Ultrasonographic examination of the palmar/plantar aspect of the fetlock in the horse: Technique and normal images

Abstract

Summary The purpose of this paper is to present a comprehensive ultrasonographic technique to image the palmar/plantar aspect of the fetlock in the horse, from the manica flexoria (MF) down to the base of the proximal sesamoid bones (PSBs) and to describe the normal images. Ultrasonography, in combination with radiography, is the technique of choice to identify and document tendon and ligament injuries in routine practice and has been shown adequate for evaluating the palmar/plantar aspect of the fetlock. Detailed descriptions of transverse and longitudinal sections performed on the weightbearing or flexed limb are provided, as well as the technique for dynamic examination of the area. A thorough knowledge of detailed ultrasonographic anatomy is critical to identify abnormal images and establish an accurate diagnosis of palmar/plantar fetlock injuries.

Dynamic flexion/extension and non‐weight bearing ultrasonography is helpful for identifying manica flexoria tears in horses

“…As in previous reports, the inclusion of a real‐time dynamic examination of the palmar/plantar aspect of the fetlock carried out on the flexed limb was especially useful when chronic tenosynovitis of the digital flexor tendon sheath was identified . A recent report described the usefulness of such technique to evaluate the presence of adhesions, which could lead to a limited relative flexor tendons gliding motion .…”

“…The digital flexor tendon mesotenons were considered abnormal when subjectively thickened, with or without abnormal hypoechoic appearance. At the palmar/plantar region of the flexed fetlock, the relative alignment between flexor tendons was assessed during static and dynamic examination, on the transverse section, and compared with reference images . On the sagittal plane, dynamic exam was essential to appreciate their relative sliding characteristics.…”

Septic tendonitis of the deep digital flexor tendon in a Thoroughbred horse referred for weight loss and intermittent fever

“…; Reef ; Busoni ; Smith and Smith ; Vanderperren and Saunders ; Seignour et al . ; Carnicer et al . ).…”

“…An ultrasonographic machine equipped with a 7.5-12 MHz linear transducer was used to examine the plantar metatarsal, fetlock and pastern regions via a plantar approach (Denoix et al 1997;Reef 1998;Busoni 2001;Smith and Smith 2008;Vanderperren and Saunders 2009;Seignour et al 2012;Carnicer et al 2013). A well-defined circular hypoechogenic/anechogenic area in the core of the DDFT was visualised ultrasonographically, which extended from 10 cm distal to the point of the hock (Fig 2) to the pastern (Zone 2B to 3C).…”

Ultrasound and clinical findings in the metacarpophalangeal joint assessment of show jumping horses in training

“…Moreover, the repetitive trauma and impact resulting from the execution of jumping movements overload the distal structures of the thoracic limbs, and the metacarpophalangeal joints, flexor tendons and hooves are the areas that are most affected by injuries [2]. The metacarpophalangeal joint, which is commonly called the fetlock, is constantly subjected to maximum exertion, which causes a large amount of biomechanical stress during locomotion, resulting in frequent injury to the soft tissue and articular surface [3,4]. Therefore, horses who perform sports activities that overload the metacarpophalangeal joint are at risk for the development of osteoarthritis and require periodic follow-ups, preferably follow-ups that involve imaging examinations and rigorous physical assessments, for the early detection of disorders [5,6].…”