Limb position, not exercise or sedation, affects power Doppler neovascularization detection in equine superficial digital flexor tendon core lesions.

Image the limb non-weight-bearing for optimal PDU neovascularization detection; exercise and detomidine sedation do not affect results.

This prospective study evaluated the effects of limb position, exercise, and sedation on the detectability of neovascularization using power Doppler ultrasonography (PDU) in superficial digital flexor tendon (SDFT) core lesions in nine Thoroughbred horses. Lesions were surgically induced, and PDU examinations were performed at week 0 (baseline) and week 12 post-induction. At each timepoint, imaging was conducted under four conditions: weight-bearing and non-weight-bearing positions, before and after light exercise (lameness examination), and before and after IV detomidine sedation. The contralateral forelimb served as a control. Statistical analysis identified limb position as the only significant variable affecting neovascularization detectability. No blood flow was detected in any limb prior to lesion induction. At week 12, neovascularization signals were significantly increased when the affected limb was imaged in the non-weight-bearing position compared to weight-bearing, regardless of exercise or sedation status. Neither light exercise nor IV detomidine sedation significantly altered PDU neovascularization detection or quantification. These findings support performing PDU in the non-weight-bearing position as a critical component of equine tendon evaluation. Clinicians can continue standard lameness workup protocols—including trotting and detomidine administration—without concern for compromising PDU accuracy, streamlining the diagnostic evaluation of SDFT tendinopathy.

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