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van Veggel ECS, Vanderperren K, Selberg KT, Bergman HJ, Hoogelander B. The Evolution of Lesions on Follow-Up Magnetic Resonance Imaging of the Proximal Metacarpal Region in Non-Racing Sport Horses That Returned to Work (2015-2023). Animals (Basel) 2024; 14:1731. [PMID: 38929351 PMCID: PMC11201264 DOI: 10.3390/ani14121731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND This study evaluates the change in an MRI of the proximal metacarpal region in a group of sport horses that returned to work. This retrospective analysis evaluated 18 limbs represented by 17 horses. RESULTS The hyperintense signal within the dorsal collagenous part of the proximal suspensory ligament (PSL) on T1W/T2*W GRE sequences decreased or stayed the same in the majority of cases. The hyperintense STIR signal within the dorsal collagenous part of the PSL resolved in the majority of the patients, and the third metacarpal bone (McIII) hyperintense STIR signal resolved in all patients. The dorsal margin irregularity of the PSL stayed the same, and McIII sclerosis and resorption of the palmar margin of McIII stayed the same in the majority of cases. McIII hyperintense STIR signal resolution carries a broad time range, with a mean of 94 days and a range of 47-202 days. CONCLUSIONS Complete normalization of the dorsal collagenous part of the PSL does not appear necessary for a return to soundness, but a resolution of the McIII hyperintense STIR signal is expected for horses returning to soundness. A rescan period of 120 days for the proximal metacarpal region is suggested. In addition, there was no significant change in the size of the PSL between the initial and final MRI.
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Affiliation(s)
| | - Katrien Vanderperren
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium
| | - Kurt T. Selberg
- Johnson Family Equine Hospital, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA;
| | - Hendrik-Jan Bergman
- Sporthorse Medical Diagnostic Centre (SMDC), 5384 RC Heesch, The Netherlands
| | - Brenda Hoogelander
- Sporthorse Medical Diagnostic Centre (SMDC), 5384 RC Heesch, The Netherlands
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Hewitt-Dedman CL, Kershaw LE, Schwarz T, Del-Pozo J, Duncan J, Daniel CR, Cillán-García E, Pressanto MC, Taylor SE. Preliminary study of proton magnetic resonance spectroscopy to assess bone marrow adiposity in the third metacarpus or metatarsus in Thoroughbred racehorses. Equine Vet J 2024. [PMID: 38699829 DOI: 10.1111/evj.14086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 03/07/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Magnetic resonance spectroscopy (MRS) has been used to investigate metabolic changes within human bone. It may be possible to use MRS to investigate bone metabolism and fracture risk in the distal third metacarpal/tarsal bone (MC/MTIII) in racehorses. OBJECTIVES To determine the feasibility of using MRS as a quantitative imaging technique in equine bone by using the 1H spectra for the MC/MTIII to calculate fat content (FC). STUDY DESIGN Observational cross-sectional study. METHODS Limbs from Thoroughbred racehorses were collected from horses that died or were subjected to euthanasia on racecourses. Each limb underwent magnetic resonance imaging (MRI) at 3 T followed by single-voxel MRS at three regions of interest (ROI) within MC/MTIII (lateral condyle, medial condyle, proximal bone marrow [PBM]). Percentage FC was calculated at each ROI. Each limb underwent computed tomography (CT) and bone mineral density (BMD) was calculated for the same ROIs. All MR and CT images were graded for sclerosis. Histology slides were graded for sclerosis and proximal marrow space was calculated. Pearson or Spearman correlations were used to assess the relationship between BMD, FC and marrow space. Kruskal-Wallis tests were used to check for differences between sclerosis groups for BMD or FC. RESULTS Eighteen limbs from 10 horses were included. A negative correlation was identified for mean BMD and FC for the lateral condyle (correlation coefficient = -0.60, p = 0.01) and PBM (correlation coefficient = -0.5, p = 0.04). There was a significant difference between median BMD for different sclerosis grades in the condyles on both MRI and CT. A significant difference in FC was identified between sclerosis groups in the lateral condyle on MRI and CT. MAIN LIMITATIONS Small sample size. CONCLUSIONS 1H Proton MRS is feasible in the equine MC/MTIII. Further work is required to evaluate the use of this technique to predict fracture risk in racehorses.
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Affiliation(s)
- Charlotte L Hewitt-Dedman
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Lucy E Kershaw
- BHF Centre for Cardiovascular Science and Edinburgh Imaging, University of Edinburgh, Edinburgh, UK
| | - Tobias Schwarz
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Jorge Del-Pozo
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Juliet Duncan
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Carola R Daniel
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Eugenio Cillán-García
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Maria Chiara Pressanto
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Sarah E Taylor
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK
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3
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Horne CR, Tufts S. Advances in Imaging Techniques to Guide Therapies and Monitor Response to the Treatment of Musculoskeletal Injuries. Vet Clin North Am Equine Pract 2023; 39:489-501. [PMID: 37482520 DOI: 10.1016/j.cveq.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Continual advancements in diagnostic imaging have allowed for more accurate and complete diagnoses of injuries in the performance horse. The use of several different imaging tools has further allowed the equine sports medicine clinician to more carefully direct treatment options, monitor response to therapy and guide rehabilitation recommendations. The advancements in diagnostic imaging and novel treatment options have led to the improvement in the overall prognosis of many injuries that affect the horse and their performance. The purpose of this section is to review the advancements made in diagnostic imaging of the horse and to aid the practitioner in the selection of the appropriate modality and how best to use them to guide treatment and monitoring decisions.
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Affiliation(s)
- Caitlyn R Horne
- North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, NC 27607, USA.
| | - Sara Tufts
- North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, NC 27607, USA
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4
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Barrett MF, Goorchenko GE, Frisbie DD. Comparison of Ultrasound and Magnetic Resonance Imaging for Identifying Soft Tissue Abnormalities in the Palmar Aspect of the Equine Digit. Animals (Basel) 2023; 13:2328. [PMID: 37508105 PMCID: PMC10376038 DOI: 10.3390/ani13142328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Damage to the soft tissue structures of the digit is a common source of equine lameness. While magnetic resonance imaging (MRI) allows for the most complete diagnostic imaging of the equine digit, ultrasound is more readily available and less expensive. This prospective diagnostic accuracy study compares ultrasound to MRI for the diagnosis of injuries visible with ultrasound within the digit, including the deep digital flexor tendon (DDFT), collateral sesamoidean ligament (CSL), and navicular bursa. Clinical patients underwent an MRI of the digit and a blinded ultrasound of the digit between the heel bulbs, and results of the two modalities were compared. A total of 70 ultrasound and MRI exams of 45 horses were included. Ultrasound had good sensitivity (85%), moderate specificity (60%), and accuracy of 70% for evaluating the dorsal tearing of the DDFT. Accuracy was lower for navicular bursa effusion (67%), navicular bursa proliferation (61%), and CSL enlargement (61%). Tearing of the DDFT distal to the navicular bone was identified with MRI in 27 limbs, 20 of which also had dorsal damage proximal to the navicular bone identified with ultrasound. Ultrasound evaluation remains a useful screening tool, particularly for the assessment of DDFT tearing proximal to the navicular bone but risks under-diagnosing pathology to the navicular bursa and CSL. Clinically significant concurrent damage to the distal DDFT and other osseous and soft tissues in the hoof capsule is unlikely to be identified without MRI.
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Affiliation(s)
- Myra F Barrett
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | | | - David D Frisbie
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
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5
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Hewitt‐Dedman CL, Biggi M, Van Zadelhoff C, Schwarz T, Reardon RJM, Taylor SE. Imaging findings and clinical outcome of foot pain attributable to insertional deep digital flexor tendon injury and/or fluid signal within the flexor surface of the distal phalanx. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C. L. Hewitt‐Dedman
- Royal (Dick) School of Veterinary Studies and Roslin Institute The University of Edinburgh Roslin UK
| | - M. Biggi
- VetCT St John’s Innovation Centre Cambridge UK
| | - C. Van Zadelhoff
- Royal (Dick) School of Veterinary Studies and Roslin Institute The University of Edinburgh Roslin UK
| | - T. Schwarz
- Royal (Dick) School of Veterinary Studies and Roslin Institute The University of Edinburgh Roslin UK
| | - R. J. M. Reardon
- Royal (Dick) School of Veterinary Studies and Roslin Institute The University of Edinburgh Roslin UK
| | - S. E. Taylor
- Royal (Dick) School of Veterinary Studies and Roslin Institute The University of Edinburgh Roslin UK
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6
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Garrett KS. When radiography and ultrasonography are not enough: the use of computed tomography and magnetic resonance imaging for equine lameness cases. J Am Vet Med Assoc 2022; 260:1113-1123. [PMID: 35544423 DOI: 10.2460/javma.22.03.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
MRI and CT have enhanced our diagnostic abilities for equine lameness beyond what is available using radiography and ultrasonography. This has allowed veterinarians to better prognosticate and treat lameness conditions, improving patient outcomes. This article discusses the basic principles behind MRI and CT, their advantages and disadvantages, the different types of equipment available for clinical use in horses, the typical diagnostic workup prior to pursuing advanced imaging, and common regions where MRI and CT are used clinically. The companion Currents in One Health by Spriet, AJVR, July 2022, discusses even more advanced equine imaging in the form of positron emission tomography. Combined, these future directions of MRI, CT, and positron emission tomography may include improved ability to image standing horses or screen for injury prevention.
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7
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ELKhamary AN, Keenihan EK, Schnabel LV, Redding WR, Schumacher J. Leveraging MRI characterization of longitudinal tears of the deep digital flexor tendon in horses using machine learning. Vet Radiol Ultrasound 2022; 63:580-592. [PMID: 35415959 DOI: 10.1111/vru.13090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 12/31/2021] [Accepted: 02/02/2022] [Indexed: 11/26/2022] Open
Abstract
While MRI is the modality of choice for the diagnosis of longitudinal tears (LTs) of the deep digital flexor tendon (DDFT) of horses, differentiating between various grades of tears based on imaging characteristics is challenging due to overlapping imaging features. In this retrospective, exploratory, diagnostic accuracy study, a machine learning (ML) scheme was applied to link quantitative features and qualitative descriptors to leverage MRI characteristics of different grades of tearing of the DDFT of horses. A qualitative MRI characteristic scheme, combining tendon morphologic features, altered signal intensity, and synovial sheath distention, was used for LT classification with an excellent diagnostic accuracy of the high-grade tears but more limited accuracy for the detection of low-grade tears. A quantitative ML approach was followed to measure the contribution of 30 quantitative phenotypic features for characterizing and classifying tendinous tears. Among the 30 imaging features, boundary curvature represented by the standard deviation and maximum had the most significant discriminatory power (P < 0.05) between normal and abnormal tendons and could be used as an aid for classifying the different grades of LTs of DDFTs. Imaging analysis-based 3D interactive surface plot supports qualitative characterization of different grades of LTs of the DDFT through clearer visualization of the tendon in three dimensions and simple integration of two perspectives features (i.e., margin/distribution and intensity/distribution). A systematic approach combining quantitative features with qualitative analyses using ML was diagnostically beneficial in MRI characterization and in discriminating between different grades of LTs of the DDFT of horses.
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Affiliation(s)
- Ahmed N ELKhamary
- Department of Surgery, Radiology and Anesthesiology, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Behera, Egypt
| | - Erin K Keenihan
- Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Lauren V Schnabel
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - William R Redding
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Jim Schumacher
- Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
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8
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Ehrle A, Lilge S, Clegg PD, Maddox TW. Equine flexor tendon imaging part 2: Current status and future directions in advanced diagnostic imaging, with focus on the deep digital flexor tendon. Vet J 2021; 278:105763. [PMID: 34678501 DOI: 10.1016/j.tvjl.2021.105763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 09/17/2021] [Accepted: 10/15/2021] [Indexed: 11/16/2022]
Abstract
Flexor tendon injuries are a common cause of lameness and early retirement in equine athletes. While ultrasonography is most frequently utilised, advanced diagnostic imaging modalities are becoming more widely available for detection and monitoring of flexor tendon lesions. Part two of this literature review details current experience with low- and high-field magnetic resonance imaging (MRI) and computed tomography (CT) for the diagnosis of equine flexor tendinopathy with a focus on the deep digital flexor tendon. Implications of the 'magic angle' artefact as well as injection techniques and the use of contrast media are discussed. Future developments in tendon imaging aim to gain enhanced structural information about the tendon architecture with the prospect to prevent injury. Techniques as described for the assessment of the human Achilles tendon including ultra-high field MRI and positron emission tomography are highlighted.
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Affiliation(s)
- Anna Ehrle
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK; Equine Clinic, Freie Universität Berlin, 10965 Berlin, Germany.
| | - Svenja Lilge
- Equine Clinic, Freie Universität Berlin, 10965 Berlin, Germany
| | - Peter D Clegg
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK
| | - Thomas W Maddox
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston CH64 7TE, UK
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9
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Evrard L, Joostens Z, Vandersmissen M, Audigié F, Busoni V. Comparison Between Ultrasonographic and Standing Magnetic Resonance Imaging Findings in the Podotrochlear Apparatus of Horses With Foot Pain. Front Vet Sci 2021; 8:675180. [PMID: 34291100 PMCID: PMC8287171 DOI: 10.3389/fvets.2021.675180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
This prospective study aimed to blindly compare the ultrasonographic and standing magnetic resonance imaging (sMRI) findings in deep digital flexor tendon (DDFT), navicular bone, and navicular bursa in horses with foot pain, positive digital analgesia, and without definitive radiographic diagnosis. Ultrasonography detected more DDFT abnormalities (32/34 feet vs. 27/34 with sMRI) but identified less palmar navicular abnormalities (23/34 feet vs. 30/34 with sMRI). In suprasesamoidean DDFT lesions, which were mainly dorsally located, changes in echogenicity did not correspond to a particular pattern of sMRI signal change. Transcuneal ultrasonography did not allow assessment of morphology and extent of distal DDFT lesions, and sporadically discriminated the affected lobe compared to sMRI. Defects of the palmar compact bone were identified with both modalities except a parasagittal defect, which was only seen at sMRI.
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Affiliation(s)
- Laurence Evrard
- Department of Clinical Sciences of Companion Animals and Equids, Equine Division, Diagnostic Imaging Section, University of Liège, Liège, Belgium
| | - Zoë Joostens
- Medical Imaging Department, Equitom Equine Clinic, Lummen, Belgium
| | - Maxime Vandersmissen
- Department of Clinical Sciences of Companion Animals and Equids, Equine Division, Diagnostic Imaging Section, University of Liège, Liège, Belgium
| | - Fabrice Audigié
- Centre d'Imagerie et de Recherche sur les Affections Locomotrices Equines, Ecole Nationale Vétérinaire d'Alfort, Goustranville, France
| | - Valeria Busoni
- Department of Clinical Sciences of Companion Animals and Equids, Equine Division, Diagnostic Imaging Section, University of Liège, Liège, Belgium
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10
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Wilson S, Spriet M, Mur PE, Anishchenko S, Beylin D, Katzman S, Galuppo L. 18 Fluorine-fluorodeoxyglucose positron emission tomography for assessment of deep digital flexor tendinopathy: An exploratory study in eight horses with comparison to CT and MRI. Vet Radiol Ultrasound 2021; 62:610-620. [PMID: 34148276 DOI: 10.1111/vru.13001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 04/11/2021] [Accepted: 04/18/2021] [Indexed: 11/28/2022] Open
Abstract
Lesions of the deep digital flexor tendon (DDFT) are a cause for foot lameness in horses. Positron emission tomography (PET) could provide valuable information regarding the metabolic activity of these lesions. The aims of this exploratory, prospective, methods comparison study were to assess the ability of 18 fluorine-fluorodeoxyglucose (18 F-FDG) PET to detect DDFT lesions and to compare the PET findings with CT and MRI findings. Eight horses with lameness due to pain localized to the front feet were included. Both front limbs of all horses were imaged with 18 F-FDG PET, noncontrast CT, and arterial contrast-enhanced CT; 11 limbs were also assessed using MRI. Two observers graded independently 18 F-FDG PET, noncontrast CT, arterial contrast CT, T1-weighted (T1-w) MRI, and T2-weighted (T2-w)/STIR MRI. Maximal standardized uptake values were measured. Lesions were found in seven of 16 DDFT on PET, 12 of 16 DDFT on noncontrast CT, six of 15 DDFT on arterial contrast CT, eight of 11 DDFT on T1-w MRI, and six of 11 DDFT on T2-w/STIR MRI. Positron emission tomography was in better agreement with arterial contrast CT (Kappa-weighted 0.40) and T2-w/STIR MRI (0.35) than with noncontrast CT (0.28) and T1-w MRI (0.20). Maximal standardized uptake values of lesions ranged from 1.9 to 4.6 with a median of 3.1. Chronic lesions with scar tissues identified on noncontrast CT or T1-w MRI did not have increased 18 F-FDG uptake. These results demonstrated that 18 F-FDG PET agreed more closely with modalities previously used to detect active tendon lesions, i.e. arterial contrast CT and T2-w/STIR MRI. 18 Fluorine-fluorodeoxyglucose PET can be used to identify metabolically active DDFT lesions in horses.
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Affiliation(s)
- Sabrina Wilson
- School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Mathieu Spriet
- School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Pablo Espinosa Mur
- School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Sergey Anishchenko
- LONGMILE Veterinary Imaging, Brain Biosciences Inc., Rockville, Maryland, USA
| | - David Beylin
- LONGMILE Veterinary Imaging, Brain Biosciences Inc., Rockville, Maryland, USA
| | - Scott Katzman
- School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Larry Galuppo
- School of Veterinary Medicine, University of California, Davis, Davis, California, USA
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11
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Acutt EV, Contino EK, Frisbie DD, Barrett MF. Deep digital flexor tendon lesions in the pastern are associated with the presence of distal tendinopathy. Equine Vet J 2021; 54:502-512. [PMID: 34050982 DOI: 10.1111/evj.13470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 04/01/2021] [Accepted: 05/20/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Correct diagnosis and characterisation of deep digital flexor tendon (DDFT) lesions in equine athletes allows targeted treatment and improved prognostication. OBJECTIVES To assess the prevalence and character of pathological change within the DDFT in the pastern with concurrent tendon injury distally. It is hypothesised that tendon lesions in the pastern will be associated with tendinopathy within the hoof capsule. STUDY DESIGN Retrospective descriptive case series. METHODS Cases with DDFT lesions in the pastern and magnetic resonance imaging (MRI) or ultrasonography of the foot were evaluated retrospectively. Lesion location and type were recorded. Odds ratios were calculated to determine the associations between more distal tendinopathy and the presence of different DDFT lesion types in the pastern. RESULTS Thirty-four MRI scans of 33 horses and 64 ultrasonographic exams of 58 horses were analysed. Lesion location and type were recorded. Distal DDFT lesions were found in 75% (95% CI: 66.0-84.0) of total cases of pastern DDF tendinopathy and in 97% (95% CI: 91.6-100.0) of cases with core lesions of the DDFT in the pastern. A core lesion in the pastern was significantly more likely (OR = 20.7, 95% CI: 2.2-191.0; P = .008) to be associated with injury in the foot than other types of pastern lesion. MAIN LIMITATIONS MRIs of the foot were not obtained on all included limbs which did not allow for fully inclusive evaluation of DDFT lesions distal to the navicular bone. CONCLUSIONS DDFT pathological change in the pastern, particularly core lesions, is associated with additional tendinopathy within the hoof capsule. When a DDFT lesion is found in the pastern, further imaging of the tendon within the foot is indicated to direct appropriate treatment and improve prognostication.
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Affiliation(s)
- Elizabeth V Acutt
- Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado, USA
| | - Erin K Contino
- Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado, USA
| | - David D Frisbie
- Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado, USA
| | - Myra F Barrett
- Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado, USA
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12
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Berner D, Brehm W, Gerlach K, Offhaus J, Scharner D, Burk J. Variation in the MRI signal intensity of naturally occurring equine superficial digital flexor tendinopathies over a 12-month period. Vet Rec 2020; 187:e53. [PMID: 32690762 DOI: 10.1136/vr.105800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 04/12/2020] [Accepted: 05/28/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Signal intensity (SI) of equine tendinopathies in MRI differs between the superficial digital flexor tendon (SDFT) and the deep digital flexor tendon (DDFT). In DDFT lesions, short tau inversion recovery (STIR) SI decreases earlier than T2-weighted (T2w) SI, while the latter decreases earlier in SDFT lesions, but long-term results using STIR sequences are lacking. METHODS Standing MRI of eight horses with naturally occurring SDFT lesions was performed at the day of treatment as well as 2, 6 and 12 months after treatment. RESULTS After 12 months, six horses were sound and showed complete resolution of increased SI in T2w fast spin echo (FSE) images, but increased SI was found in STIR images in three horses and persisted in T1w and T2*w gradient recall echo images of all horses. In contrast, hyperintense areas were still visible in the SDFT in T2w FSE images in two horses presenting with re-injury. In the six horses without re-injury, percentage of cross-sectional areas affected and SI decreased over time in all sequences. CONCLUSIONS This study suggests that SI in naturally occurring SDFT lesions decreases earlier in T2w FSE than in STIR images, in contrast to the DDFT.
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Affiliation(s)
- Dagmar Berner
- Equine Referral Hospital, Royal Veterinary College Clinical Services Division, Hatfield, UK .,Department for Horses, University of Leipzig Faculty of Veterinary Medicine, Leipzig, Sachsen, Germany
| | - Walter Brehm
- Department for Horses, University of Leipzig Faculty of Veterinary Medicine, Leipzig, Sachsen, Germany.,Saxon Incubator for Clinical Translation, University of Leipzig, Leipzig, Sachsen, Germany
| | - Kerstin Gerlach
- Department for Horses, University of Leipzig Faculty of Veterinary Medicine, Leipzig, Sachsen, Germany
| | - Julia Offhaus
- Department for Horses, University of Leipzig Faculty of Veterinary Medicine, Leipzig, Sachsen, Germany
| | - Doreen Scharner
- Department for Horses, University of Leipzig Faculty of Veterinary Medicine, Leipzig, Sachsen, Germany
| | - Janina Burk
- Institute for Veterinary Physiology, University of Leipzig Faculty of Veterinary Medicine, Leipzig, Sachsen, Germany.,Equine Clinic (Surgery), Justus-Liebig-University Giessen Faculty of Veterinary Medicine, Giessen, Hessen, Germany
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13
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Gutierrez-Nibeyro SD, Werpy NM, Gold SJ, Olguin S, Schaeffer DJ. Standing MRI lesions of the distal interphalangeal joint and podotrochlear apparatus occur with a high frequency in warmblood horses. Vet Radiol Ultrasound 2020; 61:336-345. [PMID: 32162431 DOI: 10.1111/vru.12855] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 01/12/2020] [Accepted: 01/19/2020] [Indexed: 11/30/2022] Open
Abstract
Foot pain is a common presenting complaint in Warmblood horses. The aim of this retrospective, cross-sectional study was to determine the spectrum of foot lesions detected by magnetic resonance imaging (MRI) in Warmblood horses used for dressage, jumping, and eventing. The medical records of 550 Warmblood horses with foot pain that were scanned using standing MRI were reviewed and the following data were recorded: signalment, occupation, lameness, diagnostic analgesia, imaging results, treatments, and follow-up assessments. Associations between standing MRI lesions and chronic lameness following treatment were tested. Abnormalities of the navicular bone (409 horses, 74%), distal interphalangeal joint (362 horses, 65%), and deep digital flexor (DDF) tendon (260 horses, 47%) occurred with the highest frequency. The following abnormalities were significantly associated (P < .05) with chronic lameness following conservative therapy: moderate to severe MRI lesions in the trabecular bone of the navicular bone, mild or severe erosions of the flexor surface of the navicular bone, moderate sagittal/parasagittal DDF tendinopathies, and moderate collateral sesamoidean desmopathies. Also, identification of concurrent lesions of the DDF tendon, navicular bone, navicular bursa, and distal sesamoidean impar ligament was associated with chronic lameness after conservative therapy. Development of effective treatment options for foot lesions that respond poorly to conservative therapy is necessary.
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Affiliation(s)
- Santiago D Gutierrez-Nibeyro
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois
| | | | | | - Silvia Olguin
- College of Veterinary Medicine, University of La Plata, La Plata, Buenos Aires, Argentina
| | - David J Schaeffer
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois
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Zani DD, Rabbogliatti V, Ravasio G, Pettinato C, Giancamillo MD, Zani DD. Contrast enhanced magnetic resonance imaging of the foot in horses using intravenous versus regional intraarterial injection of gadolinium. Open Vet J 2018; 8:471-478. [PMID: 30775287 PMCID: PMC6356101 DOI: 10.4314/ovj.v8i4.19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 11/20/2018] [Indexed: 12/27/2022] Open
Abstract
The use of contrast enhanced magnetic resonance imaging (MRI) for the detection of orthopedic pathologies in equine patients is poorly described. In few studies, enhanced MRI allowed to differentiate active lesions from chronic ones and to classify ambiguous lesions. The aim of this clinical prospective pilot study is to describe and compare the MRI lesions observed in horses with lameness localized to the foot using a single intravenous bolus dose of gadolinium contrast versus regional intraarterial bolus of contrast agent. Ten horses that underwent contrast enhanced MRI were included in the study. Gadolinium was injected intravenously in 3 patients and in 7 horses contrast agent was administered by intraarterial regional delivery. Regions of interest (ROI) were collected from both pre- and post-contrast images and ratios between pre- and post-contrast ROIs were calculated. No adverse reactions were noted after contrast agent injection. Injured structures that revealed greater increase in signal in post-contrast images were the deep digital flexor tendon (DDFT), the navicular spongiosa and the peritendinous tissues. Regional intraarterial administration of gadolinium provided higher ratio of contrast enhancement. Enhanced MRI using both intravenous or intraarterial injection of gadolinium, increased the diagnostic capability of MRI in horses with foot lesions. Nevertheless, regional intraarterial administration of gadolinium was considered the best choice due to the higher signal and lower volumes of contrast agent required.
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Affiliation(s)
- Donatella De Zani
- Dipartimento di Medicina Veterinaria, Centro Clinico Veterinario e Zootecnico Sperimentale, Università degli Studi di Milano, Italy
| | - Vanessa Rabbogliatti
- Dipartimento di Medicina Veterinaria, Centro Clinico Veterinario e Zootecnico Sperimentale, Università degli Studi di Milano, Italy
| | - Giuliano Ravasio
- Dipartimento di Medicina Veterinaria, Centro Clinico Veterinario e Zootecnico Sperimentale, Università degli Studi di Milano, Italy
| | - Cinzia Pettinato
- Department of Medical Physics, Policlinico S.Orsola-Malpighi, Bologna, Italy
| | - Mauro Di Giancamillo
- Dipartimento di Medicina Veterinaria, Centro Clinico Veterinario e Zootecnico Sperimentale, Università degli Studi di Milano, Italy
| | - Davide Danilo Zani
- Dipartimento di Medicina Veterinaria, Centro Clinico Veterinario e Zootecnico Sperimentale, Università degli Studi di Milano, Italy
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15
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Schoonover MJ, Whitfield CT, Young JM, Sippel KM, Payton ME. Quantitative assessment of intravenous regional limb perfusion of tiludronate as an adjunctive treatment for lameness caused by navicular syndrome in horses. Am J Vet Res 2018; 79:1313-1320. [DOI: 10.2460/ajvr.79.12.1313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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16
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Gutierrez-Nibeyro SD, McCoy AM, Selberg KT. Recent advances in conservative and surgical treatment options of common equine foot problems. Vet J 2018; 237:9-15. [PMID: 30089549 DOI: 10.1016/j.tvjl.2018.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 05/09/2018] [Accepted: 05/15/2018] [Indexed: 12/25/2022]
Abstract
Foot problems are very common causes of lameness in horses. With the recent diagnostic advances to evaluate and treat foot pathology as well as to monitor response to therapy, it is now possible to more accurately evaluate the effectiveness of many of these treatments. This review details some of the recent advances of the most common conservative and surgical treatment options for foot problems in horses, including an overview of evidence on the efficacy to support the use of these treatment options and on factors that may affect prognosis.
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Affiliation(s)
- S D Gutierrez-Nibeyro
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA.
| | - A M McCoy
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | - K T Selberg
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
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Berner D. Diagnostic imaging of tendinopathies of the superficial flexor tendon in horses. Vet Rec 2017; 181:652-654. [PMID: 29246992 DOI: 10.1136/vr.j5746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Dagmar Berner
- Department of Clinical Science & Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK
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Mizobe F, Nomura M, Kato T, Nambo Y, Yamada K. Signal changes in standing magnetic resonance imaging of osseous injury at the origin of the suspensory ligament in four Thoroughbred racehorses under tiludronic acid treatment. J Equine Sci 2017; 28:87-97. [PMID: 28955160 PMCID: PMC5608961 DOI: 10.1294/jes.28.87] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 06/15/2017] [Indexed: 11/22/2022] Open
Abstract
Problems associated with the proximal metacarpal region, such as an osseous injury associated with tearing of Sharpey’s fibers or an avulsion fracture of the origin of the suspensory ligament (OISL), are important causes of
lameness in racehorses. In the present study, four Thoroughbred racehorses (age range, 2–4 years) were diagnosed as having forelimb OISL and assessed over time by using standing magnetic resonance imaging (sMRI). At the first sMRI
examination, all horses had 3 characteristic findings, including low signal intensity within the trabecular bone of the third metacarpus on T1-weighted images, intermediate-to-high signal intensity surrounded by a hypointense rim
on T2*-weighted images, and high signal intensity on fat-suppressed images. Following the sMRI examination, all horses received 50 mg of tiludronic acid by intravenous regional limb perfusion once weekly for 3 weeks. Attenuation
of the high signal intensity on T2*-weighted and fat-suppressed images was observed on follow-up sMRI in 3 horses. Following rest and rehabilitation, these 3 horses successfully returned to racing. In contrast, the other horse
that did not show attenuation of the high signal intensity failed to return to racing. To our knowledge, this is the first report of OISL in Thoroughbred racehorses assessed over time by sMRI under tiludronic acid treatment. Our
findings support the use of sMRI for examining lameness originating from the proximal metacarpal region to refine the timing of returning to exercise based on follow-up examinations during the recuperation period.
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Affiliation(s)
- Fumiaki Mizobe
- Racehorse Hospital, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
| | - Motoi Nomura
- Racehorse Hospital, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
| | - Tomohiro Kato
- Racehorse Hospital, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
| | - Yasuo Nambo
- Department of Clinical Veterinary Science, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan
| | - Kazutaka Yamada
- Laboratory of Veterinary Radiology, School of Veterinary Medicine, Azabu University, Kanagawa 252-5201, Japan
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Groom LM, White NA, Adams MN, Barrett JG. Accuracy of open magnetic resonance imaging for guiding injection of the equine deep digital flexor tendon within the hoof. Vet Radiol Ultrasound 2017; 58:671-678. [PMID: 28681515 DOI: 10.1111/vru.12523] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 04/11/2017] [Accepted: 05/16/2017] [Indexed: 11/29/2022] Open
Abstract
Lesions of the distal deep digital flexor tendon (DDFT) are frequently diagnosed using MRI in horses with foot pain. Intralesional injection of biologic therapeutics shows promise in tendon healing; however, accurate injection of distal deep digital flexor tendon lesions within the hoof is difficult. The aim of this experimental study was to evaluate accuracy of a technique for injection of the deep digital flexor tendon within the hoof using MRI-guidance, which could be performed in standing patients. We hypothesized that injection of the distal deep digital flexor tendon within the hoof could be accurately guided using open low-field MRI to target either the lateral or medial lobe at a specific location. Ten cadaver limbs were positioned in an open, low-field MRI unit. Each distal deep digital flexor tendon lobe was assigned to have a proximal (adjacent to the proximal aspect of the navicular bursa) or distal (adjacent to the navicular bone) injection. A titanium needle was inserted into each tendon lobe, guided by T1-weighted transverse images acquired simultaneously during injection. Colored dye was injected as a marker and postinjection MRI and gross sections were assessed. The success of injection as evaluated on gross section was 85% (70% proximal, 100% distal). The success of injection as evaluated by MRI was 65% (60% proximal, 70% distal). There was no significant difference between the success of injecting the medial versus lateral lobe. The major limitation of this study was the use of cadaver limbs with normal tendons. The authors conclude that injection of the distal deep digital flexor tendon within the hoof is possible using MRI guidance.
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Affiliation(s)
- Lauren M Groom
- Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, VA, 24060
| | - Nathaniel A White
- Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, VA, 24060
| | - M Norris Adams
- Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, VA, 24060
| | - Jennifer G Barrett
- Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, VA, 24060
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Schramme M. Treatment of tendinopathy in the foot - what have we learned so far? EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- M. Schramme
- Clinéquine; VetAgro Sup; Campus Vétérinaire de Lyon; University of Lyon; France
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Humbach KE, Gutierrez-Nibeyro SD. Desmotomy of the accessory ligament of the deep digital flexor tendon for treatment of chronic deep digital flexor tendinopathy in three Quarter Horses. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12713] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- K. E. Humbach
- Department of Clinical Veterinary Medicine; College of Veterinary Medicine; University of Illinois; Urbana Illinois USA
| | - S. D. Gutierrez-Nibeyro
- Department of Clinical Veterinary Medicine; College of Veterinary Medicine; University of Illinois; Urbana Illinois USA
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22
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Marcatili M, Marshall J, Voute L. Magnetic resonance imaging-guided injection of platelet-rich plasma for treatment of an insertional core lesion of the deep digital flexor tendon within the foot of a horse. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- M. Marcatili
- School of Veterinary Medicine; College of Medical, Veterinary and Life Sciences; Weipers Centre Equine Hospital; University of Glasgow; UK
- Pool House Equine Clinic; Crown Inn Farm; Lichfield Staffordshire UK
| | - J. Marshall
- School of Veterinary Medicine; College of Medical, Veterinary and Life Sciences; Weipers Centre Equine Hospital; University of Glasgow; UK
| | - L. Voute
- School of Veterinary Medicine; College of Medical, Veterinary and Life Sciences; Weipers Centre Equine Hospital; University of Glasgow; UK
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Brokken MT, Schneider RK, Roberts GD, Holmes SP, Gavin PR, Sampson SN, Farnsworth KD, Dahlgren LA. Evaluation of a New Surgical Treatment for Equine Hind Limb Proximal Suspensory Desmitis. Vet Surg 2016; 45:868-878. [DOI: 10.1111/vsu.12527] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 05/04/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Matthew T. Brokken
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine; Washington State University; Pullman Washington
| | - Robert K. Schneider
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine; Washington State University; Pullman Washington
| | - Gregory D. Roberts
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine; Washington State University; Pullman Washington
| | - Shannon P. Holmes
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine; Washington State University; Pullman Washington
| | - Patrick R. Gavin
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine; Washington State University; Pullman Washington
| | - Sarah N. Sampson
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine; Washington State University; Pullman Washington
| | - Kelly D. Farnsworth
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine; Washington State University; Pullman Washington
| | - Linda A. Dahlgren
- Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine; Virginia Tech; Blacksburg Virginia
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Sherlock CE, Mair TS, Ireland J, Blunden T. Do low field magnetic resonance imaging abnormalities correlate with macroscopical and histological changes within the equine deep digital flexor tendon? Res Vet Sci 2014; 98:92-7. [PMID: 25555604 DOI: 10.1016/j.rvsc.2014.12.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 11/24/2014] [Accepted: 12/04/2014] [Indexed: 10/24/2022]
Abstract
Correlating magnetic resonance (MR) imaging and histopathological findings is essential to validate low field MR imaging in lame horses. This study aimed to compare signal changes in the deep digital flexor tendon (DDFT) of the distal limb on low field MR imaging with macroscopical and histological findings. Cadaver limbs from lame horses with DDFT lesions were selected. The DDFT MR imaging findings and histopathological results were graded, and macroscopical abnormalities were recorded. There was a strong correlation between MR imaging and histopathology grades (rs = 0.76, p < 0.001) in the foot. There was moderate agreement (Kappa statistic 0.52) between the MR and histopathology grades; agreement was superior further proximal in the foot. The presence and severity of pathology in the DDFT are well represented by the presence and severity of MR imaging signal changes. The study supports the use of low field MR imaging for diagnosis of equine distal limb DDFT lesions.
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Affiliation(s)
- C E Sherlock
- Bell Equine Veterinary Clinic, Mereworth, Kent ME18 5GS, UK.
| | - T S Mair
- Bell Equine Veterinary Clinic, Mereworth, Kent ME18 5GS, UK
| | - J Ireland
- Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK
| | - T Blunden
- Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK
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25
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Bertuglia A, Mollo G, Bullone M, Riccio B. Identification of surgically-induced longitudinal lesions of the equine deep digital flexor tendon in the digital flexor tendon sheath using contrast-enhanced ultrasonography: an ex-vivo pilot study. Acta Vet Scand 2014; 56:78. [PMID: 25421569 PMCID: PMC4245795 DOI: 10.1186/s13028-014-0078-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 11/11/2014] [Indexed: 11/14/2022] Open
Abstract
Background Longitudinal tears in the lateral aspect of the deep digital flexor tendon are the most common causes of pain localised to the equine digital flexor tendon sheath. However conventional ultrasonographic techniques provide limited information about acute lesions. Ultrasonographic contrast agents are newly developed materials that have contributed to advancement in human diagnostic imaging. They are currently approved for intravenous use in human and animal models. In this study we described intrathecal use in the horse. This study was undertaken to evaluate the reliability of standard and angle contrast-enhanced ultrasonography to detect and characterize surgically-induced longitudinal lesions in the deep digital flexor tendons. In this pilot study surgically-induced lesions were created in the lateral aspect of the deep digital flexor tendon within the digital flexor tendon sheath in 10 isolated equine limbs to generate a replicable model for naturally occurring lesions. Another 10 specimens were sham operated. All the limbs were examined ultrasonographically before and shortly after the intrasynovial injection of an ultrasound contrast agent containing stabilised microbubbles. The images were blindly evaluated to detect the ability to identify surgically-created lesions. The deep digital flexor tendons were dissected and a series of slices were obtained. The depth of longitudinal defects identified with contrast-enhanced ultrasound scans was compared to the real extent of the lesions measured in the corresponding gross tendon sections. Results Contrast-enhanced ultrasonography with both angle and standard approach provided a significant higher proportion of correct diagnoses compared to standard and angle contrast ultrasonography (p < 0.01). Contrast-enhanced ultrasonography reliably estimated the depth of surgically-induced longitudinal lesions in the deep digital flexor tendons. Conclusion Contrast-enhanced ultrasound of the digital flexor tendon sheath could be an effective tool to detect intrasynovial longitudinal tears of the deep digital flexor tendon, although an in vivo study is required to confirm these results for naturally occurring lesions.
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Gutierrez-Nibeyro SD, Werpy NM, White NA, Mitchell MA, Edwards RB, Mitchell RD, Gold SJ, Allen AK. Outcome of palmar/plantar digital neurectomy in horses with foot pain evaluated with magnetic resonance imaging: 50 cases (2005-2011). Equine Vet J 2014; 47:160-4. [DOI: 10.1111/evj.12262] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 02/26/2014] [Indexed: 11/27/2022]
Affiliation(s)
- S. D. Gutierrez-Nibeyro
- Department of Veterinary Clinical Medicine; College of Veterinary Medicine; University of Illinois; Urbana Illinois USA
| | - N. M. Werpy
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville Florida USA
| | - N. A. White
- Marion duPont Scott Equine Medical Center; Leesburg Virginia USA
| | - M. A. Mitchell
- Department of Veterinary Clinical Medicine; College of Veterinary Medicine; University of Illinois; Urbana Illinois USA
| | - R. B. Edwards
- Fairfield Equine Associates; Newtown Connecticut USA
| | | | - S. J. Gold
- BW Furlong & Associates; Oldwick New Jersey USA
| | - A. K. Allen
- Virginia Equine Imaging; The Plains Virginia USA
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Bladon B. Magnetic resonance imaging and foot lameness. Problem solved? Or do we know we know less now that we know more? Equine Vet J 2014; 46:264-6. [DOI: 10.1111/evj.12227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- B. Bladon
- Donnington Grove Veterinary Surgery; Newbury Berkshire UK
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