Ultrasound anatomy of the palmar canine carpus

VRU 2023- 649(3): 546-556

Background: The palmar region of the canine carpus may be affected by various disorders that require diagnostic imaging. However, the normal ultrasonographic anatomy of this region is not well described in the literature.

Study: The authors conducted a prospective, descriptive, anatomic study to describe the normal ultrasonographic characteristics of the main palmar structures of the carpus in medium to large-breed dogs, and to establish a standardized ultrasonographic protocol for evaluating them.

Methods: The study consisted of two phases: an ex vivo phase, in which 54 cadaveric specimens were examined by simultaneous ultrasound and dissection; and an in vivo phase, in which 25 carpi of 13 living healthy dogs were examined by ultrasound. The structures identified and described were: the flexor carpi radialis tendon, the retinaculum flexorum, the flexor digitorum superficialis tendon, the carpal canal and its contents, the flexor carpi ulnaris muscle, and the ulnar nerve.

Results: The authors provided detailed descriptions and images of the normal ultrasonographic appearance of the palmar carpal structures, as well as a step-by-step protocol to approach them systematically. They also compared their findings with the available anatomical and ultrasonographic literature, highlighting the similarities and differences.

Limitations: The study was limited by the small sample size, the lack of comparison with other imaging modalities, and the possible influence of breed, age, and body condition on the ultrasonographic features of the palmar carpal structures.

Conclusions: The study provided valuable information on the normal ultrasonographic anatomy of the palmar region of the canine carpus, which can serve as a reference for future clinical and research applications. The authors suggested that further studies are needed to validate their protocol and to assess the diagnostic utility of ultrasound for the evaluation of palmar carpal disorders in dogs.

Tendon of the flexor carpi radialis muscle in a right carpus (white arrows; all images). A-C, Palmar view of the dissected tendon in a right carpus. In A, the palmar common ligament is intact and the tendon runs deeply and medially. In B, the fibrocartilaginous tunnel was transected longitudinally, and in C, the tendon was removed to show the deep part of the tunnel. D, Transverse slices at the level of the discontinuous lines marked in C, and its ultrasonographic corresponding images. E and F, Longitudinal ultrasonographic images of the tendon at the intermedioradial carpal bone (E) and the enthesis (F). In the left corner below the longitudinal ultrasonographic images a scheme represents the position of the probe. B-mode ultrasound was performed using a linear transducer (6-18 MHz). Black arrow: the fibrocartilaginous tunnel; FDS: flexor digitorum superficialis muscle; FDP: flexor digitorum profundus muscle; IRB: intermedioradial carpal bone; IIMCB: second metacarpal bone.

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