Page 372 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition
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Musculoskeletal system: 1.8 Soft-tissue injuries                       347



  VetBooks.ir   1.682                                    1.683





















                                                         Fig. 1.683  Transverse scan from a palmarolateral
                                                         approach at mid-metacarpus. A poorly defined
                                                         hypoechogenic area (calipers) is present over the
          Fig. 1.682  Focal deformity of the plantar aspect of   lateral border of the SDFT and extends along the
          the distal tarsus is often referred to as ‘curb’ (arrow).   DDFT and ICL. The border of the SDFT is irregular
          The most common cause of this swelling is thickening   and poorly delineated. The overlying subcutaneous
          of the paratenon of the SDFT secondary to trauma.  tissue is very thickened.

          Fig. 1.684  Transverse scan from a palmar approach,   1.684
          mid-metacarpus. Severe, hypoechogenic thickening
          of the SDFT paratenon is visible along the palmar
          aspect of the tendon (arrowhead). It extends around
          the medial aspect of the SDFT and DDFT, displacing
          the fascia and neurovascular bundle (yellow arrows).
          The medial border of the SDFT is irregular and
          poorly defined. Echogenic material is present within
          the medial angle between the SDFT and DDFT (red
          arrow).




          plantar nerves, dorsal metacarpal nerves, etc.).
          In more chronic cases, pain on palpation may persist
          despite resolution of the oedema. Thickening of the
          tendon may be minimal.

          Differential diagnosis                         Ultrasonography
          Primary tendinopathy or desmitis; oedema from   Will  show  thickening  of  the  paratenon,  usually
          other causes; lymphangitis.                    diffuse,  with  an  initial  decrease  in  echogenicity
                                                         (Figs. 1.683, 1.684). Haemorrhage causes a thin,
          Diagnosis                                      hypoechogenic layer outside the paratenon or sepa-
          Based on a history of trauma, slipped bandage or   rating the paratenon from the underlying tendon tis-
          acute oedema, and ultrasonography.             sue, but occasionally in the early stages it may appear
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