Ultrasound of the Metacarpal/Metatarsal and Pastern Regions: Basic or Challenging?

Ultrasound of the metacarpal/metatarsal and pastern regions: Basic or challenging?

Ultrasound is the most widely used imaging modality for evaluating the soft tissues in the horse. It is practical and can be used to image a large range of structures that cause lameness in pleasure and sport horses. Because injury of the tendons and ligaments at the palmar aspect of the metacarpus, metatarsus and pastern is often responsible for lameness, equine practitioners and specialists routinely examine these areas. Although these regions are frequently scanned, it is not always easy, even for more experienced ultrasonographers. This presentation will focus on frequently encountered difficulties during ultrasonographic examination of the palmar/plantar MC/MT and pastern areas, with a continuous reflexion on the normal appearance and normal variants of the imaged structures. Most important artefacts and pitfalls will be discussed. An ultrasound exam starts with a proper patient preparation and good knowledge of your ultrasound machine. Optimizing the settings of the ultrasound machine improves the image quality significantly and makes it easier to find pathology. After choosing a proper transducer and transducer frequency, the most important settings that constantly need to be optimized are depth, focal zone, overall gain and time compensated gain. When intensely focussed on finding a lesion and an owner with high expectation standing next to you, adjusting the settings on your machine is easily forgotten. The influence of using suboptimal settings on image quality are discussed and demonstrated. […]