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U/S Mattoon and Pennick > LA Musculoskeletal > Flashcards

LA Musculoskeletal Flashcards

1
Q

List some indications of ultrasound examination of the pastern

A

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

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2
Q

What anatomical landmarks are used to know where does an ultrasonoraphic examination of the pastern starts and ends?

A

Starts at the base of the sesamoidean bones to the proximal part of P2

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3
Q

Ultrasonographic examination of the pastern was divided into 4 different anatomical leves. What are they?

A

Proximal third of P1

Intermediate third of P1

distal third of P1

Proimal interphalangeal jint and proximal part of P2

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4
Q

Name each structure that is represented by a number. This is transverse views of the pastern at the level of proximal third of P1

A
  1. SDFT
  2. DDFT
  3. Straight sesamoidean ligament
  4. Oblique sesamoidean ligaments
  5. Palmar surface of P1
  6. Skin
  7. Proximal digital annular ligament
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5
Q

Name each structure that is represented by a number. This is transverse views of the pastern at the level of mid third of P1

A
  1. SDFT
  2. DDFT
  3. Straight sesamoidean lig
  4. Oblique sesamoidean ligaments
  5. palmar surface of P1
  6. Skin
  7. Proximal digital annular ligament
  8. Synovial fold of the tendon sheath
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6
Q

Name each structure that is represented by a number. This is transverse view of the pastern at the level of distal third of P1

A
  1. SDFT
  2. DDFT
  3. Straight sesamoidean lig
  4. Oblique sesamoidean lig
  5. Palmar surface of P1
  6. Skin
  7. Proximal digital annular ligament
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7
Q

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

A
  1. SDFT
  2. DDFT
  3. Striaght sesamoidean lig
  4. Oblique sesamoidean lig
  5. palmar surfaceof P1
  6. Skin
  7. Proximal digital annular lig
  8. Palmar ligament of pastern joint
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8
Q

Name each structure that is represented by a number. This is longitudinal image of the SDFT on a palmaroproximal-dorsodistal oblique view.

A
  1. SDFT
  2. Palmar aspect of P1
  3. Skin
  4. Palmar ligament of Pastern joint
  5. Scutum
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9
Q

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

A
  1. DDFT
  2. Distal condyle of P1
  3. Skin
  4. Scutum
  5. Distal digital annular lig
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10
Q

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.

A

3mm

~6mm thick and 22mm wide

0.3-0.6mm

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11
Q

True or false: at the level of the mid third of P1, the SDFT starts to separate in 2 branches.

A

True.

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12
Q

True or false: At the distal third of P1 the SDFT is not seen because it is completely separated into 2 branches.

A

True.

The DDFT separates into 2 symmetrical oval shaped lobes

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13
Q

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.

A

False. It is the DDFT

These lesion are more often parasagittal and can extend to the corresponding branch

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14
Q

Longitudinal tears and core lesions in the SDFT are commonly found where?

A

Proximal third

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15
Q

Sonographic appearance of SDFT lesions

A

Thickening

change in echogenicity- acute= hypoechoic vs chronic= hyperechoic

may see thickening of the proximal digital annular lig

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16
Q

True or false: lesions of the DDFT are frequently associated with DFTS tenosynovitis.

A

True.

In the proximal third lesions are often found at the dorsolateral aspect

17
Q

What is your diagnosis

A

Marked tenosynovitis of the digital flexor tendo sheath

Mesotendon (asterisk) in thickened

marked effusion palmar to the SDFT

18
Q

What is your dx? comparative scans of branches of a SDFT. medial is to the left

A

Chronic tendonitis of medial branch

medial branch is markedly thickened, has reduced echogenicity and loss of normal fiber pattern

19
Q

What is your diagnosis. Comparative left and right limbs. Left limb is to the left

A

Chronic tendonitis of DDFT of left limb

20
Q

The ultrasonographic evaluation of the fetlock is divided into 3 zones. What are they?

A

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

21
Q

Name each structure that is represented by a number. This is transverse view of zone 1 of the fetlock

A
  1. SDFT
  2. DDFT
  3. medial and lateral branches of the suspensory lig
  4. the hyperechoic line dorsal to suspensory lig represents metacarpal or metatarsal III (cannon bone)
22
Q

Name each structure that is represented by a number. This is transverse view of zone 2 of the fetlock

A
  1. SDFT
  2. DDFT
  3. Intersesamoidean lig

* curvilinear hyperechoic lines medial and lateral to the intersesamoidean lig represents the proximal sesamoidean bones

23
Q

Name each structure that is represented by a number. This is transverse view of zone 3 of the fetlock

A
  1. SDFT
  2. DDFT
  3. Straight sesamoidean lig
  4. oblique sesamoidean lig

*hyperechoic line dorsal to straight sesamoidean lig represents P1

24
Q

The suspensory ligament originates __________ and inserts on ____________.

A

3rd metacarpal/metatarsal (cannon) bone

proximal sesamoids

25
Q

Major function of suspensory lig is

A

provides support to the fetlock joint by preventing hyperextension and limits palmar/plantar flexion.

26
Q

True or False: Anisotropy (off angle view) is commonly used during musculoskeletal sonographic evaluations due to the different structures that make up tendons and ligaments.

A

True

27
Q

Central core lesions of the SDFT (bowed tendon) are more commonly seen in what breeds?

A

Thoroughbreds, Quarter Horses, Standardbreds

any type of race horse

28
Q

Peripheral SDFT tears are commonly seen in what breeds?

A

western, performing, rainers, cutters

29
Q

What is your diagnosis? This is left and right comparative images. Left is on the left.

A

Core lesion and thickening of left suspensory ligament when compared to right

Right distal check ligament is thick and there is a core lesion

30
Q

where would you most commonly see check ligament tears?

A

laterally (make sure to slide your probe lateral)

31
Q

What is your diagnosis?

A

bone resorption at the insertion site of suspensory ligament

core lesion at the suspensory ligment

32
Q

True or false: The suspensory branch of the suspensory ligament are triangular in shape proximally and ovoid distally.

A

False.

ovoid: proximally

triangular distally

33
Q

What is your dx?

A

Suspensory lig branch desmopathy and enthesophyte at the insertion site

34
Q

What horse breed are geneticall predisposed for suspensory ligament degeneration?

A

Paso fino

35
Q

Normal thickness for plantar/palmar annular ligament is

A

2mm

36
Q

Sonographic appearance of annular lig injury

A

thickening

U/S Mattoon and Pennick (8 decks)

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