case_images: PMC4672201_01
case_images: Longitudinal anatomical section of the proximal metacarpus showing the origin of the proximal third interosseus muscle (suspensory ligament) over the third metacarpal bone and distal carpus. 1 - suspensory ligament; 2 - third metacarpal bone; 3 - deep palmar metacarpal vascular anastomosis; 4 - accessory ligament of the deep digital flexor tendon; 5 - deep digital flexor tendon; 6 - superficial digital flexor tendon; 7 - skin (A). Computer tomography demonstrated a mild to moderate bone remodeling (white arrows) and sclerosis (black arrows) at the proximal aspect of the third metacarpal bone at the insertion of the suspensory ligament (B).
case_images: fvets-02-00049-g001.jpg
case_images: PMC4672201_01_fvets-02-00049-g001.jpg
case_images: F1
case_images: In mutual agreement with the owner, computed tomography was performed in order to further evaluate the palmar aspect of the proximal third metacarpal bone (Figure 1A). This was more pronounced medially, with the presence of a large osteophyte axially (Figure 1B). Moreover, a moderate sclerosis at the medial aspect of the proximopalmar third metacarpal bone was present (Figure 1B).
case_images: Transverse (encircled lesion area) and longitudinal (arrow in lesion area) ultrasound images of the proximal aspect of the lateral lobe of the suspensory ligament performed at T0, T4 (12 weeks), and T5 (16 weeks). At T0, a clear hypo-echoic area could be noticed on both ultrasounds. At T4, only limited remaining hypo-echoic areas were noticed, whereas this clearly reduced at T5.
case_images: fvets-02-00049-g002.jpg
case_images: PMC4672201_02_fvets-02-00049-g002.jpg
case_images: F2
case_images: At T0 and T1, the horse received a score 1, which corresponded with the initiation of lesion filling with the presence of hypo-echoic areas, a moderate diffuse decrease in echogenicity, lacking of a parallel fiber pattern and 0-25% fiber alignment (Figure 2). At 4 weeks after the second injection (T5), a score of 4 was given, which indicated hardly any demarcation between injured and healthy tissue, faint hypo-echoic areas, an almost total fiber alignment and very mild increased thickness (Figure 2).
case_images: PMC4672201_02
case_images: Transverse (encircled lesion area) and longitudinal (arrow in lesion area) ultrasound images of the proximal aspect of the lateral lobe of the suspensory ligament performed at T0, T4 (12 weeks), and T5 (16 weeks). At T0, a clear hypo-echoic area could be noticed on both ultrasounds. At T4, only limited remaining hypo-echoic areas were noticed, whereas this clearly reduced at T5.
case_images: fvets-02-00049-g002.jpg
case_images: PMC4672201_02_fvets-02-00049-g002.jpg
case_images: F2
case_images: At T0 and T1, the horse received a score 1, which corresponded with the initiation of lesion filling with the presence of hypo-echoic areas, a moderate diffuse decrease in echogenicity, lacking of a parallel fiber pattern and 0-25% fiber alignment (Figure 2). At 4 weeks after the second injection (T5), a score of 4 was given, which indicated hardly any demarcation between injured and healthy tissue, faint hypo-echoic areas, an almost total fiber alignment and very mild increased thickness (Figure 2).