What ultrasound findings can indicate suspensory ligament injuries?

• A. Thickening of the ligament, fiber disruption, or tears in the suspensory ligament or distal sesamoidean ligaments
• B. Only calcification of bone
• C. Nerve damage in the limb
• D. No abnormality

Answer: (A)

The main idea is that injuries to the suspensory ligament show up on ultrasound as changes in the ligament’s tissue pattern. A healthy suspensory ligament looks like a bundle of parallel, echogenic fibers. When it’s injured, you commonly see thickening from edema and scar, and the normal fiber pattern becomes disrupted or irregular. Tears may appear as focal gaps or complete discontinuity within the ligament. The distal sesamoidean ligaments, if involved, can show the same kind of changes in their fibers. Surrounding soft tissues may also be edematous.

That combination—thickened tissue with disrupted or torn fibers in the suspensory ligament or distal sesamoidean ligaments—is what ultrasound detects as evidence of injury. Other scenarios, like bone calcification or nerve damage, aren’t the typical ultrasound signs of suspensory ligament injury, and a normal ultrasound would not explain the symptoms.