Aspectos radiográficos e ultrassonográficos das regiões que causam claudicação na porção distal dos membros torácicos de equinos
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Data
2018-10-16
Autores
Restrepo Bucheli, Juan José
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Universidade Estadual Paulista (Unesp)
Resumo
O dígito do membro torácico recebe estresse, produto de inúmeros fatores relacionados à movimentação. Dentre as estruturas que compõe o aparelho locomotor, os tendões e ligamentos recebem as maiores tensões. Neste sentido, a ultrassonografia torna-se uma ferramenta importante na avaliação das lesões nessas estruturas, principalmente em se tratando das estruturas no estojo córneo. Pelo presente, buscou-se avaliar a incidência de lesões na porção distal dos membros torácicos de equinos, com sinais de claudicação, por meio da ultrassonografia. Adicionalmente, avaliou-se a incidência de calcificação das cartilagens alares pela radiografia. Foram avaliados 15 cavalos adultos, de raças variadas e ambos os sexos, com idade entre quatro e 14 anos, e peso entre 400 a 550 kg, com sinais de dor palmar. Após tricotomia do digito se realizou o registro ultrassonográfico longitudinal e transversal das estruturas palmares, a partir da falange proximal (F1) até a falange distal (F3), com transdutor linear multifrequencial de 7,5 -10 -12 MHz. Foram registradas as imagens transversais e longitudinais dos dois ligamentos colaterais da articulação interfalângica distal, sobre a borda coronária, na superfície dorsomedial e dorsolateral dos dígitos. A abordagem transcuneal foi realizada após casqueamento e nivelamento da ranilha. Foram obtidas radiografias dorsopalmares na busca de ossificação das cartilagens alares, e posterior medição para graduação, segundo escala de Ruohoniemi. Em 93,33% dos cavalos observou-se lesão em pelo menos um ligamento colateral da articulação interfalângica distal, acompanhada de ossificação das cartilagens alares grau 2, em 58% dos animais. Estruturas palmares como os ligamentos sesamoideos oblíquos (46,66%) e ligamento sesamoideo reto (53,33%) também apresentaram sinais ultrassonagráficos de lesão. Foram evidenciadas lesões suprasesamoideas, sesamoideas e infrasesamoideas no tendão flexor profundo dos dedos. Só foi evidente a correspondência entre o grau 1 e 3 de calcificação da cartilagem alar e a desmopatia do ligamento colateral da articulação interfalângica distal, caracterizada por perda do padrão ultrassonográfico e áreas de fibrose ou mineralização. Sempre que houve calcificação severa, foi evidente a lesão no osso navicular e estas foram acompanhadas de desmopatias do ligamento sesamoideo distal ímpar. As desmopatias dos ligamentos colaterais da articulação interfâlangica distal, nem sempre guardam correspondência com a calcificação da cartilagem alar ipsilateral. Quando a calcificação das cartilagens alares é severa, pode alterar a capacidade de amortecimento do dígito e a saúde do aparelho navicular.
The digits on equine forelimbs withhold a great variability of weight overload, mainly caused by motion. Bones are linked through tendons and ligaments, which recieve the greatest loads during the different phases of the stride. Ultrasound has become an important aid on evaluating these structures, since they are highly prone to lesion. To that purpose, we ought to evaluate t endinous and ligamentous lesions associated to distal limb lameness in horses by ultrasonographic examination of the distal limb. Furthermore, we studied the incidence of ungular cartilages ossification through radiographic examination. Fifteen adult horse s, males and females of different breeds, aging between four and 14 years and weighting 400kg to 550kg, presenting signs of lameness related to the distal limb were included on the study. Following clipping of the hair and skin cleansing of the distal port ion of both forelimbs (below metacarpofalangeal joint), an ultrasound examination of the palmar portion was carried out by using a multifrequencial transducer (7.5 - 10 - 12 MHz). Tendinous and ligamentous structures were assessed on longitudinal and transvers al planes. Colateral ligaments of the distal interfalangeal joints were also evaluated at the dorsal aspect of the limb, over the coronary band of the hoof. Aditionally, transcuneal examinaition was performed following trimming the hoof and levelling the f rog. After completion of ultrasonographic examination, dorsopalmar radiographs of both forelimbs were taken in order to grade ossification of the ungular cartilages by using the Ruohoniemi scale. 93,33% of the horses presented ultrasonographic signs of les sion in at least one collateral ligament of the distal inferphalangeal joint; ossification of the ungular cartilage grade 2 was percieved in 58% of the horses. Palmar structures such as oblique sesamoidean ligaments (46,66%), straight sesamoidean ligament (53,33%) also presented ultrasonographic signs of disruption. Suprasesamoidean, sesamoidean and infrasesamoidean lessions were observed on the deep digital flexor tendon. There were correspondence between the grade 1 and 3 of the ossification of the ungula r cartilages and the desmopathy of the collateral ligament of the distal interphalangeal joint, characterized by lost of the echographic pattern and the presence of fibrotic or mineralized areas. Ever the ossification was severe, it was accompanied by inju ries in the navicular bone. In addition, the navicular injuries were accompanied by desmopathies of the distal sesamoid impar ligament. The desmopathies of the collateral ligaments of the distal interphalangeal joint, does not always have correspondence re lationship with the ossification of the ipsilateral ungular cartilage. When the ossification of the ungular cartilages is severe, can disturb the ability of the digit to dampen, and the navicular apparatus health.
The digits on equine forelimbs withhold a great variability of weight overload, mainly caused by motion. Bones are linked through tendons and ligaments, which recieve the greatest loads during the different phases of the stride. Ultrasound has become an important aid on evaluating these structures, since they are highly prone to lesion. To that purpose, we ought to evaluate t endinous and ligamentous lesions associated to distal limb lameness in horses by ultrasonographic examination of the distal limb. Furthermore, we studied the incidence of ungular cartilages ossification through radiographic examination. Fifteen adult horse s, males and females of different breeds, aging between four and 14 years and weighting 400kg to 550kg, presenting signs of lameness related to the distal limb were included on the study. Following clipping of the hair and skin cleansing of the distal port ion of both forelimbs (below metacarpofalangeal joint), an ultrasound examination of the palmar portion was carried out by using a multifrequencial transducer (7.5 - 10 - 12 MHz). Tendinous and ligamentous structures were assessed on longitudinal and transvers al planes. Colateral ligaments of the distal interfalangeal joints were also evaluated at the dorsal aspect of the limb, over the coronary band of the hoof. Aditionally, transcuneal examinaition was performed following trimming the hoof and levelling the f rog. After completion of ultrasonographic examination, dorsopalmar radiographs of both forelimbs were taken in order to grade ossification of the ungular cartilages by using the Ruohoniemi scale. 93,33% of the horses presented ultrasonographic signs of les sion in at least one collateral ligament of the distal inferphalangeal joint; ossification of the ungular cartilage grade 2 was percieved in 58% of the horses. Palmar structures such as oblique sesamoidean ligaments (46,66%), straight sesamoidean ligament (53,33%) also presented ultrasonographic signs of disruption. Suprasesamoidean, sesamoidean and infrasesamoidean lessions were observed on the deep digital flexor tendon. There were correspondence between the grade 1 and 3 of the ossification of the ungula r cartilages and the desmopathy of the collateral ligament of the distal interphalangeal joint, characterized by lost of the echographic pattern and the presence of fibrotic or mineralized areas. Ever the ossification was severe, it was accompanied by inju ries in the navicular bone. In addition, the navicular injuries were accompanied by desmopathies of the distal sesamoid impar ligament. The desmopathies of the collateral ligaments of the distal interphalangeal joint, does not always have correspondence re lationship with the ossification of the ipsilateral ungular cartilage. When the ossification of the ungular cartilages is severe, can disturb the ability of the digit to dampen, and the navicular apparatus health.
Descrição
Palavras-chave
Cavalos, Cartilagem alar, Ligamento colateral, Tendão flexor profundo dos dedos, Síndrome podotroclear, Equine, Collateral ligaments, Deep digital flexor tendon, Podotrochlear syndrome, Ungular cartilages