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Use of ultrasonography in the evaluation of joint disease in horses. Part 1: Indications, technique and examination of the soft tissues
Author(s) -
Redding W. R.
Publication year - 2001
Publication title -
equine veterinary education
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 31
eISSN - 2042-3292
pISSN - 0957-7734
DOI - 10.1111/j.2042-3292.2001.tb00090.x
Subject(s) - medicine , citation , library science , family medicine , computer science
Ultrasonography has advanced significantly the diagnosis and management of many types of musculoskeletal injuries in performance horses. In particular, diagnostic ultrasound is routinely used for defining and monitoring injuries to the flexor tendons and suspensory apparatus (Rantanen 1985; Genovese et al. 1987; Denoix et al. 1991; Dik et al. 1991). However, it can also be used to evaluate a variety of joint conditions (Denoix 1996). Joint injury, osteochondrosis and degenerative joint disease are significant causes of lameness in performance horses. Often, a joint is suspected as the cause of lameness but the specific source of pain can be difficult to ascertain (Stashak 1987). Intra-articular anaesthesia often significantly improves the lameness and localises it to a particular joint, but radiography may be inconclusive. In such a case, the cause of lameness is presumed to be soft tissue injury and empirical treatment is instituted. However, examining the joint surfaces and articular supporting structures using ultrasound allows more thorough evaluation of the joint and therefore aids in selection of the most appropriate treatment plan and rehabilitation regimen. Evaluation of any joint problem should begin with a thorough clinical examination, including detailed history, physical examination, gait evaluation and manipulative tests, as appropriate; and, if necessary, diagnostic regional anaesthesia (nerve and/or joint blocks). Other diagnostic procedures, such as thermography, nuclear imaging, treadmill gait analysis and neurological evaluation, may be warranted in selected cases (Lamb 1991; O’Callaghan 1991; Steckle 1991; Turner 1991). When lameness is localised to a joint, a complete radiographic study should be performed to identify any abnormality in or around the joint. Echographical evaluation of the joint (arthrosonography) and surrounding tissues should also be considered (Benson 1991; Dik 1993; Mack and Scheible 1995; Denoix 1996, 1998). While radiography has proven to be very effective in imaging the bones of the equine limb, there can be poor correlation between clinical and radiographic findings (O’Callaghan 1991). When used in combination, radiography and ultrasonography can supply more information about an orthopaedic problem than when each modality is used alone. Diagnostic ultrasound has the added advantage of providing immediate, detailed information about the soft tissues of a joint and the cartilage and subchondral bone surfaces. In this article, the indicators, technique and examination of the soft tissues using ultrasonography to evaluate joint diseases in horses is discussed.