Ultrasonographic appearance of normal and injured lateral patellar ligaments in the equine stifle.
Abstract: Ultrasound is widely used in horses with stifle lameness, yet limited information is available regarding the appearance of normal and injured lateral patellar ligaments (LPL). Objective: To map the normal ultrasonographic appearance of the LPL. To describe the clinical and ultrasonographic features of LPL injuries. Methods: Descriptive study of healthy horses and retrospective case series. Methods: Twelve horses without stifle lameness underwent ultrasonographic examination of bilateral LPLs and ultrasonographic features were recorded. Eighteen horses with LPL injury were identified from 1999 to 2011. Results: The normal LPL changes in appearance from origin to insertion. It shows ill-defined margins at the patella, becomes flattened and bilobed over the lateral trochlear ridge, is oval-triangular shaped with variable echogenicity and fibre pattern distal to the LTR, and becomes tapered with striations at the tibial insertion. LPL injury was identified in 18 horses of multiple breeds and uses. All injuries were acute, and 12 had wounds. Eleven horses were severely lame (grade 4-5/5). Ultrasonographic lesions were severe in 78% of cases. The mid to insertional portion of the LPL was most often affected. Radiography showed fractures of the tibial tuberosity (n = 6), patella (n = 4) and lateral trochlear ridge (n = 1). Fractures involved LPL attachments in 9 horses. Five were treated for osteomyelitis and one for synovial sepsis. Recheck ultrasound in 4 horses showed minimal to no change in the appearance of LPL injuries. Nine horses returned to riding, one continued as a broodmare, 2 were retired, one became a broodmare, 2 were lost to follow-up and 3 were subjected to euthanasia owing to concurrent injuries. Conclusions: Normal variations in shape, echogenicity and fibre pattern of the LPL are important considerations to prevent false positive diagnoses during ultrasonography. LPL injuries were often severe and associated with craniolateral stifle trauma. Prognosis varied from good to guarded in horses without additional severe injuries.
© 2015 EVJ Ltd.
Publication Date: 2015-05-29 PubMed ID: 25808465DOI: 10.1111/evj.12444Google Scholar: Lookup
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- Journal Article
Summary
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The research explores the use of ultrasound in diagnosing injuries to the lateral patellar ligaments (LPL) in horses, determining the normal LPL appearances and various characteristics of LPL injuries.
Research Methodology
- The study took a descriptive and retrospective approach using a selection of healthy horses and documented cases of LPL injury between 1999 and 2011.
- Both healthy and injured horses were of various breeds and uses.
- For the healthy group, 12 horses with no stifle lameness underwent ultrasound scans of bilateral LPLs. The ultrasound features were meticulously noted and recorded.
- Approaching injured cases, the researchers selected 18 horses with identified LPL injuries.
Results of the Research
- The study found that a normal LPL under ultrasound shows a change in appearance starting from its origination to the point of insertion. It begins with ill-defined margins at the patella and evolves into various shapes and patterns until it becomes tapered with striations at the tibial insertion.
- The injured LPL was observed to have severe ultrasound lesions in about 78% of cases, predominantly affecting the mid to insertion portion of the LPL.
- Concurrent injuries were common as the study found fractures in the tibial tuberosity, lateral trochlear ridge, and the patella, often involving LPL attachments. Five of the cases underwent treatment for osteomyelitis and one for synovial sepsis.
- Upon follow-up, some horses showed little to no change in the appearance of their LPL injuries on ultrasound. The post-treatment results for the horses varied with some returning to riding, others retiring, and a few subjected to euthanasia due to other concurrent injuries.
Conclusions and Implications of the Study
- The study highlights the importance of understanding normal variations in the shape, echogenicity, and fibre pattern of the LPL during ultrasonography to avoid false positive diagnoses.
- It also indicates that LPL injuries are frequently severe and associated with craniolateral stifle trauma.
- Although the prognosis differed widely, often good to guarded in horses without additional severe injuries were reported.
Cite This Article
APA
Gottlieb R, Whitcomb MB, Vaughan B, Galuppo LD, Spriet M.
(2015).
Ultrasonographic appearance of normal and injured lateral patellar ligaments in the equine stifle.
Equine Vet J, 48(3), 299-306.
https://doi.org/10.1111/evj.12444 Publication
Researcher Affiliations
- William R Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, USA.
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, USA.
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, USA.
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, USA.
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, USA.
MeSH Terms
- Animals
- Female
- Horse Diseases / pathology
- Horses
- Male
- Patellar Ligament / diagnostic imaging
- Patellar Ligament / injuries
- Patellar Ligament / surgery
- Stifle / diagnostic imaging
- Stifle / injuries
- Ultrasonography / veterinary
Citations
This article has been cited 3 times.- Law E, Wright L, Uhlhorn M, Hernlund E, Nilemo C, Rhodin M. Hypoechoic ultrasonographic findings in the patellar ligaments are common in riding and trotting horses in training (116 cases). Vet Radiol Ultrasound 2025 Jan;66(1):e13446.
- Schöpper H, Egerbacher M. Arterial Blood Supply of the Stifle Joint in Horses. Animals (Basel) 2024 Apr 24;14(9).
- Fjordbakk CT, Marques-Smith P. The equine patellar ligaments and the infrapatellar fat pad - a microanatomical study. BMC Vet Res 2023 Jan 23;19(1):20.
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