Introduction

Uses

• Investigation of:
  • Acute or chronic lameness, pain and swelling in different regions.
  • Most used for shoulder/biceps, stifle/cruciate ligaments and menisci, Achilles tendon.
• Complementary technique to radiology Radiology: appendicular skeleton (joints) Radiology: appendicular skeleton (long bones):
  • Investigate soft tissue lesions suspected or not evident from radiographs.
  • Able to distinguish between fluid and soft tissue.
  • Allow dynamic study of joints, ligaments and tendons.
• Allows ultrasound guided fine-needle aspirate Fine needle aspirate: ultrasound-guided/core biopsy Biopsy: ultrasound-guided, arthrocentesis Arthrocentesis: overview or foreign body removal.
• Structures commonly evaluated:
  • Muscle.
  • Tendon.
  • Ligament.
  • Joint space.
  • Bone surface.
  • Articular cartilage.
  • Lymph nodes.

Advantages

• Real-time imaging technique.
• Rarely requires general anesthesia.
• Economic.
• Non-invasive.
• Fast.
• Safe. 
• Repeatable.

Disadvantages

• May require patient's coat to be clipped.
• Only the surfaces of bony structures can be examined due to the lack of penetration of bone by ultrasound.
• View on articular structures may be partially obscured by bony anatomy.
• Cannot differentiate between benign and malignant conditions using ultrasound alone.

Potential problems

• Poor transducer-skin contact:
  • Inadequate clipping.
  • Insufficient coupling medium.
• Inadequate patient restraint.
• Operator inexperience and lack of anatomic knowledge.

Alternative techniques

• Radiography, Computed Tomography and Magnetic Resonance Imaging.
• Arthroscopy Arthroscopy.

Equipment

Patient preparation

Technique

Shoulder

Stifle

Achilles tendon

Other conditions

Further Reading

Publications

Refereed Papers

• Recent references from PubMed and VetMedResource.
• Lassaigne C, Boyer C, Sautier L & Taeymans 0 (2020) Ultrasound of the normal canine supraspinatus tendon: comparison with gross anatomy and histology. Vet Rec 186 (17), e14 PubMed. 
• Cook C R (2016) Ultrasound imaging of the musculoskeletal system. Vet Clin North Am Small Anim Pract 46(3), 355-371 PubMed. 
• Arnault F, Cauvin E, Viguier E, Kraft E, Sonet J, Carozzo C (2009) Diagnostic value of ultrasonography to assess stifle lesions in dogs after cranial cruciate ligament rupture: 13 cases. Vet Comp Orthop Traumatol 22, 479-485 1 PubMed.   
• Schnappauf A, Gerwing M, Koehler S, Seyrek-Intas D, Kramer M (2007) Die Ultraschalldiagnostik von Kreuzbandrupturen beim Hund. Tieraerztl Prax 35, 359-365.
• Gnudi G. and Bertoni G (2001) Echographic examination of the stifle joint affected by cranial cruciate ligament rupture in the dog. Vet Radiol Ultrasound 266-270 PubMed.  

Other sources of information

• D’Anjou M & Blond L (2015) Musculoskeletal System. In: Penninck D & D‘Anjou M (eds) Atlas of Small Animal Ultrasonography. 2nd edn, Wiley-Blackwell.