Ultrasonographic examination of the palmar aspect of the pastern of the horse: Sesamoidean ligaments
Authors: Carnicer D., Coudry V., Denoix J.‐M.
Journal: Equine Veterinary Education
Summary
# Ultrasonographic examination of the palmar aspect of the pastern of the horse: Sesamoidean ligaments The distal sesamoidean ligaments (DSL) form a critical component of the fetlock's weight-bearing apparatus, yet their injuries have historically been underdiagnosed compared with suspensory ligament lesions, partly because ultrasound examination of the pastern region presents technical challenges due to irregular bone contours and image artefacts. Carnicer and colleagues evaluated standardised ultrasonographic protocols for assessing the DSL, leveraging advances in probe technology and MRI correlation to establish reliable diagnostic imaging criteria. Their work demonstrated that DSL desmitis is considerably more prevalent in lame horses than previously recognised, with these injuries frequently occurring alongside other structural damage that substantially influences treatment decisions and prognostic outcomes. For practitioners, this research underscores the importance of meticulous pastern ultrasonography as a routine component of lameness investigation—particularly when other common sites appear unaffected—since missed DSL pathology can lead to persistent or recurrent lameness and suboptimal recovery trajectories. Understanding the ultrasonographic appearance of normal and injured DSL structures is essential for accurate diagnosis and appropriate case management in both performance and racing populations.
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Practical Takeaways
- •Consider DSL injuries in your lameness workup more frequently than historically recommended, as modern imaging shows these are common culprits in pastern-related lameness
- •Ultrasonographic assessment of the pastern requires adapted probes and careful technique to overcome imaging challenges in this region; MRI may provide better visualization when ultrasound is inconclusive
- •Always evaluate the entire suspensory apparatus when DSL injury is identified, as concurrent lesions are common and will affect prognosis and rehabilitation planning
Key Findings
- •DSL lesions are more frequently implicated in equine lameness than previously suspected, as revealed by advances in MRI and ultrasonography
- •Ultrasonography is valuable for assessing DSL desmitis, though the pastern region is technically more challenging to scan than the metacarpal area due to small irregular contact surfaces and imaging artifacts
- •DSL injuries are often associated with other injuries to the suspensory apparatus that can modify patient prognosis and management