Page 341 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

316 CHAPTER 1

VetBooks.ir 1.605 Fig. 1.605 1.606

Proximal suspen-
sory desmitis in
the forelimb of a
horse. The liga-
ment is diffusely
enlarged (double
arrows) and fills up
the entire space
between the acces-
sory ligament of
the DDFT (ICL =
inferior check liga-
ment) and the third
metacarpal bone
(Mc3). The arrow-
heads indicate the Fig. 1.606 On longitudinal views (here in a hindlimb),
deep fascia being the enlarged SL fills up the connective tissue space and
displaced palmarly displaces the deep fascia (short arrows). In severe cases,
against the ICL. the plantar ligament margin becomes convex. TCL =
tarsal check ligament.

Ultrasonography 1.607
Lesions occur within the proximal 2–5 cm of the lig-
ament. They may be extremely subtle. Comparison
with the contralateral limb is warranted. Expected
signs include any of the following:

• Enlargement of the ligament is characterised
by decreased space between it and the check
ligament (accessory ligament of the DDFT
[AL-DDFT]) or increased width (Fig. 1.605).
The flexor tendons may be displaced palmarly/
plantarly. The palmar/plantar outline of the
enlarged SL is convex on longitudinal scans
(Fig. 1.606).
• Poor definition of the ligament margins
(Fig. 1.607) and loss of the hypoechogenic space
(loose connective tissue) around the ligament.
• One or several, diffuse or well-defined Fig. 1.607 Severe, diffuse proximal suspensory
hypoechogenic areas (Fig. 1.608). desmitis in the hindlimb of a French Warmblood.
• Diffuse hypoechogenicity, extending over the The suspensory ligament (SL) is markedly enlarged,
whole cross-section of the ligament (Fig. 1.609) displacing the DDFT and surrounding tissues.
or a varying portion of it (Fig. 1.610). Diffuse The plantar and dorsal boundaries of the ligament
tears often only affect the dorsal one-third to are ill defined (yellow arrows) and merge with the
one-half (Fig. 1.611), less commonly the lateral surrounding connective tissue, the deep plantar fascia
or medial heads. and the tarsal check ligament (red arrow).