximal to insertion. Results: The frequency of grade 2 (moderate) ultrasonographic abnormalities was high. Combined data showed a prevalence of 58% (554/960) grade 2 SLBs. Interobserver agreement was good (kappa = 0.65). Periligamentous fibrosis was over represented in hindlimbs (64%). Combined observer data showed there was no statistical difference in branch scores based on limb or laterality. Follow-up over 12 months revealed only two horses were excluded from competition due to SLB injury. Main Limitations: Sample size was small. Images were obtained in static mode, limbs were not clipped of hair, lameness evaluation was under FEI veterinary inspection and not performed by the authors and follow-up evaluation was from FEI competition records and communication only, and was limited to 1 year. Conclusions: Regularly competing elite showjumping Warmbloods have a high prevalence of subclinical SLB ultrasongraphic abnormalities, which may not contribute to causing lameness, poor-performance or be viewed entirely negatively at prepurchase examination. Judicious interpretation of moderate severity SLB abnormalities is advised due the low incidence of clinical injury demonstrated during the 1 year follow-up.
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Lacitignola L, Rossella S, Pasquale DL, Crovace A. Power Doppler to investigate superficial digital flexor tendinopathy in the horse. Open Vet J 2019; 9:317-321. [PMID: 32042652 PMCID: PMC6971361 DOI: 10.4314/ovj.v9i4.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/15/2019] [Indexed: 12/02/2022] Open
Abstract
Background: Recent advances in tendinopathy research have focused on tendon vascularization detected with Color Doppler (CD) ultrasound. The use of CD has also been described in horses in a study on chronic lesions of superficial digital flexor tendon and suspensory ligament. Aim: The aim of this study was to investigate the occurrence and distribution of power Doppler (PD) signal in horses with superficial digital flexor tendinopathy. Methods: Twenty-five horses with tendinopathy were included and 10 healthy horses with no lameness and no ultrasonographic abnormalities were used for comparison. Results: In all horses with tendinopathy, the PD signal was visible while normal tendons with no abnormalities in B-mode were PD signal-free. Conclusion: We can speculate that PD could provide essential information about the healing process than the grayscale ultrasound.
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Affiliation(s)
- Luca Lacitignola
- Dipartimento dell'Emergenza e dei Trapianti di Organi (D.E.T.O.), Sezione di Cliniche Veterinarie e P.A, Università degli Studi di Bari "Aldo Moro", s.p. per Casamassima Km 3, 70010 Valenzano, Italy
| | - Santovito Rossella
- Dipartimento dell'Emergenza e dei Trapianti di Organi (D.E.T.O.), Sezione di Cliniche Veterinarie e P.A, Università degli Studi di Bari "Aldo Moro", s.p. per Casamassima Km 3, 70010 Valenzano, Italy
| | - De Luca Pasquale
- Dipartimento dell'Emergenza e dei Trapianti di Organi (D.E.T.O.), Sezione di Cliniche Veterinarie e P.A, Università degli Studi di Bari "Aldo Moro", s.p. per Casamassima Km 3, 70010 Valenzano, Italy
| | - Antonio Crovace
- Dipartimento dell'Emergenza e dei Trapianti di Organi (D.E.T.O.), Sezione di Cliniche Veterinarie e P.A, Università degli Studi di Bari "Aldo Moro", s.p. per Casamassima Km 3, 70010 Valenzano, Italy
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Elemmawy YM, Senna NA, Abu-Seida AM, Youssef AF. Suspensory Branch Desmitis in a Horse: Ultrasonography, Computed Tomography, Magnetic Resonance Imaging, and Gross Postmortem Findings. J Equine Vet Sci 2019; 80:49-55. [PMID: 31443833 DOI: 10.1016/j.jevs.2019.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 02/08/2023]
Abstract
Injury of suspensory ligament (SL) branch is a frequently diagnosed problem in horses of different ages and disciplines. This case reports for the first time the ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI) findings in a 10-year-old draught horse with traumatic chronic SL branch desmitis of 8 months duration. The horse had a grade 3 of 5 left hindlimb lameness with a moderately hot, painful, and diffuse swelling from the tarsus till the hoof. Ultrasonography, both SL branches appeared as enlarged hyperechogenic structures with poor demarcation of their margins and massive periligamentous echogenic materials consistent with fibrosis. Computed tomography showed no osseous lesions but did show enlarged, hypodense, and heterogeneous SL branches with an evidence of periligamentar and peritendenious adhesions and air entrapment areas intermingled within fibrous adhesion. Magnetic resonance imaging revealed no abnormal signal intensity received from the proximal part of SL and its body. There were high and intermediate signal intensities received from inflammatory fluid and periligamentar fibrous adhesions, respectively, around SL branches. Both CT and MRI findings were confirmed by gross postmortem examination. In conclusion, CT and MRI are valuable tools for diagnosis of extensive adhesions associated with chronic SL branch desmitis.
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Affiliation(s)
- Yahya M Elemmawy
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Nasser A Senna
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Ashraf M Abu-Seida
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt.
| | - Ahmed F Youssef
- Department of Diagnostic Imaging, Faculty of Medicine, Benha University, Benha, Qalyubia, Egypt
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Garcia da Fonseca RM, Evrard L, Rabba S, Salciccia A, Busoni V. Dynamic flexion/extension and non-weight bearing ultrasonography is helpful for identifying manica flexoria tears in horses. Vet Radiol Ultrasound 2018; 60:65-74. [PMID: 30121953 DOI: 10.1111/vru.12675] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 04/12/2018] [Accepted: 06/01/2018] [Indexed: 11/26/2022] Open
Abstract
Lesions of the manica flexoria are a tenoscopic finding in horses with digital flexor tendon sheath tenosynovitis. This retrospective case series study describes the ultrasonographic findings in seven horses admitted for digital flexor tendon sheath swelling associated with lameness and tenoscopic confirmation of a manica flexoria tear. Six horses had a partial manica flexoria tear, one a complete rupture. The ultrasonographic examination included a static examination on the weight and non-weight bearing limb and a dynamic limb assessment during flexion and extension. The main ultrasonographic finding at the static weight bearing examination in horses with a partial tear was an asymmetrical appearance of the manica flexoria at the level of the junction with the lateral border of the superficial digital flexor tendon, or an incomplete visualization of the manica flexoria in case of complete rupture. The split edges of the completed ruptured manica flexoria were seen floating in the synovial fluid at the examination in flexion. In six of seven cases, the superficial digital flexor tendon slid abnormally relative to the deep digital flexor tendon, during flexion/extension movements, with medial displacement of the superficial digital flexor tendon, appearance of an anechoic gap between the flexor tendons or reduced superficial digital flexor tendon sliding. Because ultrasonographic diagnosis of the manica flexoria tear is considered challenging, detection of these ultrasonographic features is helpful to increase the likelihood of identifying manica flexoria tears prior to tenoscopy. Authors recommend static ultrasonographic examination of the manica flexoria using a flexed limb position and dynamic ultrasonographic examination using flexion and extension positioning for horses with suspected digital sheath injury.
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Affiliation(s)
| | - Laurence Evrard
- Department of Clinical Sciences of Companion Animals and Equids, Diagnostic Imaging Section - Faculty of Veterinary Medicine - University of Liège, Liège, Belgium
| | - Silvia Rabba
- Department of Diagnostic Imaging, Instituto Veterinario di Novara, Granozzo con Monticello, Italy
| | - Alexandra Salciccia
- Department of Clinical Sciences of Companion Animals and Equids, Diagnostic Imaging Section - Faculty of Veterinary Medicine - University of Liège, Liège, Belgium
| | - Valeria Busoni
- Department of Clinical Sciences of Companion Animals and Equids, Diagnostic Imaging Section - Faculty of Veterinary Medicine - University of Liège, Liège, Belgium
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