Page 233 - Adams and Stashak's Lameness in Horses, 7th Edition

Diagnostic Imaging 199

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Figure 3.10. Lateromedial (LM) projection of carpal effusion.
Note the soft tissue thickening on the dorsal aspect of the carpus
obliterating the normal fat pads (see Figure 3.9). There are multiple,
Figure 3.9. Lateromedial (LM) projection of a normal carpus small, and irregular osseous bodies on the palmar and dorsal
showing the fat pads (adipose tissue bodies) as lucent structures aspects of the carpus consistent with osteochondral fragments.
within the dorsal soft tissues (arrows).

Soft Tissue Thickening
Soft tissue thickening in the equine extremity can be
localized or diffuse. Diffuse swelling is often associated
with edema or cellulites. Localized thickening may be
identified radiographically within or around joints, ten­
dons, or muscles (Figure 3.10). Differentials include
synovial effusion, direct soft tissue injury such as tendi­
nous lesions, and masses such as granulomas and
abscesses, among other differentials. Though neoplasia
of the equine limb is rare, it should still be considered as
a differential when warranted. Radiographic signs of
soft tissue thickening include an increased soft tissue
prominence, displacement of fat bodies (adipose tissue)
around the joint capsule or tendon sheaths, and mot­
tling or obliteration of adipose tissue in fascial planes
around muscles, joint capsules, or tendons.

Mineralization
Dystrophic mineralization of soft tissue in equine Figure 3.11. Lateromedial (LM) projection of the distal extremity.
limbs is most frequently secondary to trauma or degen­ Linear soft tissue mineralization is present just palmar to the flexor
erative injury. Mineralization within ligamentous and cortex of the navicular bone consistent with dystrophic mineralization
tendinous structures usually indicates chronic or more of the deep digital flexor tendon in this region.
advanced degenerative disease and is most commonly
seen in the suspensory ligament branches and distal deep
digital flexor tendon (DDFT; Figure 3.11). Synovial “cauliflower‐shaped” appearance is usually present with
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mineralization and articular chondral fragment minerali­ calcinosis circumscripta.
zation indicate chronic joint disease. Hematomas, granu­
lomas, and areas of necrosis can mineralize as can certain Gas
types of neoplasia such as mast cell tumor. Calcinosis
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circumscripta is a form of dystrophic mineralization Gas may be present in the soft tissue structures of
most frequently seen periarticular in the horse. A round equine limbs as a result of traumatic lacerations, puncture