B‐mode and power Doppler ultrasonography of the equine suspensory ligament branches: A descriptive study on 13 horses

Ultrasonography is routinely used to achieve the diagnosis of equine suspensory ligament desmopathy. In human medicine, power Doppler ultrasonography has also been found to be useful for the diagnosis of tendon/ligament injuries. The aim of this prospective, pilot study was to assess the presence or absence of power Doppler signal in suspensory ligament branches and compare B-mode findings with power Doppler findings in suspensory ligament branches of lame and non-lame limbs. Thirteen horses were used (eight lame horses, with lameness related to pain in the suspensory ligament branches, and five non-lame horses). Ten lame limbs and 24 sound limbs were assessed by B-mode and power Doppler ultrasonography. The severity of power Doppler signal was scored by two independent readers. The B-mode ultrasonographic examination revealed abnormalities in branches of lame limbs and in branches of sound limbs. Suspensory ligament branches that were considered normal in B-mode showed no power Doppler signal. However, power Doppler signal was detected in suspensory ligament branches that were abnormal in B-mode, both in lame and sound limbs. Power Doppler scores were subjectively higher in suspensory ligament branches of lame limbs and in branches with more severe B-mode changes. Findings supported the use of power Doppler as an adjunctive diagnostic test for lame horses with suspected suspensory desmopathy.

[1]  A. Reginelli,et al.  The effect of foot position on Power Doppler Ultrasound grading of Achilles enthesitis , 2016, Rheumatology International.

[2]  H. Alfredson,et al.  Ultrasound and Doppler-Guided Surgery for the Treatment of Jumper’s Knee in Professional Rugby Players , 2015, PST 2015.

[3]  S. Dyson,et al.  Clinical features, diagnostic imaging findings and concurrent injuries in 71 sports horses with suspensory branch injuries , 2014 .

[4]  P. Ramzan,et al.  Subclinical ultrasonographic abnormalities of the suspensory ligament branch of the athletic horse: A survey of 60 Thoroughbred racehorses. , 2013, Equine veterinary journal.

[5]  A. Scott,et al.  Tendons – time to revisit inflammation , 2013, British Journal of Sports Medicine.

[6]  D. Murata,et al.  A preliminary study of diagnostic color Doppler ultrasonography in equine superficial digital flexor tendonitis. , 2012, The Journal of veterinary medical science.

[7]  R. Lorentzon,et al.  Substance P accelerates hypercellularity and angiogenesis in tendon tissue and enhances paratendinitis in response to Achilles tendon overuse in a tendinopathy model , 2011, British Journal of Sports Medicine.

[8]  S. Dyson Is degenerative change within hindlimb suspensory ligaments a prelude to all types of injury , 2010 .

[9]  F. Mayer,et al.  [Achilles tendon power Doppler sonography in 953 long distance runners - a cross sectional study]. , 2010, Ultraschall in der Medizin.

[10]  S. Dyson Proximal metacarpal and metatarsal pain: a diagnostic challenge , 2010 .

[11]  I. Wright,et al.  Arthroscopic diagnosis and treatment of intra-articular insertional injuries of the suspensory ligament branches in 18 horses. , 2010, Equine veterinary journal.

[12]  I. Wright,et al.  Treatment of chronic or recurrent proximal suspensory desmitis using radial pressure wave therapy in the horse. , 2010, Equine veterinary journal.

[13]  R. Bahr,et al.  Color Doppler Ultrasound Findings in Patellar Tendinopathy (Jumper's Knee) , 2008, The American journal of sports medicine.

[14]  S. Torp-Pedersen,et al.  Settings and artefacts relevant in colour/power Doppler ultrasound in rheumatology , 2007, Annals of the rheumatic diseases.

[15]  H. Langberg,et al.  Colour Doppler ultrasonography and sclerosing therapy in diagnosis and treatment of tendinopathy in horses—a research model for human medicine , 2007, Knee Surgery, Sports Traumatology, Arthroscopy.

[16]  H. Langberg,et al.  Tendinopathy and Doppler activity: the vascular response of the achilles tendon to exercise , 2006, Scandinavian journal of medicine & science in sports.

[17]  H. Alfredson,et al.  Neovascularisation in chronic tendon injuries detected with colour Doppler ultrasound in horse and man: implications for research and treatment , 2005, Knee Surgery, Sports Traumatology, Arthroscopy.

[18]  H. Alfredson,et al.  Effects on neovascularisation behind the good results with eccentric training in chronic mid-portion Achilles tendinosis? , 2004, Knee Surgery, Sports Traumatology, Arthroscopy.

[19]  S. Forsgren,et al.  Is vasculo-neural ingrowth the cause of pain in chronic Achilles tendinosis? , 2003, Knee Surgery, Sports Traumatology, Arthroscopy.

[20]  A. Metzdorf,et al.  Achilles tendons: clinical relevance of neovascularization diagnosed with power Doppler US. , 2003, Radiology.

[21]  R. Lysens,et al.  Correlation between power Doppler ultrasonography and clinical severity in Achilles tendinopathy , 2003, International Orthopaedics.

[22]  Markus Walther,et al.  Synovial tissue of the hip at power Doppler US: correlation between vascularity and power Doppler US signal. , 2002, Radiology.

[23]  H. Bliddal,et al.  Ultrasound and Power Doppler findings in jumper's knee - preliminary observations. , 2001, European journal of ultrasound : official journal of the European Federation of Societies for Ultrasound in Medicine and Biology.

[24]  R. Lorentzon,et al.  Neovascularisation in Achilles tendons with painful tendinosis but not in normal tendons: an ultrasonographic investigation , 2001, Knee Surgery, Sports Traumatology, Arthroscopy.

[25]  T. Mutazindwa,et al.  Unilateral traumatic adrenal haematoma presenting as pheochromocytoma. , 1998, European journal of radiology.

[26]  M. Valle,et al.  Power Doppler sonography: clinical applications. , 1998, European journal of radiology.

[27]  S. Dyson,et al.  Suspensory ligament desmitis. , 1995, The Veterinary clinics of North America. Equine practice.

[28]  J. Rubin,et al.  Detection of soft-tissue hyperemia: value of power Doppler sonography. , 1994, AJR. American journal of roentgenology.

[29]  V. Busoni,et al.  Follow-up ultrasonographic examination of proximal suspensory desmopathies - a review 28 cases , 2008 .

[30]  S. Dyson,et al.  Scintigraphic evaluation of the proximal metacarpal and metatarsal regions of horses with proximal suspensory desmitis. , 2007, Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association.

[31]  S. Dyson,et al.  Chapter 73 – The Suspensory Apparatus , 2003 .

[32]  E. Wisner,et al.  Chapter 1 – Physical Principles, Instrumentation, and Safety of Diagnostic Ultrasound , 2002 .

[33]  L. Solbiati,et al.  Power Doppler sonography: general principles, clinical applications, and future prospects , 1998, European Radiology.

[34]  M. V. van Holsbeeck,et al.  Musculoskeletal ultrasonography. , 1998, The Orthopedic clinics of North America.

[35]  S. Dyson Proximal suspensory desmitis: clinical, ultrasonographic and radiographic features. , 1991, Equine veterinary journal.