Page 332 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Musculoskeletal system: 1.8 Soft-tissue injuries 307

VetBooks.ir Fig. 1.591 Immature and 1.591 1.592

early fibrous scar tissue is
fairly homogeneous and still
fairly hypoechogenic as small
vessels and poorly arranged
collagen fibres accumulate
in a diffuse pattern. (Arrows
indicate lesion margins.)

Fig. 1.592 More mature
scar tissue (4–9 months)
contains larger fibre bundles
in a poorly organised pattern
that creates a more brightly
echogenic but heterogeneous
pattern. (Arrows indicate
lesion margins.)

1.593 1.594

Figs. 1.593, 1.594 Healed tendon injury (11 months after initial onset). The lesion (arrows) is ill defined and
iso- to hyperechogenic to the rest of the tendon, with a slightly more densely packed, less regular pattern both
in transverse (1.593) and long-axis (1.594) scans. Partial but irregular restoration of fibre alignment is visible on
the longitudinal image (arrowheads).

heterogeneous but iso- to hyperechogenic images on with a mixture of mature scar tissue and subacute
transverse scans and short, coarse linear echoes on lesion. This induces a continuous increase in tendon
long-axis images (Figs. 1.593, 1.594). CSA and a very heterogeneous tissue, often very dif-
Chronic tendinopathy, due to poor healing and fuse and containing hyper- and hypoechogenic areas
repeat microtearing, corresponds to an active lesion (Figs. 1.595, 1.596). Mineralisation may be present