共查询到20条相似文献，搜索用时 37 毫秒
1.
The aim of the study was to characterize radiopharmaceutical uptake patterns in horses with clinical and ultrasonographic evidence of proximal suspensory desmitis. It was hypothesized that radiopharmaceutical uptake in the proximal palmar (plantar) aspect of the third metacarpal (metatarsal) bone would be greater in lame limbs of horses with proximal suspensory desmitis than in sound limbs and that there would be a positive correlation between the severity of ultrasonographic abnormalities and the degree of radiopharmaceutical uptake. Nuclear scintigraphic evaluation of the proximal metacarpal or metatarsal regions of 126 horses with ultrasonographic evidence of proximal suspensory desmitis was performed. In all horses lameness was substantially improved by perineural analgesia of the palmar metacarpal (subcarpal) or plantar metatarsal (subtarsal) nerves. Scintigraphic images were assessed subjectively, by profile analysis and using region of interest analysis. Associations between the degree of ultrasonographic abnormality and radiopharmaceutical uptake ratios and the presence of radiographic abnormalities and radiopharmaceutical uptake ratios were analyzed. Subjectively, the majority of horses had normal radiopharmaceutical uptake. Profile analysis provided little additional information. However with region of interest analysis there was greater radiopharmaceutical uptake ratios in plantar images in the proximal metatarsal regions of lame limbs compared with nonlame limbs. There was no association between radiological abnormalities and radiopharmaceutical uptake ratios. In forelimbs there was no association between ultrasonographic lesion grade and radiopharmaceutical uptake ratios, however in hindlimbs there was a significant relationship between ultrasonographic grade and radiopharmaceutical uptake ratios. 相似文献
2.
S. Dyson 《Equine Veterinary Education》2014,26(10):538-542
The accessory ligament of the hindlimb suspensory ligament arises from the plantar aspect of the calcaneus and fourth tarsal bones and blends with the suspensory ligament in the proximal aspect of the metatarsus. The accessory ligament of the suspensory ligament of both hindlimbs of 12 mature horses, with no history of hindlimb lameness, was assessed ultrasonographically. The ligament comprised linear parallel echoes which were consistently shorter than those of the lateral digital flexor tendon; the dorsal and plantar borders were parallel. Lameness associated with injury of the accessory ligament of the suspensory ligament was identified in 6 of 8 lame hindlimbs of 5 horses, unilaterally in 4 horses and bilaterally in one horse. In all horses there was concurrent proximal suspensory desmopathy. There was localised oedematous swelling on the distal medial aspect of the chestnut extending distally in 2 horses. Lameness was best identified when the horses were ridden. Perineural analgesia of the deep branch of the lateral plantar nerve abolished lameness in 3 horses but perineural analgesia of the tibial nerve was required to abolish lameness in the hindlimb with injury of the accessory ligament of the suspensory ligament in 2 horses. Injury of the accessory ligament of the suspensory ligament was characterised by marked decrease in echogenicity of the ligament and loss of parallel alignment of the linear echoes, which were shorter than normal in longitudinal images. 相似文献
3.
4.
Reasons for performing study: There is limited information on magnetic resonance imaging (MRI) findings in the carpus and proximal metacarpal region of lame horses. Objectives: To document MRI findings in horses with lameness localised to the carpus and/or proximal metacarpal region. Methods: Clinical records of horses that underwent MRI of the carpus and/or proximal metacarpal region at the Animal Health Trust between January 2003 and September 2010 were reviewed. Magnetic resonance images of all horses and available radiographs, ultrasonographic and scintigraphic images were assessed. When possible, MRI findings were related to the results of other diagnostic imaging techniques. Results: Seventy‐two MR studies of 58 lame limbs in 50 horses from a broad range of work disciplines and ages were reviewed. The most commonly detected primary abnormality was decreased signal intensity in T1‐ and T2‐weighted images in the medial aspect of the carpal bones and/or the proximomedial aspect of the metacarpal bones (n = 29). Nine horses had syndesmopathy between the second and third metacarpal bones. In 6 horses the primary abnormalities were identified in the palmar cortex of the third metacarpal bone (McIII). Significant abnormalities of the suspensory ligament (SL) with associated lesions in the adjacent palmar cortex of the McIII were seen in 4 limbs. Ligament and associated osseous abnormalities between the second and third carpal bones and second and third metacarpal bones were detected in 4 limbs. Conclusions and potential relevance: Magnetic resonance imaging enabled diagnosis of a variety of lesions not detected by conventional imaging in horses from a wide range of work disciplines. The distribution of injury types differed considerably from previous studies. 相似文献
5.
Tóth F Schumacher J Schramme M Holder T Adair HS Donnell RL 《Veterinary surgery : VS》2008,37(4):328-335
Objective— To describe pathologic changes in the deep branch of the lateral plantar nerve (DBLPN) of horses determined to be lame because of proximal suspensory desmitis (PSD), and to report the outcome after treatment by excision of a segment of the horses' DBLPN.
Study Design— Retrospective case series.
Animals— Adult horses (n=16).
Methods— Horses determined to be lame on one or both pelvic limbs because of PSD were treated by excision of a segment of the DBLPN, and 30 nerves were examined histologically. Owners were contacted to obtain information about the horses ≥6 months after surgery.
Results— Histologic changes suggestive of chronic nerve compression were identified in both nerves of 11 bilaterally lame horses and in the lame limb of 5 unilaterally lame horses. The nerve of the sound limb of 2 of 3 unilaterally lame horses that had bilateral nerve resection also had histologic changes compatible with nerve compression. Ten of 16 horses (62.5%) with follow-up information returned to soundness after excision of the DBLPN.
Conclusions— Pathologic changes of the DBLPN associated with compression may complicate PSD of the pelvic limbs. Excision of the nerve may resolve lameness caused by PSD.
Clinical Relevance— Horses lame because of PSD of the pelvic limb may remain lame after desmitis has resolved because of compression of the DBLPN. Excising a portion of this nerve may resolve lameness. 相似文献
Study Design— Retrospective case series.
Animals— Adult horses (n=16).
Methods— Horses determined to be lame on one or both pelvic limbs because of PSD were treated by excision of a segment of the DBLPN, and 30 nerves were examined histologically. Owners were contacted to obtain information about the horses ≥6 months after surgery.
Results— Histologic changes suggestive of chronic nerve compression were identified in both nerves of 11 bilaterally lame horses and in the lame limb of 5 unilaterally lame horses. The nerve of the sound limb of 2 of 3 unilaterally lame horses that had bilateral nerve resection also had histologic changes compatible with nerve compression. Ten of 16 horses (62.5%) with follow-up information returned to soundness after excision of the DBLPN.
Conclusions— Pathologic changes of the DBLPN associated with compression may complicate PSD of the pelvic limbs. Excision of the nerve may resolve lameness caused by PSD.
Clinical Relevance— Horses lame because of PSD of the pelvic limb may remain lame after desmitis has resolved because of compression of the DBLPN. Excising a portion of this nerve may resolve lameness. 相似文献
6.
Our aims were to evaluate the pattern of radiopharmaceutical uptake in horses with lameness related to the metacarpophalangeal and/or metatarsophalangeal joint and compare the results with similar information from sound horses. It was hypothesized that there would be a difference in radiopharmaceutical uptake between the lame and contralateral limb in unilaterally lame horses and that there would be a difference between lame and sound horses. Nuclear scintigraphic images of 43 horses with forelimb lameness and 30 horses with hindlimb lameness were evaluated. In all horses lameness was improved by intraarticular analgesia of the joint, or by perineural analgesia of the palmar/plantar (at the junction of the proximal 3/4 and the distal 1/4 of the metacarpal/metatarsal regions) and palmar/plantar metacarpal/metatarsal nerves. All images were assessed subjectively and a quantitative image analysis was performed by drawing a vertical line profile through the center of each joint in the lateral images and using region of interest analysis in both lateral and dorsal/plantar images. Ratios of radiopharmaceutical uptake were compared for each region between lame and contralateral limbs in unilaterally lame horses and between lame and control horses. There was a significant difference in the ratio of radiopharmaceutical uptake in the proximal aspect of the proximal phalanx between lame and nonlame forelimbs in unilaterally lame horses and in both lame and contralateral limbs of lame horses compared with control horses for the regions of the distal aspect of the third metacarpal/metatarsal bone and the proximal sesamoid bones. However, the profile analysis was of limited clinical value. 相似文献
7.
Desmitis of the proximal aspect of the suspensory ligament, or interosseus medius muscle, of the pelvic or thoracic limb is a commonly diagnosed cause of lameness of performance horses. Despite medical treatments available for horses with proximal suspensory desmitis (PSD), most horses treated medically for PSD of a pelvic limb remain persistently lame; this persistent lameness may be the result of a neuropathy caused by compression of nerves by an enlarged suspensory ligament. Few horses with PSD of a thoracic limb remain persistently lame. Based on the results of reports citing successful treatment of horses chronically lame because of PSD of a pelvic or thoracic limb, by excising a portion of the deep branch of the lateral plantar or palmar nerve (DBLPlN/DBLPaN), we theorized that persistent lameness of horses caused by PSD of a thoracic limb may also be due to compression of nerves that supply the ligament. The aim of this study was to determine if histological signs of compression neuropathy of the DBLPaN are present in horses with PSD in a thoracic limb. To test this hypothesis, we induced PSD by instilling collagenase into the ligament and then examined the DBLPaN after harvesting this nerve 2 months later. We found that the DBLPaNs of all treated limbs showed histologic changes suggestive of nerve compression. We conclude that studies examining the DBLPaN of horses with naturally occurring PSD for histological evidence of neuropathy are warranted. 相似文献
8.
Reasons for performing study: Neurectomy of the deep branch of the lateral plantar nerve and plantar fasciotomy have become accepted as methods of treatment of proximal suspensory desmopathy (PSD), but there are limited long‐term studies documenting the outcome. Objectives: To describe long‐term follow‐up in horses with PSD alone or with other injuries contributing to lameness and poor performance, including complications, following neurectomy and fasciotomy. Methods: Follow‐up information was acquired for 155 horses that had undergone neurectomy and fasciotomy for treatment of PSD between 2003 and 2008. Success was classified as a horse having been in full work for >1 year post operatively. Horses were divided into 3 groups on the basis of the results of clinical assessment and diagnostic analgesia. Horses in Group 1 had primary PSD and no other musculoskeletal problem. Horses in Group 2 had primary PSD in association with straight hock conformation and/or hyperextension of the metatarsophalangeal joint. Horses in Group 3 had PSD and other problems contributing to lameness or poor performance. Results: In Group 1, 70 of 90 horses (77.8%) had a successful outcome, whereas in Group 3, 23 of 52 horses (44.2%) returned to full function for >1 year. Complications included iatrogenic damage to the plantar aspect of the suspensory ligament, seroma formation, residual curb‐like swellings and the development of white hairs. All horses in Group 2 remained lame. Conclusions and clinical relevance: There is a role for neurectomy of the deep branch of the lateral plantar nerve and plantar fasciotomy for long‐term management of hindlimb PSD, but a prerequisite for successful management requires recognition of risk factors for poor outcome including conformation features of straight hock or fetlock hyperextension. 相似文献
9.
10.
REASONS FOR PERFORMING STUDY: Proximal suspensory desmitis (PSD) is diagnosed with increasing frequency in horses and radial pressure wave therapy (RPWT) is a widely used therapy for painful orthopaedic conditions in man and dogs. There are, however, few published data as to the outcome of its use in PSD. OBJECTIVE: To evaluate the use of RPWT in the treatment of chronic or recurrent PSD in the horse, an injury which carries a poor prognosis for return to athletic function with conservative management alone. HYPOTHESIS: RPWT and controlled exercise improves the prognosis of chronic or recurrent PSD in the horse when compared to previously published results of controlled exercise alone. METHODS: The use of RPWT in the management of chronic or recurrent proximal suspensory desmitis (PSD) was evaluated in 65 horses. Diagnosis was based on response to local analgesia, ultrasonography and radiography. Horses were classified according to severity of ultrasonographic lesions, whether fore- or hindlimbs were affected, and duration of lameness prior to diagnosis. Horses were treated 3 times at 2-week intervals and followed a controlled exercise programme; they were reassessed clinically and ultrasonographically 10-12 weeks after diagnosis, when further exercise recommendations were made dependent upon the animal's progress. RESULTS: Forty-one percent of horses with hindlimb lameness and 53% with forelimb lameness were nonlame and returned to full work 6 months after diagnosis. The prognosis was significantly affected by the ultrasonographic grade at the time of diagnosis and by ultrasonographic evidence of resolution of the lesion in hindlimb cases. CONCLUSIONS: These findings, when compared to previously published results of treatment using controlled exercise alone, suggest that RPWT improves the prognosis for PSD in the hindlimb. POTENTIAL RELEVANCE: RPWT is a useful treatment modality for chronic or recurrent PSD when combined with controlled exercise. Further studies are required on the effect of RPWT employing histology and biomechanics in order to fully evaluate its use on equine tissues. 相似文献
11.
S Dyson 《Equine veterinary journal》1991,23(1):25-31
Clinical, ultrasonographic and radiographic features of proximal suspensory desmitis in the forelimb and the hindlimb are described. Acute cases may present with slight, localised, oedematous swelling, heat, distension of the medial palmar (plantar) vein and/or pain, whereas chronic cases or those rested immediately after onset of lameness usually have no detectable clinical signs suggestive of the source of pain. In these cases local analgesia is required to identify pain in the proximal metacarpal (metatarsal) region. Transverse ultrasonographic images of the suspensory ligament usually yield the most information and a variety of abnormalities of the proximal suspensory ligament have been identified including i) enlargement ii) poor definition of one or more of the margins of the suspensory ligament, especially dorsally iii) a well circumscribed, central hypoechoic area iv) one or more poorly defined hypoechoic areas, central or more peripheral v) a larger area of diffuse decrease in echogenicity (such lesions were seen most commonly in the hindlimb and appeared to warrant a more guarded prognosis than focal lesions). Radiographic abnormalities were identified in hindlimbs more often than in forelimbs and were usually seen in a dorsopalmar (dorsoplantar) view, and/or a lateromedial projection. Radiographic abnormalities included sclerosis of the trabeculae, a change in orientation of the trabeculae and entheseophyte formation. The most extensive radiographic abnormalities were seen together with an ultrasonographic type v lesion. The prognosis for return to full athletic function and sustained future soundness was better for forelimbs than hindlimbs, especially if the lesion, identified ultrasonographically, resolved. 相似文献
12.
Two young adult endurance horses were presented for investigation of sudden-onset forelimb lameness during competition. Clinical examination revealed a severe forelimb lameness and pain on palpation of the proximal palmar metacarpal area. Initial radiographic survey of the affected forelimb was unremarkable in both cases. A week of box rest resulted in only a mild improvement in the lameness. A second radiographic examination did not reveal any significant abnormalities. In both cases, scintigraphic examination was suggested, but was declined by the owner, and the lameness had significantly improved after local infiltration of 3 mL of anaesthetic solution in the proximal suspensory region. Radiographic and ultrasonographic examinations of the carpus and proximal suspensory region were unremarkable in Case 2. Case 1 had increased thickness of the medial lobe of the proximal aspect of the suspensory ligament. A computed tomographic examination was performed and an incomplete longitudinal (fatigue) fracture of the proximal third metacarpal bone was detected. After 8 months of box rest and rehabilitation, re-examination revealed resolution of the lameness in both cases. Advanced diagnostic imaging should be considered in young endurance horses with severe lameness during competition or training, in which radiographic and ultrasonographic examinations are unremarkable or do not explain the severity of the lameness. Computed tomography imaging is considered a useful diagnostic imaging technique to detect incomplete longitudinal palmar metacarpal cortical (fatigue) fractures due to its ability to provide excellent bone detail. 相似文献
13.
Reasons for performing study: There is limited information on potential diffusion of local anaesthetic solution after various diagnostic analgesic techniques of the proximal metacarpal region. Objective: To document potential distribution of local anaesthetic solution following 4 techniques used for diagnostic analgesia of the proximal metacarpal region. Methods: Radiodense contrast medium was injected around the lateral palmar or medial and lateral palmar metacarpal nerves in 8 mature horses, using 4 different techniques. Radiographs were obtained 0, 10 and 20 min after injection and were analysed subjectively. A mixture of radiodense contrast medium and methylene blue was injected into 4 cadaver limbs; the location of the contrast medium and dye was determined by radiography and dissection. Results: Following perineural injection of the palmar metacarpal nerves, most of the contrast medium was distributed in an elongated pattern axial to the second and fourth metacarpal bones. The carpometacarpal joint was inadvertently penetrated in 4/8 limbs after injections of the palmar metacarpal nerves from medial and lateral approaches, and in 1/8 limbs when both injections were performed from the lateral approach. Following perineural injection of the lateral palmar nerve using a lateral approach, the contrast medium was diffusely distributed in all but one limb, in which the carpal sheath was inadvertently penetrated. In 5/8 limbs, following perineural injection of the lateral palmar nerve using a medial approach, the contrast medium diffused proximally to the distal third of the antebrachium. Conclusions and potential relevance: Inadvertent penetration of the carpometacarpal joint is common after perineural injection of the palmar metacarpal nerves, but less so if both palmar metacarpal nerves are injected using a lateral approach. Following injection of the lateral palmar nerve using a medial approach, the entire palmar aspect of the carpus may be desensitised. 相似文献
14.
RAPHAEL LABENS MICHAEL C. SCHRAMME IAN D. ROBERTSON DONALD E. THRALL W. RICH REDDING 《Veterinary radiology & ultrasound》2010,51(1):11-18
Sonography is commonly used for diagnosis of desmopathy of the proximal part of the suspensory ligament in horses. However, magnetic resonance (MR) imaging has been stated to be superior for detecting disease and localizing lesions. In this retrospective study of 39 horses or 46 hind limbs with lameness due to proximal plantar metatarsal pain, the clinical and diagnostic findings are discussed and sonography and MR imaging compared for examination of the proximal part of the suspensory ligament. With MR imaging interpreted as the clinical gold standard, desmopathy of the proximal part of the suspensory ligament was diagnosed in 21 hind limbs, proximal plantar metatarsal pain of unknown cause in 12, an osseous injury at the origin of the suspensory ligament in four and a condition unrelated to the suspensory ligament in nine. Based on these findings, sonography had a sensitivity of 0.77 and 0.66 and specificity of 0.33 and 0.31 for diagnosing proximal suspensory desmopathy and for accurately localizing lesions, respectively. MR imaging changes consistent with proximal suspensory desmopathy were signal hyperintensities and an increase in cross-sectional area compared with the contralateral limb. Anesthesia of the deep branch of the lateral plantar nerve is not specific neither for proximal suspensory desmopathy, as conditions unrelated to the suspensory ligament were diagnosed, nor for diagnosis of proximal plantar metatarsal pain, as conditions outside the proximal plantar metatarsal region were also diagnosed. 相似文献
15.
The normal gastrocnemius tendon may contain some muscular tissue proximally. This results in a patchy echogenicity ultrasonographically where it lies caudal or lateral to the superficial digital flexor tendon (SDFT). When it has assumed a position dorsal (cranial) to the SDFT the gastrocnemius tendon has a more uniform echogenicity and its margins are well defined. Five horses had lameness associated with lesions identified ultrasonographically in the gastrocnemius tendon in the latter region. Lameness ranged from mild to severe and was characterised by reduced hock flexion, lowered arc of foot flight, shortened length of the cranial phase of the stride and in some horses a reduced duration of weight bearing during the caudal phase of the stride. Lameness was variably accentuated by flexion of the proximal or distal limb joints of the lame limb. Perineural analgesia of the tibial and fibular nerves or the tibial nerve alone substantially improved the lameness. All horses remained lame 2-3 months after initial examination, with minimal change in the ultrasonographic appearance of the lesion(s). 相似文献
16.
The purpose of this study was to describe ultrasonographic changes of the equine palmar metacarpal area attributed to the infiltration of local anesthetic solution and to determine whether these changes were noted immediately or at 24 h. The palmar metacarpal region of one forelimb in each of six horses was examined ultrasonographically with a 10-MHz linear array transducer and a 7.5-MHz curvilinear transducer. Transverse and longitudinal images were recorded at 5-cm intervals distal to the accessory carpal bone. High and low palmar and palmar metacarpal nerve blocks were performed with a 2% mepivacaine hydrochloride solution. Ultrasonographic examinations similar to the initial examination then were performed immediately, 1 h and 24 h postinjection. Cross-sectional area and mean pixel value were determined for the superficial and deep digital flexor tendons, the accessory ligament of the deep digital flexor tendon, the suspensory ligament, and the suspensory branches at each level and time period. Subjective ultrasonographic changes also were noted. No significant difference was noted in the cross-sectional area or mean pixel value of any structure at any level or time period compared to baseline. Subjective changes in the tendons and ligaments were not noted. There was mild hypoechoic swelling of the surrounding soft tissues and gas in the region of the injections. Gas could interfere with the evaluation of the origin of the suspensory ligament and the proximal portion of the accessory ligament of the deep digital flexor tendon within the first hour but was not detectable ultrasonographically at 24 h. Based on these findings, if gas interferes with an ultrasonographic examination performed temporally close to perineural anesthesia, a repeat examination at 24 h is recommended. 相似文献
17.
A. NAGY G. BODÒ S. J. DYSON F. COMPOSTELLA A. R. S. BARR 《Equine veterinary journal》2010,42(6):512-518
Reasons for performing study: Evidence‐based information is limited on distribution of local anaesthetic solution following perineural analgesia of the palmar (Pa) and palmar metacarpal (PaM) nerves in the distal aspect of the metacarpal (Mc) region (‘low 4‐point nerve block’). Objectives: To demonstrate the potential distribution of local anaesthetic solution after a low 4‐point nerve block using a radiographic contrast model. Methods: A radiodense contrast medium was injected subcutaneously over the medial or the lateral Pa nerve at the junction of the proximal three‐quarters and distal quarter of the Mc region (Pa injection) and over the ipsilateral PaM nerve immediately distal to the distal aspect of the second or fourth Mc bones (PaM injection) in both forelimbs of 10 mature horses free from lameness. Radiographs were obtained 0, 10 and 20 min after injection and analysed subjectively and objectively. Methylene blue and a radiodense contrast medium were injected in 20 cadaver limbs using the same techniques. Radiographs were obtained and the limbs dissected. Results: After 31/40 (77.5%) Pa injections, the pattern of the contrast medium suggested distribution in the neurovascular bundle. There was significant proximal diffusion with time, but the main contrast medium patch never progressed proximal to the mid‐Mc region. The radiological appearance of 2 limbs suggested that contrast medium was present in the digital flexor tendon sheath (DFTS). After PaM injections, the contrast medium was distributed diffusely around the injection site in the majority of the limbs. In cadaver limbs, after Pa injections, the contrast medium and the dye were distributed in the neurovascular bundle in 8/20 (40%) limbs and in the DFTS in 6/20 (30%) of limbs. After PaM injections, the contrast and dye were distributed diffusely around the injection site in 9/20 (45%) limbs and showed diffuse and tubular distribution in 11/20 (55%) limbs. Conclusions and potential relevance: Proximal diffusion of local anaesthetic solution after a low 4‐point nerve block is unlikely to be responsible for decreasing lameness caused by pain in the proximal Mc region. The DFTS may be penetrated inadvertently when performing a low 4‐point nerve block. 相似文献
18.
B‐mode and power Doppler ultrasonography of the equine suspensory ligament branches: A descriptive study on 13 horses 
下载免费PDF全文
下载免费PDF全文 Silvia Rabba Sigrid Grulke Denis Verwilghen Laurence Evrard Valeria Busoni 《Veterinary radiology & ultrasound》2018,59(4):453-460
Ultrasonography is routinely used to achieve the diagnosis of equine suspensory ligament desmopathy. In human medicine, power Doppler ultrasonography has also been found to be useful for the diagnosis of tendon/ligament injuries. The aim of this prospective, pilot study was to assess the presence or absence of power Doppler signal in suspensory ligament branches and compare B‐mode findings with power Doppler findings in suspensory ligament branches of lame and non‐lame limbs. Thirteen horses were used (eight lame horses, with lameness related to pain in the suspensory ligament branches, and five non‐lame horses). Ten lame limbs and 24 sound limbs were assessed by B‐mode and power Doppler ultrasonography. The severity of power Doppler signal was scored by two independent readers. The B‐mode ultrasonographic examination revealed abnormalities in branches of lame limbs and in branches of sound limbs. Suspensory ligament branches that were considered normal in B‐mode showed no power Doppler signal. However, power Doppler signal was detected in suspensory ligament branches that were abnormal in B‐mode, both in lame and sound limbs. Power Doppler scores were subjectively higher in suspensory ligament branches of lame limbs and in branches with more severe B‐mode changes. Findings supported the use of power Doppler as an adjunctive diagnostic test for lame horses with suspected suspensory desmopathy. 相似文献
19.
REASONS FOR PERFORMING STUDY: Desmopathy of the accessory ligament of the deep digital flexor tendon (ALDDFT) in the hindlimb is an unusual cause of lameness in horses, and reports of the condition are sparse. OBJECTIVES: To describe the clinical and ultrasonographic findings, therapy and outcome of 23 horses treated for desmopathy of the ALDDFT in the hindlimb. METHODS: Records of 23 horses with ultrasonographic evidence of desmopathy of the ALDDFT in one or both hindlimbs from 3 referral centres were reviewed retrospectively. Age, breed, sex, duration and nature of clinical signs, results of clinical and lameness examinations, treatment and outcome were recorded. RESULTS: In 13 horses (Group A), there was an acute onset of unilateral lameness. Ten horses (Group B) had an insidious or sudden onset of postural abnormality. There were 10 cobs, 5 British native-breed ponies and 8 horses of various larger breeds. Twenty horses were used for general purposes, and mean age was 12 years. Enlargement of the ALDDFT in the affected hindlimb(s) was identified in all horses. In 44% of horses, ultrasonographic abnormalities were localised to part of the ALDDFT. Treatment included box-rest and controlled exercise, and 10 horses were subjected to desmotomy or desmectomy of the ALDDFT. Seventy-three percent of horses in Group A returned to full function, while 90% of those in Group B remained lame. CONCLUSIONS: Two distinct clinical conditions are associated with the ALDDFT of the hindlimb. Traumatically induced injury resulting in acute onset lameness appears to have a favourable prognosis, with most horses returning to previous work. However, postural changes, once present, are irreversible and indicate a poor prognosis. POTENTIAL RELEVANCE: Desmopathy of the ALDDFT should be recognised as a potential cause of hindlimb lameness and this study provides clinical and prognostic information. Knuckling and/or semiflexion of the metatarsophalangeal joint may accompany the condition; therefore, if a horse is presented with a flexural deformity of this joint, desmopathy of the ALDDFT should be considered as a primary differential diagnosis. 相似文献
20.
Ultrasonography of the proximal third interosseus muscle (PTIOM, suspensory ligament) is routinely performed for the diagnosis of the cause of proximal metacarpal/tarsal pain. As a result of the complex architecture and deep localisation of this ligament, performing and interpreting ultrasonographic images of this structure can be difficult. This paper describes an ultrasonographic procedure that allows complete imaging of the PTIOM in the forelimbs using a combination of approaches including sagittal and palmarocollateral approaches on the weightbearing limb with linear and convex probes. Moreover, the procedure includes images made on the flexed limb, thereby allowing a better contact and a more complete representation of the PTIOM and palmar aspect of the metacarpal bones. 相似文献