Limitations of Diagnostic Ultrasound of Bowed Tendons

Diagnostic ultrasound has become a popular means of monitoring the healing of superficial digital flexor tendon (SDFT) injuries, also known as bowed tendons. As image analysis software has been developed, the technique has become more widespread. The problem is that with so many practitioners of varying skill using different types of ultrasound equipment, the repeatability and therefore reliability of the information gathered must be questioned. To assess repeatability, the SDFTs of 14 Thoroughbred racehorses were recently examined using diagnostic ultrasound.

Two operators, one more skilled than the other, captured images from the same limbs of the same horses, then compared measurements (for accuracy of a single measurement) of the cross-sectional area (CSA) of the tendon at a specified level. The more experienced operator then used two different types of ultrasound equipment to again evaluate each tendon for comparison.

Upon examination of the results, it appears that the two operators were able to capture consistent images from the same tendons, and the more skilled operator was able to produce repeatable results with different equipment. However, the one caveat was inconsistency in the computerized analysis of the images. The actual CSA measurement varied significantly depending upon the skill of the operator. Therefore, while it might be reasonable to have a horse's tendon injury evaluated by different veterinarians at different locations, it could be advisable to have serial images (those taken in a series) used to monitor healing analyzed by one skilled practitioner.

Equine Veterinary Journal, 33(1), 33-37, 2001.

About the Author

Susan Piscopo, DVM, PhD

Susan Piscopo, DVM, PhD, is a free-lance writer in the biomedical sciences. She practiced veterinary medicine in North Carolina before accepting a fellowship to pursue a PhD in physiology at North Carolina State University. She lives in northern New Jersey with her husband and two sons.

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