Equine Essentials: Brush up on your DIPJ CL ultrasound!

Journal of Equine Veterinary Science, 2012

Author

Obi Veterinary Education
April 08, 2025

Laurence Evrard, Géraldine Bolen, Nathalie Maquet, Valeria Busoni

Background
The study investigates the ultrasonographic (US) anatomy of the collateral ligaments (CLs) of the distal interphalangeal joint (DIPJ) in horses. While magnetic resonance imaging (MRI) is the standard for diagnosing CL injuries, it is costly and not widely available. Ultrasonography offers a more accessible diagnostic alternative but is limited by partial visibility of the CLs due to the hoof capsule and imaging artifacts.

Methods
Ultrasonographic imaging was conducted on five live horses and 22 cadaver forelimbs, using transverse and longitudinal planes. A subset of six limbs was evaluated via computed tomography (CT) to assess the portion of CLs visible with ultrasonography. Additionally, MRI was employed to confirm the normalcy of cadaver limbs. The US findings were correlated with CT and MRI to determine the structural and functional imaging capacity of ultrasonography.

Results
Ultrasonography reliably visualized the proximal portion of the CLs in all limbs. Transverse US images showed oval-shaped echogenic ligaments, while longitudinal images revealed two distinct fiber bundles with divergent orientations. The US-visible portion of the ligament was estimated at 57% of its total length on average. Hypoechoic artifacts observed during imaging were attributed to anisotropy caused by varying fiber orientations within the ligament. The quality of imaging depended on the hoof's shape and the relative positioning of the coronary band to the CL.

Limitations
The study noted variability in imaging quality due to limb-specific factors like coronary band shape. While ultrasonography visualized a significant portion of the ligament, the distal segments remained inaccessible due to hoof shadowing. Additionally, the study was limited by its use of cadaver limbs, which might not fully replicate live clinical conditions.

Conclusions
Ultrasonography is a practical, accessible method for examining the proximal portion of the CLs in horses, visualizing approximately half of the ligament's length. The findings provide a detailed reference for normal CL anatomy and artifacts, improving the interpretation of clinical ultrasonographic images. Despite its limitations, ultrasonography serves as a valuable diagnostic tool when MRI is unavailable.

Fig. 2. Dorsal view and transverse section of the foot demonstrating the planes used for transverse (A) and longitudinal (B) images. (A) Four different transverse images are obtained using an increasing proximodistal angulation of the ultrasound (US) beam with the probe on the coronary band (dotted lines T1-T4). Images T1, T2, T3, and T4 correspond to a proximodistal angulation of approximately 10°-15°, 15°-20°, 25°-30°, and 45°-50°, respectively. (B) Three different longitudinal images are obtained using an increasing dorsopalmar angulation of the US beam (dotted lines L1-L3). Images L1, L2, and L3 correspond to a dorsoabaxial–palmaroaxial angulation of approximately 5°-10°, 15°-20°, and 25°-30° to the frontal plane, respectively.

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