Ultraschalldiagnostik am Karpalgelenk des Rindes

The aim of the present study was to formulate a standardised
ultrasonographic examination procedure of the carpal region in
cattle. Aided by an experimental filling of the joint pouches,
those transducer positions were identified, at which the presence
of an added filling can be detected best. The gained insights were
then applied to clinical cases. Examinations were made with the
real-time ultrasound unit Sonoline Prima (Fa. Siemens), equipped
with a 5/7,5-MHz multi-frequency linear transducer. Initially, 8
isolated cadaver specimens were used to update and enlarge the
topographic anatomical knowledge, and to recognize the typical
ultrasonographic appearance. For the standardised examination
procedure, the carpus was divided in 4 horizontal and in 8 vertical
planes, which can be discovered by means of prominent bone
structures on both young and adult cattle. The resulting 32 planes
were scanned horizontally and vertically each, beginning proximally
and moving the transducer distally one step at a time. Only the
musculus abductor pollicis longus had to be examined in an oblique
direction. The examination procedure was applied to 11 carpal
joints of healthy cattle of all ages and sexes. The carpal flexor
and extensor tendons, partially their tendon sheaths, the medial
and lateral collateral ligament, the ligamentum
accessoriometacarpeum and the bone surfaces of the carpus could be
imaged without greater problems with the exception of the musculus
abductor pollicis longus. The ultrasonographic imaging of the
larger vessels and the median nerve, running over the palmar and
medial aspects of the carpus, required some practice and did not
succeed in every case. The antebrachiocarpal joint space, the
intercarpal and carpometacarpal joint spaces could be clearly
defined as interruptions of the echogenic bone surfaces, whereas
the joint pouches could only be detected around the dorsal and the
lateral aspects; Their joint capsules could not be identified. The
topography of each ultrasonographic picture was explained in detail
by means of drawn illustrations and it was compared to frozen
anatomical sections. By doing so, a good correlation of structures
in ultrasonographic pictures and anatomic parts could be performed.
The experimental filling of the joints showed that the filled joint
pouches of the carpus could be illustrated most easily close to the
puncture sites of joints described in the literature. This worked
out best when holding the transducer in a vertical position.
Furthermore, 24 cattle with diseases of the carpal region, i.e.
arthritis, bursitis, tendinitis, and tendovaginitis, could be
examined. In conclusion, the following can be stated. The
ultrasonographic pictures, illustrations, and frozen anatomical
sections that were produced in this work for the different planes,
describe nearly all structures of the carpus. On the grounds of
these reference images an ultrasonographic examination of both
healthy and diseased carpal joints can be performed a lot easier.