Page 380 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Musculoskeletal system: 1.8 Soft-tissue injuries 355

VetBooks.ir 1.704 1.705

Fig. 1.704 Transverse scan over the dorsal Fig. 1.705 Transverse scan over the dorsal aspect of
proximal aspect of the metacarpus. The CDE tendon the tarsus. The soft tissues are severely thickened over
has very irregular contours with two irregular the surface of the trochlear groove of the talus. The
and hypoechogenic clefts (red arrows), the sheath tibialis cranialis tendon (TC) is barely recognisable,
membrane is thickened (yellow arrows) and fluid although intact (double arrow). Echogenic (‘cellular’)
distension has an echogenic, ‘cellular’ appearance. fluid and gas bubbles accumulate under the skin (white
This was due to a septic tenosynovitis secondary to a arrow). A large gas bubble forms an acoustic shadowing
wound over the dorsal tarsus. artefact (yellow arrows). A fluid-filled fistula (red arrows)
perforates the soft tissues into the TC tendon sheath.

1.706

Fig. 1.706 Longitudinal scan over the dorsal
aspect of the mid-metacarpal region. The common
digital extensor tendon (CDE) is focally severely
enlarged, with complete loss of the normal striation
and decreased echogenicity (double arrow). Fluid
accumulates deep to the tendon, at the level of the
periosteum (yellow arrows), and focal irregularity of
the third metacarpal bone surface (Mc3) suggests a
probable sequestrum (red arrow). Although no skin
wound is visible, septic tendinitis and osteitis was
probably secondary to a puncture wound.

wound into the sheath, with associated gas and Management
debris, may be visible (Fig. 1.705). Septic tendinop- Conservative treatment of traumatic tendonitis or
athy may be present from primary laceration of the tenosynovitis, based on box rest, systemic and topi-
tendon or secondary invasion of the tendon tissue cal anti-inflammatory drugs and regular in-hand
(Fig. 1.706). exercise, is often effective. Initially, the limb should