Page 377 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

352 CHAPTER 1

VetBooks.ir production may occur secondarily to trauma not Ultrasonography
This is the diagnostic method of choice.
affecting the tendon. If extensive, it may occasion-
ally interfere with the extensor tendons and cause
secondary tendonitis. Tenosynovitis may occur with or without overt ten-
don lesions. The changes observed resemble those of
In some cases, the use of contrast medium admin- digital sheath tenosynovitis, with a thickened syno-
istration (tenography or arthrography) may be use- vial membrane, anechogenic fluid distension and
ful to look for abnormal communications between mass formation due to synovial thickening and/or
synovial sheaths and/or joints or to look for fistulas pannus (fibrous tissue and fibrinous material) accu-
between the tendon sheaths and skin wounds. mulation (Fig. 1.695–1.697).

1.695 1.696

Fig. 1.695 Transverse plane scan over the dorsal Fig. 1.696 Longitudinal scan over the dorsal aspect of
aspect of the tarsus. The synovial sheath of the long the carpus. The synovial sheath of the common digital
digital extensor tendon (ELD) is slightly distended extensor tendon (CDE) is distended with anechogenic
with mild thickening of the synovial lining membrane fluid (sh). The synovial membrane is markedly thickened
(arrows). The tendon has a normal ultrasonographic by inflammatory changes (double arrows), with enlarged
appearance. villi protruding into the sheath cavity (yellow arrows).
Note the focal constriction of the swollen sheath by a
small carpal retinaculum (arrowhead).
1.
1.697 7
9
6

Fig. 1.697 Chronic tenosynovitis can lead to
marked distension of the tendon sheaths without
associated tendon changes. On this longitudinal scan
over the dorsal proximal aspect of the carpus, the
sheath of the extensor carpi radialis tendon (ECR)
is severely distended (sh), revealing the underlying,
normally curled up capsule of the antebrachiocarpal
joint (JC). The tendon has a normal appearance
with regular, longitudinal fibre pattern, although
the visceral synovial sheath lining is moderately
thickened. RCB = radial carpal bone.