Hypoechoic ultrasonographic findings in the patellar ligaments are common in riding and trotting horses in training (116 cases)

Ellen Law, Linda Wright, Margareta Uhlhorn, Elin Hernlund, Carolina Nilemo, Marie Rhodin

Background
The study focuses on hypoechoic ultrasonographic findings in the patellar ligaments (PLs) of horses, a region increasingly examined for injuries linked to hindlimb lameness. While PL injuries are noted in equine medicine, their ultrasonographic characteristics in active horses remain poorly described. The research aims to document the ultrasonographic appearance of the PLs and infrapatellar fat pad (IFP) in training horses and investigate their relationship with movement asymmetry, a proxy for lameness.

Methods
A prospective observational study was conducted on 116 horses across three categories: cavalry horses, privately owned Warmbloods, and Standardbred trotters. All horses underwent B-mode and color Doppler ultrasonography of both stifles, alongside objective gait analysis using an inertial sensor-based system. Associations between ultrasonographic findings, age, and movement asymmetry were statistically analyzed.

Results
Hypoechoic regions were common in the intermediate PL (20.7% of horses), particularly in the caudal aspect of the mid-third. The IFP displayed a consistent hypoechoic striated pattern. No significant association was observed between ultrasonographic findings in the PLs or IFP and hindlimb lameness. Color Doppler did not reveal increased blood flow in hypoechoic areas, suggesting no neovascularization.

Limitations
The study did not perform local anesthetic blocking to confirm the clinical significance of ultrasonographic findings or the precise source of lameness. Additionally, no histological analysis was conducted to differentiate between pathological and normal anatomical variations.

Conclusions
Hypoechoic findings in the patellar ligaments are frequent in training horses but do not correlate with movement asymmetry or lameness. These findings highlight the importance of distinguishing normal biological variation from pathological changes through further research.

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