Current and Emerging Quantitative Imaging Modalities for Diagnosing and Monitoring Equine Tendon and Ligament Injuries.
Authors: R. Urion, Meghann Lustgarten, E. Hostnik
Journal: The Veterinary clinics of North America. Equine practice
Summary
# Editorial Summary Technological advances in diagnostic imaging are fundamentally reshaping how equine veterinarians detect, characterise and track tendon and ligament injuries beyond conventional ultrasound and radiography. This review synthesises three emerging quantitative approaches: elastography techniques that measure tissue stiffness and strain mechanics, advanced computed tomography including PET/CT fusion and dual-energy protocols, and diffusion-weighted MRI which reveals fibre microstructure and functional integrity at the cellular level. Collectively, these modalities address critical diagnostic gaps by enabling earlier detection of subclinical damage, providing objective assessment of structural continuity during rehabilitation, and offering prognostic information about functional recovery—capabilities that conventional imaging cannot reliably deliver. For equine practitioners, integration of these tools into diagnostic protocols offers the potential to refine clinical decision-making, optimise rehabilitation timelines, and ultimately improve outcomes for performance and leisure horses with soft tissue injuries. As these technologies become more accessible and standardised, understanding their complementary strengths relative to traditional methods will be essential for evidence-based clinical practice.
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Practical Takeaways
- •Consider requesting advanced imaging modalities (elastography, dual-energy CT, or diffusion-weighted MRI) when conventional ultrasound or radiographs are inconclusive, particularly for early-stage or subtle injuries
- •These quantitative techniques can provide objective data on tissue healing and functional recovery, helping inform more evidence-based decisions about return-to-work timelines
- •Elastography ultrasound may be accessible through referral centers and offers real-time assessment of tissue quality without radiation exposure
Key Findings
- •Elastography ultrasonography can assess tissue stiffness and strain properties beyond traditional ultrasound capabilities
- •PET/CT fusion and dual-energy CT provide enhanced diagnostic capabilities for detecting structural changes in tendons and ligaments
- •Diffusion-weighted MRI enables evaluation of fiber microstructure and functionality to monitor healing progression
- •Emerging quantitative imaging modalities improve detection of early injuries and prediction of functional outcomes compared to conventional imaging