IMAGING DIAGNOSIS-AVULSION OF THE MEDIAL COLLATERAL LIGAMENT OF THE TARSUS IN A HORSE

Ultrasonography of the normal donkey tarsus (equus asinus)

Tarsal joint illness is a frequent source of hind limb lameness due to the complex anatomy of the region and the presence of numerous bony and soft tissue structures. Proper lameness diagnosis aims to discover the structure provoking lameness. Ultrasonography documents valuable information of soft tissues and characterizes soft tissue injuries that have heretofore been difficult to obtain either noninvasively or via radiography. The objectives of the current study were to develop and describe a standardized ultrasonographic protocol for investigation of the tarsal region in donkeys. The donkey tarsal anatomy was investigated in 5 cadavers and the tarsi of 11 healthy lameness free adult donkeys were echographically investigated. The dorsal, plantar, lateral and medial aspects of the tarsal region were substantially evaluated at four anatomical landmarks in both the longitudinal and horizontal planes using a multi-frequency 5-12 MHz linear transducer. Sonoanatomy of the extensor and flexor tarsal tendons, collateral and plantar ligaments, and synovial pouches was delineated and described. Systematic echography of the tarsal region allowed accurate localization and thorough exploration of various soft tissues of clinical interest in the donkey tarsus. Sonograms provided in this study should serve as a reference database for tarsal ultrasonography in clinical circumstances.

Arthroscopically accessible anatomy of the tarsal collateral ligaments in the horse

OBJECTIVE

To describe the arthroscopically accessible anatomy of the tarsal collateral ligaments in the horse.

STUDY DESIGN

Descriptive study.

ANIMALS

Cadaveric equine hind limbs (n = 24) obtained from horses without tarsal disease.

METHODS

Two pairs of tarsal joints were used to obtain silicone models of the tarsocrural joint and dissect the tarsal collateral ligaments (CLs). Ten pairs of tarsocrural joints had arthroscopic exploration and the accessible parts of the tarsal CLs were marked with an arthroscopic hook knife. Subsequently, the limbs were dissected and the marked positions were allocated to the specific parts of the CLs.

RESULTS

Ipsilateral arthroscope and instrument portals were used in each pouch of the tarsocrural joint. Via the plantaromedial pouch, the superficial (2/20 limbs), middle (7), deep (6) or both middle and deep (3) short medial CL and the long medial CL (14) were reached. Access via the plantarolateral pouch allowed manipulation of the deep short lateral CL (20/20 limbs) and the long lateral CL (20). Dorsally, arthroscopy via the dorsomedial pouch gave access to the deep short medial CL (20/20 limbs), while the superficial (9) or middle (10) or both superficial and middle (1) short lateral CL could be reached via the dorsolateral joint recess.

CONCLUSIONS

Limited parts of the tarsal CLs can be observed or manipulated arthroscopically in normal equine tarsocrural joints.

Ultrasound approach to the canine distal tibia and trochlear ridges of the talus

The aim of the present study was to evaluate to what extent the distal tibia and the trochlear ridges of the talus can be examined with ultrasound (US) in the dog and to establish a protocol for an optimal US examination of these ridges. Six hind limbs of deceased adult mixed-breed dogs were used. In two limbs, needles were placed using US guidance on the trochlea of the talus, just dorsal to and plantar to the distal tibia: one with the tarsal joint in extension and one with the joint in flexion. Then mediolateral (ML) radiographs of both joints were made with the needle in place to determine the percentage of the trochlear ridge of the talus that can be seen using US imaging. An US examination of the tarsal joint was performed on the four other limbs using microconvex (8 MHz) and linear (12 MHz) transducers (Logiq 7) and compound imaging. A three-step protocol was performed including a dorsal approach with the limb extended and the linear transducer (step I), a plantar approach with the limb flexed and the linear transducer (step II), and a plantar approach with the limb flexed and the microconvex transducer (step III). After the US examination, the four limbs were frozen and sectioned, two in a transverse and two in a sagittal plane. Bony structures on the US images were matched with the corresponding anatomic sections. The distal tibia and both trochlear ridges of the talus were easily recognized on the US images using the proposed protocol. When combining the dorsal and plantar approaches, it was possible to visualize up to 75% of the trochlear ridges of the talus in the dog.