SAEVA Congress 2018 Proceedings | 12-15 February 2018 | ATKV Goudini Spa
Mild abaxial desmitis with enthesiophytes
Sonographic monitoring of tendon or ligament healing
The anechoic lesion imaged in the acutely injured horse corresponds to an area of
hemorrhage at the site of fiber rupture. Clot in the acutely injured tendon or ligament
may appear echoic and may be mistaken by the novice sonologist for normal tendon
or ligament. This mistake can be avoided by evaluating the sagittal view of the
tendon or ligament in the acutely injured horse, as well as the transverse view. In
spite of the normal or near normal echogenicity of organized hemorrhage, it lacks a
linear fiber pattern. The appearance of an anechoic lesion associated with cavitation
or lysis of the clot may take 5 – 7 days or more in some horses.
With progressive tendon or ligament healing, the cross-sectional areas of the lesion
and the tendon or ligament usually decreases and the lesion site gradually fills with
hypoechoic amorphous echoes that should represent granulation tissue and
immature fibrous tissue. The echogenicity of the injured area gradually increases
and the demarcation between the injured and uninjured tendon or ligament become
less distinct. The echogenicity of the lesion site usually increases with maturation of
the fibrous tissue. Short randomly aligned linear echoes can be imaged in the
repairing region in the sagittal scan plane. A central echogenic scar surrounded by a
hypoechoic "halo" may be detected in the superficial digital branch with a repaired
core lesion. Peritendinous hypoechoic to echogenic tissue representing immature
and maturing fibrous tissue is often imaged adjacent to the injured superficial digital
flexor tendon branch and can result in adhesions between the branch and the
surrounding tendinous and peritendinous structures. New areas of fiber disruption
often occur adjacent to the previously repaired area or associated with adhesions to
the surrounding tendinous or peritendinous structures.
Sonographic Follow-Up
Follow-up sonographic examinations should be performed every 2-3 months and at
pivotal changes in the horse’s exercise program. Increases in exercise intensity
should not occur unless continued sonographic improvement is detected. If the
lesion remains hypoechoic with a poor quality fiber pattern over several
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