Although areas of mineralisation can be detected with radiography and ultrasonography on specific views, it is recognised that lesions can be missed with conventional imaging modalities. Tendon and ligament mineralisations are not uncommon findings in diagnostic imaging and have been reported in humans and horses. Both CT systems were generally superior in identifying heterotopic mineralisations than MRI, while MRI provided information on soft tissue pathology related to the lesions, which may be important for management. Suspensory-branch/intersesamoidean ligament mineralisations were identified by CBCT in standing cases one had associated T2 hyperintensity. Macro-examination showed ligament disruption/splitting and discolouration. All abaxial avulsions had suspensory-branch splitting on T1 images with T2 and STIR hyperintensity. On MRI, fragments were most identifiable on T1 images. All modalities identified seven ossified fragments showing cortical/trabecular pattern: capsular (1), palmar sagittal ridge (1), proximal phalanx (2) without macroscopic abnormality, and proximal sesamoid bones (3). Macro-examination found corresponding disruption/splitting and discolouration. MRI failed to identify all mineralisations, but detected suspensory branch splitting, and T2 and STIR hyperintensity in 4 suspensory-branches and 3 oblique-sesamoidean-ligaments. CBCT and FBCT identified twelve mineralisations with homogeneous hyperattenuation: oblique-sesamoidean-ligament (5) without macroscopic abnormality deep-digital-flexor-tendon (1) and suspensory-branch (6) with macroscopic abnormalities. Retrospective review of the CBCT/MR images from two standing horses was also included. Images from 12 equine cadaver limbs were examined for heterotopic mineralisation and adjacent pathology and verified by macro-examination. The study aimed to identify heterotopic mineralisation and adjacent pathology in the fetlock region with cone-beam (CB) computed tomography (CT), fan-beam (FB) CT, and low-field magnetic resonance imaging (MRI). Heterotopic mineralisation in equine distal limbs has been considered an incidental finding and little is known about its imaging features.
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