This was a 5 year old mare with sudden onset of severe lameness in the right hind limb following an unknown incident in the pasture. After several visits the lameness remained fairly significant. The lameness was localized to the right stifle. Radiographs did not reveal any significant abnormalities at which time the use of digital ultrasound was elected. The ultrasound exam was performed using our new portable digital ultrasound system, and the examination revealed several lesions in the stifle that were not evident using portable digital x-ray equipment. Arthroscopy was elected and performed at CSU for better visualization of the joint and to evaluate the lesions as thoroughly as possible. The hope was to be able to determine the extent of damage and the possibility of stem cell/platelet rich plasma therapy. Once on the surgery table this horse had lesions so extensive that further therapy would be unsuccessful and euthanasia was elected. Our ability to use ultrasound technology enabled us to move forward with a diagnosis and therapeutic plan. Although this particular case ended with the inability to pursue further therapy and recovery, this case demonstrates the possibilities of diagnosing soft tissue injuries that would be impossible while utilizing just conventional radiographs. It is the goal of VetweRx Equine to be able to deliver this kind of diagnostic quality and thoroughness to all of our clientele. We believe the technology we possess gives us the tools necessary in order to achieve that goal and become proficient at lameness diagnosis.

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Radiographs of this stifle show no significant abnormalities. In addition to the doctors in our practice, they were reviewed by radiologists at CSU, Dr. Kawcak at CSU, and Dr Gaughan at Littleton Large Animal. The only small abnormality noted which may have been incidental was mild flatening of the medial femoral condyle as outlined by the Blue arrow in figure 3.

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To better understand the cause of lameness in this horse and ultrasound exam of the stifle was ordered using our new digital ultrasound system. The box on figure 4 shows disorganization of the origin of the medial collateral ligament ( MCL). The box in figure 5 shows several possible tears in the medial meniscus as well as the meniscus being prolapsed and compressing the MCL. The box in figure 6 shows significant disorganization of the fibers of the MCL at its distal insertion.

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This horse was taken to surgery and arthroscopic examination of the joint was performed. Due to the severity of the injury to the meniscus and collateral ligament, euthanasia was performed on the surgery table. These post mortem images of the stifle show severe tearing of the right medial meniscus as compared to the normal left medial meniscus in figure 7. Figure 8 and 9 show cartilage erosion on the medial femoral condyle which was not evident on radiographs. Figure 10 demonstrates cartilage erosion at the joint surface on the tibia, also not apparent on radiographs.