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RADIOGRAPHIC AND ULTRASONOGRAPHIC DIAGNOSIS OF
STENOSING TENOSYNOVITIS OF THE ABDUCTOR POLLICIS LONGUS
MUSCLE IN DOGS

KATHARINA M. HITTMAIR, VERONIKA GROESSL, ELISABETH MAYRHOFER

Stenosing tenosynovitis of the abductor pollicis longus muscle causes chronic front limb lameness in dogs. The
lesion, similar to de Quervain’s tenosynovitis in people, is caused by repetitive movements of the carpus. Thirty
dogs with front limb lameness, painful carpal flexion, and a firm soft tissue swelling medial to the carpus
were examined prospectively. Seven dogs had bilateral abductor pollicis longus tenosynovitis. Radiographs of
the carpus were characterized by a deeper radiolucent medial radial sulcus and bony proliferations medial
and slightly cranial to the distal radius, resulting in stenosis of the tendon sheath and subsequent tendinitis.
Ultrasonographic examination of the firm soft tissue swelling medial to the carpus was characterized by an
irregular hypoechoic abductor pollicis longus tendon or tendinitis in 22 of 37 dogs. Nineteen of 37 abductor
pollicis longus tendon sheaths were fluid-filled and all tendon sheaths were thickened, more hyperechoic, with
small hyperechoic mineralizations embedded in the connective tissue of the abductor pollicis longus tendon
sheath in 25 dogs. Enthesopathy of the abductor pollicis longus tendon was identified in seven dogs. While
radiographs of stenosing tenosynovitis of the abductor pollicis longus are helpful in visualizing the deep radial
sulcus and osteophytes medial to the distal radius, ultrasonography is useful to distinguish between lesions of
the tendon or tendon sheath and to determine thickness and fluid content of the abductor pollicis longus tendon
sheath.  C 2012 Veterinary Radiology & Ultrasound.

Key words: abductor pollicis longus muscle, dog, stenosing tenosynovitis, ultrasound.

Introduction first metacarpal bone with an embedded sesamoid bone.7


The muscle is an abductor of the first digit, an adductor of

C hronic front limb lameness in mid-sized to large-breed


dogs with a firm swelling at the medial aspect of the an-
tebrachiocarpal joint may be caused by stenosing tenosyn-
the carpus, and stabilizes the carpus medially.8
In humans, chronic tendovaginitis of the abductor polli-
cis longus was first described in 1895.9 The clinical symp-
ovitis of the abductor pollicis longus muscle.1–6 toms included swelling and pain over the radial styloid
Although the first digit of the front limb in dogs does with reduced thumb motion caused by inflammation of the
not appear to serve a purpose, it is provided with a strong synovial sheath of the abductor pollicis longus and exten-
muscle and tendon. The abductor pollicis longus muscle sor pollicis brevis muscle. The condition is referred to as
originates on the lateral surface of the radius and ulna and de Quervain’s disease or de Quervain’s tenosynovitis after
the interosseous membrane. Its fibers blend into a strong the author of this first published account. Tenosynovitis of
tendon toward the carpus, crossing the tendon of the exten- the abductor pollicis longus is a lesion with degeneration
sor carpi radialis muscle, and passing into the medial sulcus of the synovial layer of the tendon sheath in conjunction
of the radius under the short medial collateral ligament. A with thickening and fluid accumulation.10 Stenosing ten-
tendon sheath of varying length is located in this segment. dovaginitis occurs when ongoing friction causes fibrosis
The tendon inserts medially on the proximal aspect of the and mineralization of the tendon sheath, thereby causing
pain and reduced function of the thumb.11, 12
From the Department of Companion Animals and Horses, Diagnostic
Diagnostic imaging methods of de Quervain’s disease
Imaging Section, University of Veterinary Medicine, Veterinärplatz 1, 1210 in people include radiographs of the carpus, showing a
Vienna, Austria (Hittmair, Groessl, and Mayrhofer). groove in the medial distal radius with sclerosis and small
Presented in part at the Annual Conference of the European Asso-
ciation of Veterinary Diagnostic Imaging in Naples, Italy, October 5–8, osteophytes in the soft tissue swelling.13 Scintigraphy and
2005. magnetic resonance imaging are also employed.13, 14 Ultra-
Address correspondence and reprint requests to Katharina M. sonography is an efficient diagnostic tool for abductor pol-
Hittmair, at the above address. E-mail: katharina.hittmair@vetmeduni.
ac.at licis longus tenosynovitis, as the fluid-filled tendon sheath
Received April 1, 2011; accepted for publication September 21, 2011.
doi: 10.1111/j.1740-8261.2011.01886.x
Vet Radio & Ultrasound, Vol. 53, No. 2, 2012, pp 135–141.

135
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136 HITTMAIR, GROESSL, AND MAYRHOFER 2012

and fibrosis are readily appreciated.15, 16 The histopatho-


logic appearance of the thickened abductor pollicis longus
tendon sheath in people is characterized by accumulation of
mucopolysaccharide and evidence of myxoid degeneration
and chondroid metaplasia.17
Stenosing tenosynovitis of the abductor pollicis longus
has been reported in dogs2–4 and treatment has been
evaluated.1 The dogs presented with chronic front limb
lameness and a firm swelling medial to the distal radius.
Flexion and rotation of the carpus caused pain.
Radiographs of the carpus in dogs with abductor pol-
licis longus tenosynovitis were characterized by a dis-
tinct distal radial sulcus, soft tissue swelling, and irregu-
lar mineralization located medial to the radial sulcus with
varying mineralization.1–5 Histopathologic evaluation of
these tendon sheaths reveal similar findings as in de Quer-
vain’s disease with thickening and chondroid or osseous
metaplasia.1, 2, 4
Ultrasonography has been reported to be of little value as
a diagnostic tool for abductor pollicis longus tenosynovitis
in dogs.8 In a previous study, 59 abductor pollicis longus
tendons and tendon sheaths in 30 fresh cadaver large-breed
dogs were examined ultrasonographically and measured.6
The purpose of the present study was to determine the
value of ultrasonography in diagnosing tenosynovitis of
the abductor pollicis longus in dogs and to characterize the FIG. 1. Diagram of the abductor pollicis longus tendon with transducer
ultrasonographic findings. positions (arrows). The tendon is black, surrounded by a light gray tendon
sheath. Transducer position 1: at the distal radial groove; transducer position
2: medial to the carpus, and transducer position 3: insertion on the first
metacarpal bone.
Materials and Methods
Thirty dogs presenting from 2001 to 2010 with chronic for soft tissue swelling medial and dorsal to the carpus,
front limb lameness, a firm swelling over the medial aspect a distinct distal radial groove, and osteophytes or enthe-
of the carpus, and painful carpal flexion were evaluated. sophytes along the medial distal radius, carpus, and first
Survey radiographs were considered positive for abductor metacarpal bone.
pollicis longus tenosynovitis when a distinct distal medial Ultrasonographic evaluation of the abductor pollicis
radial groove and/or osteophytes or enthesiphytes were longus tendon was performed using either a 10–5 MHz
visible along the medial distal aspect of the radius or carpus. or 15–7 MHz linear transducer.∗ The region around the
These dogs were then examined ultrasonographically. distal medial radius, medial carpus, and mediopalmar first
Breeds included five Golden Retrievers, two Labrador digit was clipped. The dogs were in lateral recumbency with
Retrievers, two Collies, two Rottweilers, two Ameri- the affected limb in a relaxed but extended position. Ultra-
can Staffordshire Terriers, eight mixed breeds, and one sonography was also performed on the contralateral ab-
Samoyed, German Shepherd, Münsterländer, English Set- ductor pollicis longus in unilaterally affected dogs with the
ter, Pointer, German Longhair Pointer, Briard, English same technique. The abductor pollicis longus tendon was
Bulldog, and Australian Shepherd each. The dogs weighed examined in a sagittal plane at three standardized points:
between 25 and 43 kg with a mean of 33 kg. The mean the distal radial groove, medial to the carpus, and at inser-
age of the dogs was 6.5 years (range 0.5–12.2 years). There tion on the first metacarpal bone (Fig. 1). Data collected
were 15 male dogs, one neutered male, one female, and 13 included the contours of the distal radius and radial groove,
neutered females. Fourteen dogs were companion animals, tendon thickening with changes in echogenicity, presence
seven were involved with agility training, and the remainder of anechoic fluid in the tendon sheath, thickness and cal-
were working dogs including five hunting dogs, two mili- cification of the tendon sheath, and signs of an enthe-
tary dogs, one service, and one sled dog. Ten dogs had a sopathy. The abductor pollicis longus tendon and tendon
history of a previous injury to one of the front limbs. sheath were measured at all three examination points. These
Mediolateral and dorsopalmar radiographs of both dis-
∗ Philips HDI 5000, Bothell, WA.
tal front limbs were acquired. Radiographs were evaluated
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VOL. 53, NO. 2 STENOSING TENOSYNOVITIS ABDUCTOR POLLICIS LONGUS MUSCLE 137

TABLE 1. Radiographic and Ultrasonographic Evaluation of Abductor


Pollicis Longus Tenosynovitis (n = 37)

Radiography Ultrasonography
Deep radial sulcus 35 -
Osteophytes distal radius 31 36
Soft tissue swelling medial to carpus 37 (37)*
Tendinitis - 22
Fluid in tendon sheath - 19
Tendon sheath thickening - 37
Tendon sheath mineralization - 25
Enthesopathy 6 7

Soft tissue swelling (ultrasonography) subdivided into lesions of the ten-
don and tendon sheath.

measurements were compared to previous data6 with a nor-


mal value of 1.2–1.9 mm for the tendon and <2.0 mm
for the tendon sheath. Measurements were also compared
to the nonaffected contralateral abductor pollicis longus
tendon. Abductor pollicis longus tendon thickening was
graded by using a 3-point scale according to the following FIG. 2. Comparative radiographs of the carpus, 8-year-old male Golden
measurements: grade 0: normal, <2.0 mm; grade 1: mild Retriever, agility training. (A) Right carpus, dorsopalmar view. The distal
radial groove is radiolucent with radiopaque contours (arrows). Soft tissue
thickening, ≥2.0 to <2.5 mm; grade 2: moderate to severe swelling is present medial to the carpus. The sesamoid bone at the abductor
thickening, ≥2.5 mm. A 4-point system was used to evalu- pollicis longus insertion is visible (arrowhead). (B) Left carpus, dorsopalmar
ate tendon sheath thickening: grade 0: normal, <2.0 mm; view. Normal distal radius and carpus.

grade 1: mild thickening, ≥2.0 to <3.0 mm; grade 2: moder-


ate thickening, ≥3.0 to <4.0 mm; grade 3: severe thickening,
≥4.0 mm.

Results
A total of 37 carpi had lesions of the abductor pollicis
longus. Seven of 30 dogs (23%) had evidence of bilateral
abductor pollicis longus tenosynovitis, 10 (33%) had lesions
of the right abductor pollicis longus and 13 dogs (43%) had
changes on the left. Radiographic and ultrasonographic
findings are summarized in Table 1.
The nonaffected contralateral carpi (n = 23) were ra-
diographically normal. A soft tissue swelling medial and
dorsal to the distal radius and carpus was visible on all
radiographs of affected limbs (37/37 = 100%). In 35 of
37 radiographs of the distal radius (95%), the medial sul-
cus was deeper than the nonaffected limb, appearing more
radiolucent with radiopaque contours (Fig. 2). Bony pro- FIG. 3. Radiographs of the left carpus, 5-year-old, male Golden Retriever,
liferations and osteophytes either in or around the radial hunting dog; dorsopalmar (A) and mediolateral (B) view. (A) Tubular bony
proliferations (arrowheads) are present distal to the radial groove (arrows)
groove were seen in 31/37 carpi (84%). These osteophytes surrounded by soft tissue swelling. (B) Bony proliferations are seen on the
were either singular in the groove or more extensive with ir- craniodistal aspect of the radius (arrowheads) with soft tissue swelling.
regular tubular proliferations extending beyond the styloid
process (Fig. 3). These bone formations were presumed to
be caused by ossification of the abductor pollicis longus ten- Soft tissue swelling medial to the carpus and osteophytes
don sheath. Enthesopathies of the abductor pollicis longus along the radial groove were seen in all of these dogs.
were visible in 6 of 37 carpal radiographs (16%), recogniz- Ultrasonography of the carpal soft tissue swelling and the
able as osteophytes and periosteal reactions at the medial abductor pollicis longus allowed distinguishing between le-
aspect of the proximal aspect of the first metacarpal bone. sions of the tendon and tendon sheath. In the nonaffected
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138 HITTMAIR, GROESSL, AND MAYRHOFER 2012

FIG. 4. Ultrasound image of the normal abductor pollicis longus ten-


don of an 8-year-old male Golden Retriever, agility training; sagittal view,
transducer position 2, medial to the carpus (c). The parallel fiber pattern
is uniformly hyperechoic. The tendon is demarcated by a hyperechoic line,
the peritendineum. The surrounding tendon sheath is echogenic with a thin FIG. 6. Ultrasound image of abductor pollicis longus enthesopathy, 3.9-
hypoechoic to anechoic layer (double-headed arrows). year-old neutered female Collie, companion dog; sagittal view, transducer
position 3, insertion site. The abductor pollicis longus tendon has irregular
fibers and is hypoechoic (arrows) with no clear fiber pattern near its insertion
on the first metacarpal bone (mc I) and a hypoechoic to anechoic area. The
contours of the first metacarpal bone are irregular (arrowheads), the tendon
sheath is thickened (double-headed arrow).

dons had a mean thickness of 1.6 mm with a range of 1.3–


1.9 mm and were scored a grade 0.
A similar tendon lesion was present at the insertion site
of the abductor pollicis longus in 7 of 37 dogs (19%). These
enthesopathies were characterized by irregular fibers of the
abductor pollicis longus tendon with a hypoechoic area
FIG. 5. Ultrasound image of abductor pollicis longus tendinitis, 5-year-
old, male Golden Retriever, companion dog; sagittal view, transducer posi- representing edema near the first metacarpal bone. The
tion 2, medial to the carpal bones (c). The tendon fiber pattern is irregular contour of the proximal first metacarpal bone was irregular
and more hypoechoic (arrows). with some osteophytes (Fig. 6).
In 19 of 37 affected abductor pollicis longus tendons
(51%), the tendon sheath was distended and contained
contralateral abductor pollicis longus tendons (n = 23), the
varying amounts of anechoic fluid surrounding the ten-
tendon was uniformly hyperechoic with a parallel fiber pat-
don (Fig. 7). In some instances, the fluid was visible as a
tern (Fig. 4). The peritendineum appeared as a hyperechoic
thin line, while others had extensive filling. The fluid-filled
line demarcating the tendon. The mean tendon diameter
was 1.6 mm (1.3–1.8 mm), which was scored as grade 0
or normal. The tendon sheath was slightly echogenic with
a thin hypoechoic to anechoic line (synovial layer) par-
allel to the abductor pollicis longus. The abductor pollicis
longus tendon sheath had a mean thickness of 1.2 mm (0.9–
1.8 mm) and was a grade 0 or normal.
In 22 of the 37 affected abductor pollicis longus tendons
(59%), the tendon was thickened and had an irregular fiber
pattern (Fig. 5). The overall echogenicity of the tendon was
slightly more hypoechoic. The lesions were diagnosed as ab-
ductor pollicis longus tendinitis. These tendons measured
from 2.0 to 3.0 mm, with 15 tendons scoring grades 1 and
7 with a grade 2 (Table 2). The remaining 15 of 37 ten-

TABLE 2. Ultrasonographic Scoring System of Adductor Pollicis Longus


Tendon Thickening (n = 37)
FIG. 7. Ultrasound image of abductor pollicis longus tenosynovitis with a
Tendon thickness Number of tendons fluid-filled tendon sheath, 8-year-old male Samoyed, sled dog; sagittal view,
Grade 0 <2.0 mm 15 transducer position 2. There is a large amount of anechoic fluid in the tendon
Grade 1 ≥2.0 to <2.5 mm 15 sheath (f). The abductor pollicis longus tendon is clearly outlined. A hypoe-
Grade 2 ≥2.5 mm 7 choic lesion is visible in the hyperechoic tendon (arrow) and there is no clear
fiber pattern due to tendinitis.
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VOL. 53, NO. 2 STENOSING TENOSYNOVITIS ABDUCTOR POLLICIS LONGUS MUSCLE 139

TABLE 3. Ultrasonographic Scoring System of Adductor Pollicis Longus


Tendon Sheath Thickening (n = 37)

Tendon thickness Number of tendon sheaths


Grade 0 <2.0 mm 0
Grade 1 ≥2.0 to <3.0 mm 12
Grade 2 ≥3.0 to <4.0 mm 17
Grade 3 ≥4.0 mm 8

Discussion
Stenosing tenosynovitis or de Quervain’s disease in peo-
ple is caused by repetitive movements of the wrist or overuse
of the thumb.18, 19 Besides work-related disorders affect-
ing factory employees, de Quervain’s tenosynovitis may
FIG. 8. Ultrasound image of abductor pollicis longus tenosynovitis with also be caused by excessive knitting, rock climbing, play-
a thickened tendon sheath, 9-year-old male American Staffordshire Terrier, ing a musical instrument, or using a computer mouse
companion dog; sagittal view, transducer position 2. An irregularly thick-
ened, hypoechoic tendon sheath is visible (double-headed arrows). or Blackberry.20, 21 The function of the abductor pollicis
longus in dogs is abduction and extension of the first digit
and medial stabilization of the carpus.7 The canine thumb
tendon sheath was best visualized over the soft tissue is a vestigial digit with only minimal movement. The cause
swelling, medial to the carpal bones. of abductor pollicis longus tenosynovitis in dogs is repeti-
All 37 abductor pollicis longus tendons (100%) had a tive motion or overuse of the carpal joint.1 Of the 30 dogs
thickened tendon sheath (Fig. 8). The thickness of the ab- in this study, seven were involved with agility training and
ductor pollicis longus tendon sheath varied along the ten- nine were working dogs. In agility training, repetitive move-
don with an irregular inner surface. The echogenicity of the ments of the carpus are caused by quick turns, stops, and
wider tendon sheath ranged from hypoechoic to a medium jumping over obstacles. Working dogs, such as hunting,
echogenicity. In 25 of 37 thickened tendon sheaths (68%), sled, or military dogs, are also trained in this field. The
mineralization and small calcifications were identified as amount of exercise in the remaining 14 companion dogs
hyperechoic foci in the distended tendon sheath with or was not noted.
without distal acoustic shadowing (Fig. 9). Measurements All dogs with abductor pollicis longus tenosynovitis were
of the abductor pollicis longus tendon sheath ranged from large-breed dogs. In a previous study Boxers and German
2.0 to 6.7 mm. Twelve tendon sheaths scored a grade 1, 17 Shepherds were overrepresented.5 Neither of these breeds
a grade 2, and 8 thickened tendon sheaths were a grade 3 was present in this study. Eight of the 30 dogs (27%) were
(Table 3). mixed breeds and seven (23%) were Retrievers. Previous
reports on abductor pollicis longus tenosynovitis include a
German Shepherd,2 Golden Retriever,3 and Collie.4
In people, de Quervain’s tenosynovitis is diagnosed com-
monly in women.14 This is thought to be due to the smaller
diameter of the female hand, hormonal changes, and repet-
itive housework.19 In most instances, the dominant hand
is affected. In previous reports on stenosing tenosynovi-
tis of the abductor pollicis longus in dogs, males were
overrepresented.1, 5, 6 We did not find this predominance,
with 16 of 30 dogs being male. A side predilection was also
not observed, and 7 of 30 dogs had bilateral tenosynovitis
of the abductor pollicis longus.
While radiographic changes of de Quervain’s disease in
people are limited to radiolucent areas in the distal radial
styloid with some soft tissue mineralization,13, 14 stenos-
ing tenosynovitis of the abductor pollicis longus in dogs
FIG. 9. Ultrasound image of abductor pollicis longus tenosynovitis with a was characterized by soft tissue swelling, a deep distal ra-
thickened tendon sheath, 6-year-old male Rottweiler, military dog, transducer dial groove, bony proliferations along the abductor pollicis
position 2. The irregularly thickened tendon sheath has mixed echogenic-
ity (double-headed arrows). There are small hyperechoic foci in the tendon longus tendon sheath, and enthesopathies. These findings
sheath (arrowheads). are consistent with those described in previous reports.1–6, 8
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140 HITTMAIR, GROESSL, AND MAYRHOFER 2012

Enthesopathies at the origin of the straight part of the with tendon as well as tendon sheath thickening. To evalu-
short radial collateral ligaments should be considered as a ate the gliding motion of the abductor pollicis longus ten-
differential diagnosis for stenosing abductor pollicis longus don in the tendon sheath, the first digit can be moved during
tenosynovitis.22 With these injuries, irregularities and new the ultrasound examination.
bone formation are seen at the radial tubercle above the In people, ultrasonography is used to assess changes in
styloid process. In the study, none of the dogs showed lame- the size of the abductor pollicis longus and extensor pollicis
ness of the front limb found with abductor pollicis longus brevis tendons and to identify a septum between the two
tenosynovitis.22 Other differential diagnoses for abductor tendons.15 The tendons are contained in the first extensor
pollicis longus tenosynovitis include trauma, arthritis, and compartment of the wrist, but are divided by a septum
neoplasia.23 in some patients. This provides useful information for the
Although ultrasonography was previously deemed to be surgical approach to release both tendon sheaths.
of limited value for abductor pollicis longus tenosynovitis,8 In previous histologic studies, abductor pollicis longus
we found it to be useful. All dogs with front limb lameness tenosynovitis was not characterized by inflammation, but
had a firm swelling medial to the carpus. With the help of rather by accumulation of mucopolysaccharide within the
ultrasonography, these soft tissue swellings could be differ- fibrous tendon sheath in both people and dogs.1, 4, 17 In few
entiated into those with fluid accumulation and those with instances, lymphocytes were found within the connective
thickening of the abductor pollicis longus tendon, thicken- tissue, but not in the synovial lining. Signs of myxoid de-
ing of the abductor pollicis longus synovial sheath or all generation are considered characteristic of de Quervain’s
three. Thickening of the abductor pollicis longus tendon disease, which can lead to chondroid or osseous metaplasia
(n = 22) was scored a grade 1 in 15 dogs with measure- of the tendon sheath in both people and dogs. This con-
ments within 0.5 mm above normal. Seven dogs had a grade dition is therefore not an inflammatory disease, and it has
2 score with the widest abductor pollicis longus tendon at been postulated that the term stenosing tenosynovitis is a
3 mm. The range of abductor pollicis longus tendon mea- misnomer.17
surements was minimal, ultrasonographically a disrupted Abductor pollicis longus tenosynovitis in human patients
fiber pattern and hypoechogenicity were more apparent. is treated with intrasheath corticosteroid infiltration.25
In all dogs, tenosynovitis of the abductor pollicis longus When this is ineffective, surgical release of the tendons
was found in conjunction with tendon sheath thickening. or compartment reconstruction is performed.26, 27 In dogs,
Mild thickening or a grade 1 was found in 12 dogs, a grade acute abductor pollicis longus tenosynovitis is treated with
2 or moderate thickening was found in 17 dogs, and in local methylpredinosolone injections medial to the distal
8 dogs the tendon sheath was severely thickened with mea- radius and carpus and the area is massaged.1 After immo-
surements of up to 6.7 mm. The soft tissue swelling medial bilization, this treatment should be repeated. In chronic dis-
to the distal radius and carpus seems to be due to abduc- ease, surgical intervention is required with debridement of
tor pollicis longus tendon sheath thickening. There was no the tendon sheath or resection of osteophytes.1, 4 Tenotomy
clinical correlation between the ultrasonographic scoring of the abductor pollicis longus tendon is also performed.1, 3
system for the abductor pollicis longus tendon (Table 1) Complete resection of the first digit was reported in one
and tendon sheath (Table 2) and the degree of lameness in case.2 While rupture or resection of the abductor pol-
the dogs. licis longus tendon does not impair thumb function in
Small mineralizations within the tendon sheath wall, not people,28, 29 tenotomy in one dog leads to instability of the
seen radiographically, were visualized ultrasonographically carpal joint and osteoarthritis.1 It is unknown how much
as small hyperechoic foci. These mineralizations or fibroses medial support the abductor pollicis longus tendon pro-
are caused by chronic inflammation and present with acous- vides the carpus and whether osteoarthritis developed from
tic shadowing only when they exceed 2–3 mm.24 When more other causes. Long-term follow-up examinations of dogs
extensive calcifications are present in the tendon sheath, with resected abductor pollicis longus tendons are needed
visualization of the tendon sheath and tendon may be im- to prove the effects. Of the 30 dogs in this study, 16 were lost
paired. Because of the ossifying tenosynovitis of the abduc- to follow-up. Two underwent surgery with debridement of
tor pollicis longus near the distal radial groove (transducer the abductor pollicis longus tendon sheath and resection
position 1, Fig. 1), the tendon and its sheath were not iden- of bony proliferations and were free of lameness 2 months
tified. The best imaging position was medial to the carpus later. The remaining 12 dogs were treated with oral non-
(transducer position 2). steroidal anti-inflammatory drugs, methylprednisolone in-
Enthesopathies at the insertion of the abductor pollicis jections and 3 weeks of joint immobilization. Additionally,
longus tendon on the first metacarpal bone were visible the dogs were treated with shock wave therapy. All dogs ex-
ultrasonographically. The tendon was distended with a hy- perienced reduction or disappearance of the firm swelling
poechoic area at the insertion and enthesiphytes appeared medial to the carpus, no pain on flexion of the carpus,
as hyperechoic foci. These enthesopathies were associated and lameness was not observed. One dog was reexamined
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VOL. 53, NO. 2 STENOSING TENOSYNOVITIS ABDUCTOR POLLICIS LONGUS MUSCLE 141

ultrasonographically 2 months after treatment and had a graphic findings include soft tissue swelling medial to the
grade 0 tendon thickness (1.4 mm) compared to a previous carpus, radiolucent distal radial groove, and bony prolifera-
grade 2 (3.3 mm). tions that form a tunnel around the abductor pollicis longus
In summary, stenosing tenosynovitis of the abductor tendon. Ultrasonography proved useful in determining the
pollicis longus in dogs is characterized by thickening and extent of the abductor pollicis longus lesion and scoring the
mineralization of the tendon sheath. Characteristic radio- grade of tendinitis and tenosynovitis.

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