LA Musculoskeletal Flashcards
List some indications of ultrasound examination of the pastern
Synovial sheath effusion, soft tissue swelling/thikening/deformation in pastern area
abnormal radiographic or scintigraphic findings
suspicion suspensory lig injury
luxation or subluxation of the proximal or distal interphalangeal joints
What anatomical landmarks are used to know where does an ultrasonoraphic examination of the pastern starts and ends?
Starts at the base of the sesamoidean bones to the proximal part of P2
Ultrasonographic examination of the pastern was divided into 4 different anatomical leves. What are they?
Proximal third of P1
Intermediate third of P1
distal third of P1
Proimal interphalangeal jint and proximal part of P2
Name each structure that is represented by a number. This is transverse views of the pastern at the level of proximal third of P1
- SDFT
- DDFT
- Straight sesamoidean ligament
- Oblique sesamoidean ligaments
- Palmar surface of P1
- Skin
- Proximal digital annular ligament
Name each structure that is represented by a number. This is transverse views of the pastern at the level of mid third of P1
- SDFT
- DDFT
- Straight sesamoidean lig
- Oblique sesamoidean ligaments
- palmar surface of P1
- Skin
- Proximal digital annular ligament
- Synovial fold of the tendon sheath
Name each structure that is represented by a number. This is transverse view of the pastern at the level of distal third of P1
- SDFT
- DDFT
- Straight sesamoidean lig
- Oblique sesamoidean lig
- Palmar surface of P1
- Skin
- Proximal digital annular ligament
Name each structure that is represented by a number. This is transverse palmarocollateral views of the pastern at the level of distal third of P1
- SDFT
- DDFT
- Striaght sesamoidean lig
- Oblique sesamoidean lig
- palmar surfaceof P1
- Skin
- Proximal digital annular lig
- Palmar ligament of pastern joint
Name each structure that is represented by a number. This is longitudinal image of the SDFT on a palmaroproximal-dorsodistal oblique view.
- SDFT
- Palmar aspect of P1
- Skin
- Palmar ligament of Pastern joint
- Scutum
Name each structure that is represented by a number. This is transverse view of the pastern at the level of proximal pastern joint and P2
- DDFT
- Distal condyle of P1
- Skin
- Scutum
- Distal digital annular lig
In a standard horse (~550kg) the SDFT is ____mm thick, DDFT is ____mm thick and _____mm wide, and proximal digital annular lig is _________ mm thick.
3mm
~6mm thick and 22mm wide
0.3-0.6mm
True or false: at the level of the mid third of P1, the SDFT starts to separate in 2 branches.
True.
True or false: At the distal third of P1 the SDFT is not seen because it is completely separated into 2 branches.
True.
The DDFT separates into 2 symmetrical oval shaped lobes
True or false: At the level of the pastern joint and proximal P2 the SDFT are palmar to the scutum attached on the flexor tuberosity.
False. It is the DDFT
These lesion are more often parasagittal and can extend to the corresponding branch
Longitudinal tears and core lesions in the SDFT are commonly found where?
Proximal third
Sonographic appearance of SDFT lesions
Thickening
change in echogenicity- acute= hypoechoic vs chronic= hyperechoic
may see thickening of the proximal digital annular lig
True or false: lesions of the DDFT are frequently associated with DFTS tenosynovitis.
True.
In the proximal third lesions are often found at the dorsolateral aspect
What is your diagnosis
Marked tenosynovitis of the digital flexor tendo sheath
Mesotendon (asterisk) in thickened
marked effusion palmar to the SDFT
What is your dx? comparative scans of branches of a SDFT. medial is to the left
Chronic tendonitis of medial branch
medial branch is markedly thickened, has reduced echogenicity and loss of normal fiber pattern
What is your diagnosis. Comparative left and right limbs. Left limb is to the left
Chronic tendonitis of DDFT of left limb
The ultrasonographic evaluation of the fetlock is divided into 3 zones. What are they?
Zone 1: 4cm above proximal sesamoid bones
zone 2: at the level of the proximal sesamoid bones
zone 3: distal to the base of sesamoid bone to mid P1
Name each structure that is represented by a number. This is transverse view of zone 1 of the fetlock
- SDFT
- DDFT
- medial and lateral branches of the suspensory lig
- the hyperechoic line dorsal to suspensory lig represents metacarpal or metatarsal III (cannon bone)
Name each structure that is represented by a number. This is transverse view of zone 2 of the fetlock
- SDFT
- DDFT
- Intersesamoidean lig
* curvilinear hyperechoic lines medial and lateral to the intersesamoidean lig represents the proximal sesamoidean bones
Name each structure that is represented by a number. This is transverse view of zone 3 of the fetlock
- SDFT
- DDFT
- Straight sesamoidean lig
- oblique sesamoidean lig
*hyperechoic line dorsal to straight sesamoidean lig represents P1
The suspensory ligament originates __________ and inserts on ____________.
3rd metacarpal/metatarsal (cannon) bone
proximal sesamoids
