SAEVA Congress 2018 Proceedings | 12-15 February 2018 | ATKV Goudini Spa
The flat short medial collateral ligament inserts on the proximal and distal tuberosity of the tibial tarsal bone , part of that is immediately adjacent to the attachment of the long collateral ligament . The round short medial collateral ligament inserts on the distomedial aspect of the sustentaculum tali and the plantaromedial aspect of the central tarsal bone . The short flat deep collateral ligament inserts on the tibial tarsal bone .
The articular capsule is easily imaged in the dorsomedial compartment of the tarsocrual joint . There is a large dorsomedial recess that is imaged just below the medial malleolus of the tibia . There is minimal synovial fluid imaged in the dorsomedial compartment of the tarsocrual joint with distinct synovial villi floating within the fluid . Little fluid is normally imaged in the plantaromedial or plantarolateral compartments of the joint . The articular cartilage of the dorsal aspect of the talus is readily visualized , enabling the medial and lateral trochlear ridges to be evaluated ultrasonographically . With flexion of the hock , the caudoproximal portion of the trochela of the talus can also be imaged . Minimal synovial fluid is imaged in the distal intertarsal joint along its medial aspect or in the tarsometatarsal joint along its plantarolateral aspect . There should be clean distinct articular margins visible of these 2 joints with an anechoic space detected representing the joint .
Abnormal ultrasonographic appearance of joints
Synovitis
The normal joint fluid is anechoic or sonolucent with the joint lined by a thin synovial membrane and surrounded by a thicker echoic joint capsule . Synovial villa or fronds can be imaged protruding into the joint space . Marked thickening of the joint capsule and synovial lining can be seen in horses with chronic proliferative synovitis and villonodular lesions in the synovia can be imaged as echogenic synovial masses .
Flocculent , hypoechoic to echogenic fluid may be imaged in septic arthritis . A hemarthrosis is suggested by the presence of large quantities of uniformly echoic fluid , particularly in horses with periarticular hematomas . Synovial fistulae or synoviocoeles ( ruptures of the joint capsule ) can be located ultrasonographically , as can periarticular fluid accumulations . The defect between the synoviocoele and the tarsal sheath usually has to be imaged with the limb nonweightbearing to see the communication between the 2 fluid compartments .
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