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1.
Charles R.  Pugh  DVM  MS  Phillip J.  Johnson  BVSc  MS  Gregory  Crawley  DVM  MS  Susan T.  Finn  DVM  MS 《Veterinary radiology & ultrasound》1994,35(3):183-188
The equine shoulder region is difficult to investigate by conventional imaging modalities. Diagnostic ultrasound has proven valuable for investigation of soft tissue injuries of the human shoulder. In a horse with shoulder lameness, the authors employed diagnostic ultrasound to augment the use of conventional radiography. A defect in the subchondral bone layer of the medial humeral tuberosity, with adjacent bony fragments were clearly identified with ultrasound. Ultrasound was used for initial evaluation of the bicipital tendon and bursa. The technique was subsequently used to follow and evaluate the post-operative condition of the proximal cranial humerus, bicipital tendon and bursa in this patient. The bicipital regions of 2 immature and 3 adult normal horses were also examined with to illustrate the normal ultrasonographic anatomy of the cranial shoulder region.  相似文献   

2.
This study was intended to document normal ultrasonographic appearance of the equine shoulder and anatomic landmarks useful in clinical imaging. Both forelimbs of five equine cadavers and both forelimbs of six live adult horses were used. To facilitate understanding of the images, a zoning system assigned to the biceps brachii and to the infraspinatus tendon was developed. Ultrasonography was performed with a real-time B-mode semiportable sector scanner using 7.5- and 5-MHz transducers. On one cadaver limb, magnetic resonance imaging (MRI) was performed using a system at 1.5 Tesla, T1-weighted spin-echo sequence. Ultrasonography images were compared to frozen specimens and MRI images to correlate the ultrasonographic findings to the gross anatomy of the shoulder. Ultrasonography allowed easy evaluation of the biceps brachii and the infraspinatus tendon and their bursae, the supraspinatus muscle and tendons, the superficial muscles of the shoulder, and the underlying humerus and scapula. Only the lateral and, partially, the caudal aspects of the humeral head could be visualized with ultrasound. Ultrasonographic appearance, orientation, and anatomic relationships of these structures are described. Ultrasonographic findings correlated well with MRI images and with gross anatomy in the cadavers' limbs.  相似文献   

3.
To provide a series of detailed ultrasonographic images of the canine calcaneal tendon, greyhound cadaver pelvic limbs were scanned with a high-resolution transducer, and images compared with dissected specimens. The three components of the calcaneal tendon are the tendons of insertion of the gastrocnemius, superficial digital flexor, and a conjoined tendon formed by tendons from the biceps femoris, semitendinosus, and gracilis. Each of these three tendons was visible in transverse ultrasound images, each measuring 2.4-3.2-mm thick at mid-calcaneal tendon. Improved understanding of the anatomy of the calcaneal tendon will support clinical ultrasonography of this region.  相似文献   

4.
REASONS FOR PERFORMING STUDY: Centesis of the bicipital bursa using an 8.9 cm long spinal needle has been reported but the alternative of employing a 3.8 cm long hypodermic needle requires validation. OBJECTIVE: To compare the efficacy of 2 different methods of centesis of the bicipital bursa and to evaluate the usefulness of ultrasonographic imaging to determine the location of solution administered when centesis of the bursa is attempted. METHODS: For Trial 1, 6 clinicians, who had no previous experience of centesis of the bicipital bursa, attempted to inject a solution composed of an aqueous radiopaque contrast medium and physiological saline solution (PSS) into the bicipital bursae of 2/12 horses using the previously described distal approach to inject one bursa and a proximal approach to inject the contralateral bursa. The bicipital tendon and bursa were examined ultrasonographically before and after injection; and both shoulders were examined radiographically to identify the location of the medium. In Trial 2, another 6 clinicians, also with no previous experience of centesis, repeated Trial 1, using 6 horses, but the radiopaque contrast medium was mixed with air instead of PSS. RESULTS: Accuracy of centesis using the proximal approach was 39% and that of the distal approach 28%. Ultrasonographic examination of the shoulder allowed the location of solution and air to be accurately predicted in all 12 shoulders examined. CONCLUSIONS: Clinicians who have had no previous experience performing centesis of the bicipital bursa are unlikely to be successful in centesis using either approach. Radiographic examination after injecting a radiopaque contrast medium may be necessary to assess the success of centesis especially if bursal fluid is not obtained during centesis. Injecting air along with the radiopaque contrast medium provides more accurate ultrasonographic confirmation of centesis and better radiographic definition than does injection without air.  相似文献   

5.
Severe, chronic lameness in the left forelimb of a five-year-old Arab stallion was localised to the bicipital bursa by local anaesthesia and gamma scintigraphy. Radiographic and ultrasonographic examinations of the proximal humeral tubercles and bicipital bursa revealed new bone production in the region of the intertubercular grooves and irregularities in the density of the soft tissues of the bicipital tendon and bursa. An endoscopic examination of the bicipital bursa with a standard arthroscope under general anaesthesia was a useful diagnostic procedure. The stallion was euthanased, and marked fibrocartilage fibrillation and formation of adhesions were found postmortem, confirming a diagnosis of chronic fibrinous bursitis.  相似文献   

6.
ULTRASONOGRAPHIC ANATOMY OF THE NORMAL CANINE STIFLE   总被引:1,自引:0,他引:1  
Ultrasonographic examination of the normal canine stifle joint was performed to characterize its normal anatomy. Stifles of four normal adult dogs were imaged in sagittal and transverse planes and each anatomic structure visualized was recorded. Normal anatomic structures consistently seen included the patellar tendon, medial and lateral menisci, the cranial cruciate ligament and femoral condyle cartilage. The caudal cruciate ligament was visualized in two dogs. Collateral ligaments and meniscal ligaments were not visualized. The dogs were then euthanized and each stifle was isolated. Following removal of superficial muscles and skin, each stifle was imaged in a water bath to definitively identify the structures that had previously been visualized on the live dogs. The ultrasonographic appearance of the isolated stifle specimens was similar to that found in live dogs. The results of this study indicate that ultrasound can be used to image the normal anatomy of the canine stifle. The echogenicity of the patellar ligament, cruciate ligaments, menisci and articular cartilage was similar to that previously reported in equine stifles and human knees.  相似文献   

7.
The left and right shoulder region of 19 healthy cattle and the left and right shoulders of six bovine cadavers were examined ultrasonographically using a 7.5 MHz linear and a 3.5 MHz convex transducer. The lateral shoulder muscles were successfully imaged in all cases; the joint space appeared as a funnel shaped interruption of the hyperechoic bone surfaces of the distal part of the scapula and the proximal and lateral part of the humeral head. In healthy cattle, the synovial cavities of the scapulohumeral joint, the bicipital bursa and the infraspinous bursa could not be clearly defined. After experimental filling with water, the synovial cavities could be differentiated as discrete anechoic zones. In this study, the normal ultrasonographic appearance of the soft tissue structures and bone surfaces of the scapula and proximal humerus is presented, providing basic reference data for the ultrasonographic evaluation of the bovine shoulder region.  相似文献   

8.
Rupture of the biceps brachii tendon sheath was diagnosed in two dogs which were presented with chronic thoracic limb lameness. In each case, diagnosis was achieved by positive contrast arthrography, which revealed obvious leakage of contrast agent from the distal portion of the tendon sheath. Arthroscopy was performed in each affected shoulder joint and no other significant lesions were found. In one dog, concomitant bicipital tendinopathy was confirmed by histopathology. Both dogs were treated by bicipital tendon transposition, and tenodesis and both showed improvement in the degree of lameness following surgery. Tearing of the biceps brachii tendon sheath has not been reported previously but should be included in the differential diagnosis for shoulder lameness in the adult dog.  相似文献   

9.
AIM: To describe the clinical, radiographic, and sonographic features of 15 dogs with bicipital tendinitis and tenosynovitis, classify them according to cause, and evaluate the long-term efficacy of treatment. METHODS: Dogs exhibiting forelimb lameness with pain localised to the biceps tendon were included in the study. Sonographic examination of the tendon and tendon sheath, and radiographic examination including positive contrast arthrograms of the shoulder joint were performed, and assessed for features consistent with biceps tendon disease. In some cases, synovial-fluid analysis and surgical investigation were also undertaken. The causes of the conditions were classified as either traumatic, mechanical, neoplastic or inflammatory. Dogs were treated conservatively with rest and anti-inflammatory drugs, or surgically by either transection of the transverse humeral ligament or tenodesis of the biceps tendon. Assessment of the effects of treatment was made by re-examination at six weeks and from information gained by telephone interview with the dog's owner at longer-term follow-up. RESULTS: Bicipital tendinitis and tenosynovitis were common causes of forelimb lameness in active, middle-aged or older, medium to large-breed dogs. The most sensitive physical tests for localising pain to the biceps apparatus were shoulder flexion with the elbow extended, focal digital pressure applied directly to the biceps origin, and the biceps retraction test. Sonographic assessment was found to be more sensitive than shoulder radiography or arthrography for characterising the lesion. Conservative treatment of 11 traumatic cases resulted in good or excellent function at long-term follow-up. One mechanical bicipital tendinitis secondary to mineral deposits within the supraspinatus tendon improved following transection of the transverse humeral ligament and removal of the deposits. One of two cases of inflammatory tendinitis/ tenosynovitis improved following tenodesis. One dog with neoplastic disease did not improve and was euthanased. CONCLUSIONS: The diagnosis of bicipital tendinitis and tenosynovitis requires a careful examination using a combination of physical tests. Of the ancillary tests, sonography was the most reliable, however information gained from all tests was useful in fully evaluating the biceps apparatus and shoulder joint. The classification system employed in this study was helpful in selecting a treatment protocol and determining the likely prognosis.  相似文献   

10.
This paper describes seven dogs with traumatic bicipital tenosynovitis in which complete clinical, radiographic, and surgical evaluations were performed. All were adult dogs of medium to large breed and were presented with a chronic front limb lameness of several months' duration and shoulder muscle atrophy. Survey radiographs of the scapulohumeral joint showed new bone production almost exclusively in the region of the biceps tendon, i.e., the intertubercular groove and the supraglenoid tuberosity. Arthrograms in six of seven dogs revealed difficulty in filling or irregular filling of the bicipital tendon sheath, best seen on the mediolateral view of the shoulder. On surgical exploration, macroscopic lesions of the tendon and/or the sheath were observed in all dogs and included adhesions, fibrosis, scar tissue, edema, and thickening. Partial tear of the tendon was observed in three dogs.  相似文献   

11.
OBJECTIVE: To determine the clinical and pathologic findings in dogs with primary bicipital tenosynovitis. ANIMALS: 19 dogs with 20 shoulder joints treated surgically for bicipital tenosynovitis and 8 shoulder joints from 4 clinically normal dogs. PROCEDURE: Histologic abnormalities of tendon sheaths of the biceps brachii in affected dogs were determined by use of comparison with findings in clinically normal dogs. Specimens were graded for inflammation, fibrosis, villous hypertrophy, vascular prominence, and synovial cell proliferation. Histopathologic results were statistically evaluated for relationship with clinical findings and treatment before surgery. RESULTS: Synovial villous hypertrophy and vascular prominence were the most consistent histologic findings in 16 and 14 of 20 affected joints, respectively. Evidence of inflammation was lacking in 6 joints. Ten joints had inflammatory cell infiltration of the tendon sheath. Plasma cells and lymphocytes were the most common infiltrates; however, the type and amount of inflammatory cell infiltrate were variable. Fibrosis of the tendon sheath was seen in 8 joints, and synovial cell proliferation was seen in 11 joints. Other changes included accumulation of hemosiderin, focal calcification, osseous metaplasia, lysis of collagen, and fibrocartilaginous metaplasia. No significant relationship was detected between histopathologic findings and clinical findings or treatment before surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Inflammation was more variable than hypothesized and may not be a consistent pathophysiologic feature of bicipital tenosynovitis. In some dogs, this disease may be the result of a degenerative process rather than an inflammatory process.  相似文献   

12.
The accuracy of a technique for centesis of the bicipital bursa using a 9 cm, spinal needle inserted through the tendon of the biceps brachii muscle was evaluated. A veterinary radiologist who had no previous experience of performing centesis of the bicipital bursa and an equine clinician who had little experience in performing the procedure, attempted to inject a solution of aqueous radiopaque contrast medium into the bicipital bursae of 8 horses using an approach in which the bursa was accessed by directing a needle through the tendon of origin of the biceps brachii muscle until cartilage in the lateral portion of the intertubercular groove was contacted. Centesis of the bicipital bursa using this approach in horses having no signs of disease of the bursa was consistently successful if the cubital joint was flexed and the scapulohumoral joint extended.  相似文献   

13.
Ultrasonographic examination is an essential diagnostic tool that complements radiographic examination in the diagnostic work-up of injury to the tuber calcanei area. Using a plantar approach, the superficial digital flexor tendon, gastrocnemius tendon, the bone surfaces of the two lobes of the tuber calcanei and the gastrocnemius bursa and the calcaneal bursa of the superficial digital flexor tendon (if distended) can be accurately assessed. Using a collateral approach, the tenocalcaneal ligaments of the superficial digital flexor tendon and the branches of the calcaneal tendon of the caudal femoral muscles can be imaged. This paper describes the normal anatomy of the tuber calcanei area and presents the complete ultrasonographic procedure and normal ultrasonographic images of this region.  相似文献   

14.
Ultrasonography of the shoulder is of interest in the diagnosis of proximal forelimb lameness. The proximal tendon of the biceps brachii (PTBB) and its associated structures are frequently injured and should be included in the routine ultrasonographic examination of the shoulder. This paper describes a complete ultrasonographic procedure for examining the bicipital apparatus, on transverse and longitudinal scans, from the insertion of the PTBB on the supraglenoid tubercle to the muscle body below the intertubercular sulcus.  相似文献   

15.
OBJECTIVE: To describe the ultrasonographic appearance of the normal and diseased biceps brachii tendon and its tendon sheath in dogs. STUDY DESIGN: A prospective clinical study. ANIMALS: One hundred twenty client-owned dogs. METHODS: In the first part of the study, the ultrasonographic appearance of the normal biceps brachii muscle and the surrounding soft tissue was determined in 27 healthy dogs. Standard views were described and established. In the second part, 120 dogs with suspected pathology of the biceps brachii muscle were examined ultrasonographically. Fifty-five of these dogs had no sonographic changes, and 65 dogs had sonographically detectable pathologic changes of the tendon or the tendon sheath or both. The mean age of the affected dogs was 3.7 years. The ratio of males to females was 1.95:1. Sedation or anesthesia of the dogs was required because of the extreme movements of the leg necessary for the examination. To achieve a perpendicular view of the tendon and the tendon sheath, the area of the shoulder joint was rotated outward and abducted as far as possible. Examination of the muscle-tendon apparatus of the biceps brachii muscle was divided into 4 main sections. RESULTS: Linear transducers (7.5-10 MHz) allowed the soft tissue structures to be easily visualized with ultrasonography. Pathologic changes of the tendon and tendon sheath were visualized sonographically by using high-frequency linear probes. Partial or complete tendon rupture, medial luxation of the tendon, corpora libera in the tendon sheath, and tenosynovitis were clearly shown. CONCLUSIONS: High-frequency ultrasonography using linear transducers allows the examiner to accurately define the pathologic changes in the region of the biceps brachii tendon in dogs. CLINICAL RELEVANCE: The use of sonography for diagnosis of disease processes of the tendon and tendon sheath of the biceps brachii muscle complements clinical and radiographic examination findings.  相似文献   

16.
17.
CASE DESCRIPTION: 3 horses with penetrating wounds to the shoulder area were examined because of forelimb lameness. CLINICAL FINDINGS: All horses had physical examination findings (decreased cranial phase of the stride, swelling in the shoulder region, and signs of pain on manipulation of the shoulder) that were suggestive of problems in the upper portion of the forelimb. Injury to the biceps tendon or bursa was the primary differential diagnosis in each instance, but no abnormalities involving those structures were found. Radiographic and ultrasonographic imaging revealed injuries to the caudal eminence of the greater tubercle of the humerus, the infraspinatus tendon, and the infraspinatus bursa. Examination with ultrasound was more sensitive than radiography at detecting both osseous and soft tissue changes. TREATMENT AND OUTCOME: All 3 horses responded favorably to treatment with antimicrobials and non-steroidal anti-inflammatory drugs. Although initial response to standing lavage was favorable in 1 horse, endoscopic lavage was later required. Standing removal of fracture fragments was performed in 2 horses. Ultrasonographic imaging was helpful in monitoring the response to treatment and changes in the affected structures. All 3 horses eventually became sound after treatment. CLINICAL RELEVANCE: Infraspinatus bursitis and tendonitis should be included in the differential diagnoses of horses with shoulder lameness. Diagnosis and monitoring should include ultrasonographic monitoring. The prognosis for return to soundness after appropriate treatment appears to be good.  相似文献   

18.
This study evaluates 76 cases of shoulder instability in dogs, functional outcome after treatment, and the effectiveness of medial biceps tendon transposition using a metallic staple. Clinical examinations of the shoulder were performed and radiographs were taken. Conservative treatment or surgery (biceps tendon transposition or arthrodesis) was then opted for on the basis of type of instability, associated lesions and dog (age, weight, behaviour). Long-term functional outcome was categorized as 'excellent', 'good', 'average' or 'poor'. In our series, the most frequently affected breed was the Poodle (13%). Humeral head intermittent displacement was either medial (80%), lateral (19%) or cranial (1%). On clinical examination, 97% of the animals experienced pain. In anaesthetised dogs, shoulder instability was observed in 90% of the population. Muscle atrophy (33%) and associated radiographic lesions (34%) were less frequent. Ninety-five percent of the dogs were treated surgically, either by bicipital tendon transposition (81%) or by shoulder arthrodesis (19%). Results were 'good' to 'excellent' in 25% of the animals treated conservatively, and in 84.5% and 87.5%, respectively, in those treated by tendon transposition and arthrodesis. Complications did not arise from the use of a metallic staple to anchor the tendon during medial transposition. Tendon transposition or arthrodesis resulted in a good functional outcome in more than 80% of the dogs with shoulder instability. During the medial transposition, the biceps tendon was easily and effectively stabilized using a metallic staple.  相似文献   

19.
Objective— To evaluate the diagnostic potential of magnetic resonance imaging (MRI) compared with a reference standard, arthroscopic and/or open surgery, in dogs with soft tissue shoulder pathology. Study Design— Retrospective study. Animals— Dogs (n=21). Methods— Magnetic resonance (MR) images were retrospectively evaluated in 21 dogs that had surgically identified soft tissue shoulder pathology. The musculotendinous units of the biceps, infraspinatus, teres minor, supraspinatus, subscapularis, and the medial and lateral glenohumeral ligaments (MGHL and LGHL) were graded as either normal or abnormal. Abnormal structures were further classified as being either inflamed, partially torn, or fully torn. Impingement of the biceps tendon was also evaluated. Results were reported in terms of agreement and concordance between MRI findings and surgical findings. Agreement was defined as the percentage of times MRI findings concurred with surgical findings with respect to a structure being either normal or abnormal. Concordance was defined as the percentage of times MRI concurred with the exact surgically assessed pathology when abnormality was identified. Results— The findings were biceps tendon: 90% agreement with 100% concordance; subscapularis: 95% agreement with 62% concordance; MGHL: 84% agreement with 83% concordance; LGHL: 88% agreement with 100% concordance; infraspinatus: 100% both agreement and concordance; biceps tendon impingement: 90% agreement with 100% concordance. Conclusions— Soft tissue abnormalities of the canine shoulder were readily identified on preoperative MR images. Clinical Relevance— MRI shows great potential as a diagnostic tool in the evaluation of canine shoulder disease.  相似文献   

20.
High-resolution, real-time ultrasonographic examinations of the neck were performed on eight normal dogs maintained under general anesthesia. Water-soluble dye was injected into imaged structures under sonographic guidance in two dogs. The anatomy of the neck was verified at postmortem by visualization of dye deposited in the injected structures. Anatomical mapping was then completed by performing complete cervical ultrasound examinations in the remaining six dogs. Normal ultrasonographic anatomy of the canine neck and major anatomic landmarks useful in clinical imaging are described.  相似文献   

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