Dr. Frantz ultrasounding a hind suspensory ligament
Dr. Frantz ultrasounding a hind suspensory ligament

Digital Ultrasound

The portability and improvement in ultrasound image quality has progressed significantly over the past 10 years. Now being able to follow the healing progress of a bowed tendon or torn ligament has become commonplace. Making measurements and manipulating images to enhance quality as with digital radiography has allowed for quantum leaps in diagnostic abilities. Instead of just doing lower legs other areas are being investigated with excellent results. Diagnostic images of a torn ligament in the back can be seen between vertebrae, a meniscal injury involving a stifle joint can be evaluated and tendon injuries involving the shoulder can be monitored. Recently an exam was done on a horse's eye to diagnose a tumor.

Most lamenesses will require a radiographic evaluation to determine the cause once the problem has been localized. Now with the advent of digital ultrasound many of these same areas will be evluated for soft tissue lesions that are not as readily appreciated with x-rays.

Ultrasound of Large Lesion in Superficial Digital Flexor Tendon
Ultrasound of Large Lesion in Superficial Digital Flexor Tendon

2 images of a Superficial Digital Flexor Tendon injury. The green outlines the tendon and the red indicates the"hole" where the tendon fibers are injured. Over time this area of fiber damage will fill in so that the whole tendon will have a similar pattern as the more white areas.

Tendon lesion when first diagnosed.
Tendon lesion when first diagnosed.

This horse had a left fore lameness with obvious swelling in the area of his tendon. On the ultrasound exam separation of fibers plus a hole was found in the Superficial Digital Flexor.

2nd Ultrasound exam 1.5 months following first exam after Shockwave.
Ultrasound exam 1.5 months following first exam after Shockwave.

Following 3 Shockwave treatments there was significant improvement in the tendon. The damaged areas had filled in and it was difficult to visualize the previous injury. At this point the horse was able to start controlled walking.

Stifle ultrasound
Stifle ultrasound

In this image the meniscus which is the cartilage disk that is on the tibial surface of the stifle joint can be seen. This is the same type of structure that people have in their knees and can be torn. Normally this has a triangular shape. The black space next to this is joint fluid in one of the stifle joint pouches.

Injured meniscus
Injured meniscus

In this image a large tear can be seen running diagonally across the meniscus. This is a significant finding and one that would be consistent with a traumatic injury resulting in lameness. The horse will undergo surgical exploration of the joint with arthroscopy.