The angle contrast ultrasound technique in the flexed limb improves assessment of proximal suspensory ligament injuries in the equine pelvic limb
Authors: Denoix J.‐M., Bertoni L.
Journal: Equine Veterinary Education
Summary
# Editorial Summary Diagnosing proximal suspensory ligament (PSL) injuries in the equine hindlimb presents a genuine clinical challenge due to the anatomically complex proximal metatarsal region, which can obscure pathology during standard ultrasonographic examination. Denoix and Bertoni demonstrated that employing an angle contrast ultrasound technique with the limb flexed substantially improves visualisation of PSL desmopathies and enthesopathies, yielding subjectively superior sensitivity compared to conventional imaging approaches. Whilst ultrasonography inherently struggles to characterise deep osseous involvement, integration with additional imaging modalities yields comprehensive diagnostic information about the full extent of injury affecting soft tissue and skeletal structures alike. Beyond diagnosis, this refined ultrasound protocol enables clinicians to stage lesions accurately and longitudinally monitor the repair process throughout rehabilitation, facilitating evidence-based prognostication regarding the horse's realistic return to competitive function. For farriers, veterinarians, and physiotherapists managing PSL-lame horses, adopting the flexed-limb angle contrast technique represents a practical, accessible means of substantially improving diagnostic confidence and tailoring individualised recovery protocols with greater precision.
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Practical Takeaways
- •Request flexed-limb, angle contrast ultrasound technique when evaluating hindlimb proximal suspensory ligament injuries for better diagnostic accuracy than standard scanning
- •Use serial ultrasound examinations to monitor healing progression and guide rehabilitation protocols, adjusting intensity based on tissue repair stage
- •Combine ultrasound with other imaging modalities (radiography, MRI) to fully assess deep bone involvement alongside soft tissue damage
Key Findings
- •Angle contrast ultrasound technique in the flexed limb improves assessment of proximal suspensory ligament injuries in equine hindlimbs
- •The technique provides improved sensitivity compared with standard ultrasonographic approach for PSL pathology
- •Combined ultrasonography with other imaging procedures helps identify both soft tissue and deep osseous injuries
- •Ultrasonography allows monitoring of repair process to guide rehabilitation programs and establish return-to-work prognosis