1
|
Giorio ME, Graham RJ, Berner D, O'Neill HD, Bladon BM. Presence and size of synovial masses within the navicular bursa correlate well between magnetic resonance imaging and bursoscopy and have a guarded prognosis. Equine Vet J 2023. [PMID: 38131123 DOI: 10.1111/evj.14040] [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: 06/12/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Focal hyperintense lesions within the navicular bursa emanating from the dorsal border of the deep digital flexor tendon (DDFT) can be recognised on T1-weighted magnetic resonance images (MRI) and have been attributed to lameness in horses. Removal of these lesions, also referred to as synovial masses, by navicular bursoscopy is currently recommended. OBJECTIVES To investigate the correlation between MRI and navicular bursoscopic findings. It is hypothesised that the prognosis following surgery is proportional to the size of the DDFT lesion. STUDY DESIGN Retrospective analysis of clinical records. METHODS Horses undergoing standing low-field MRI and navicular bursoscopy with >1 year follow-up were included. A grading system was developed to classify the size of synovial mass(es) and lesion(s) of the DDFT on MRI and at surgery. Generalised estimating equations were used to evaluate the association between MRI findings and surgery and between outcome and severity of the tendon injury. RESULTS Fifty-nine horses presenting over a 15-year period (2006-2021) fulfilled inclusion criteria. Ninety navicular bursae were examined both on MRI and endoscopically. There was strong correlation between the size of synovial masses and tendon lesions on MRI and bursoscopy (p < 0.001, OR: 25.61, 95% CI 8.71-75.29 and p < 0.001, OR: 7.34, 95% CI 2.70-19.92, respectively). Size of tendon lesion and synovial mass had no impact on prognosis (p = 0.3, OR: 1, 95% CI 1-1 and p = 0.1, OR: 1, 95% CI 1-1, respectively), which was guarded (30.5% return to previous level of exercise). MAIN LIMITATIONS Performance data for conservatively treated horses with MRI-detected synovial masses was not considered, nor was the effect of navicular bursal effusion. Horses were not randomly assigned to treatment protocols. CONCLUSION There is good correlation between MRI and bursoscopic findings of DDFT lesions and synovial masses within the navicular bursa, with no false positives. Size of the synovial masses and DDFT lesions does not influence prognosis following navicular bursoscopy.
Collapse
Affiliation(s)
- Maria Elisabetta Giorio
- Equine Referral Hospital, Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Robyn J Graham
- Equine Hospital, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
| | - Dagmar Berner
- Equine Referral Hospital, Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | | | | |
Collapse
|
2
|
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
| |
Collapse
|
3
|
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.
Collapse
|
4
|
Fürst AE, Lischer CJ. Other Clinical Problems of the Equine Foot. Vet Clin North Am Equine Pract 2021; 37:695-721. [PMID: 34782100 DOI: 10.1016/j.cveq.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Many disorders affect the equine foot, and many hoof problems have multiple predisposing causes. Surgery may be necessary after conservative management has failed. Diseases of the hoof capsule may seem simple, but their effect on performance can be long-lasting and healing is often prolonged. Diagnosis of problems within the hoof capsule is enhanced with the use of computed tomography and MRI. The prognosis of fractures has improved with strategic placement of lag screws across fracture planes using aiming devices and advanced intraoperative imaging techniques. Collaboration between the clinician and a skilled farrier is important for successful management of hoof disorders.
Collapse
Affiliation(s)
- Anton E Fürst
- Equine Department, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zurich 8057, Switzerland.
| | - Christoph J Lischer
- Faculty of Veterinary Medicine, Equine Clinic, Freie Universität Berlin, Oertzenweg 19b, Berlin 14163, Germany
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Johnson SA, Biscoe EW, Eilertson KE, Lutter JD, Schneider RK, Roberts GD, Cary JA, Frisbie DD. Tissue predictability of elastography is low in collagenase induced deep digital flexor tendinopathy. Vet Radiol Ultrasound 2021; 63:111-123. [PMID: 34585463 DOI: 10.1111/vru.13026] [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: 03/31/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 01/03/2023] Open
Abstract
Elastography is an emerging imaging modality for characterizing tendon injury in horses, but its ability to differentiate tissue deformability relative to treatment group and biochemical properties using a prospective, experimental study design remain unknown. Objectives of the current study were to (a) to investigate differences in glycosaminoglycan, DNA, and soluble collagen levels in mesenchymal stem cell (MSC) treated limbs compared to untreated control limbs utilizing a collagenase model of tendinopathy; (b) compare elastographic features between treatment groups; and (c) determine tissue-level predictive capabilities of elastography in relation to biochemical outcomes. Bone marrow was collected for MSC culture and expansion. Tendinopathy of both forelimb deep digital flexor tendons (DDFTs) was induced with collagenase under ultrasonographic guidance. One randomly assigned limb was treated with intra-lesional MSC injection with the opposite limb serving as an untreated control. Horses were placed into a controlled exercise program with elastographic evaluations performed baseline (0) and 14, 60, 90, and 214 days post-treatment. Postmortem biochemical analysis was performed. MSC-treated limbs demonstrated significantly less (42%) glycosaminoglycan (P = .006). Significant differences in elastographic region of interest (ROI) percent hardness, ROI color histogram, and subjective lesion stiffness were appreciated between treatment groups at various study time points. Elastographic outcome parameters were weak predictors of biochemical tissue analysis, with all R2 values ≤ 0.50. Within this range of differences in glycosaminoglycan content between treatment groups, elastography outcomes did not predict biochemical differences. Tissue-specific differences between DDFTs treated with MSCs compared to controls were apparent biochemically, but not predicted by elastography.
Collapse
Affiliation(s)
- Sherry A Johnson
- Department of Clinical Sciences, Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | | | - Kirsten E Eilertson
- Graybill Statistics & Data Science Laboratory, Department of Statistics, Colorado State University, Fort Collins, Colorado, USA
| | - John D Lutter
- Kansas State University Veterinary Health Center 1800 Denison Ave, Manhattan, Kansas, USA
| | | | - Gregory D Roberts
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Julie A Cary
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - David D Frisbie
- Department of Clinical Sciences, Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
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.
Collapse
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
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Beccati F, Pepe M, Antinori L, Pascucci L, Chiaradia E, Mandara MT. Sympathetic Innervation and Adrenergic Receptors in Equine Deep Digital Flexor Tendinopathy: Preliminary Results. J Comp Pathol 2018; 163:33-37. [PMID: 30213372 DOI: 10.1016/j.jcpa.2018.07.005] [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: 05/13/2018] [Revised: 07/13/2018] [Accepted: 07/16/2018] [Indexed: 12/01/2022]
Abstract
The aim of this study was to delineate the pattern of sympathetic innervation in the suprasesamoidean region of the deep digital flexor tendon (DDFT) in horses with tendinopathy by immunohistochemical labelling for tyrosine hydroxylase (TH) and α-1 adrenergic receptor (α1-AR). Twelve forelimbs were obtained from 10 horses with DDFT tendinopathy and six feet obtained from six horses were used as healthy controls. Post-mortem radiographic, ultrasonographic and gross examinations were performed on the suprasesamoidean area of the DDFT to assess the presence of tendinopathy. Longitudinal sections were collected and processed. Lesions were classified as core lesions, dorsal border lesions and parasagittal oblique splits. Immunohistochemistry was performed and the degree of immunoreaction was classified as absent, mild or marked. Seven core lesions, four dorsal border lesions and one parasagittal oblique split were identified. There was no increased expression of sympathetic innervation in samples with a dorsal border lesion of the DDFT compared with healthy samples. In contrast, core lesions showed increased expression of α1-AR and reduced expression of TH, which supports the hypothesis of a compensatory imbalance between the sympathetic mediator and the sympathetic receptors as a cause or effect of structural damage. In addition, adrenergic activation could stimulate cell proliferation and differentiation within these lesions.
Collapse
Affiliation(s)
- F Beccati
- Sport Horses Studies Centre, Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia, Italy.
| | - M Pepe
- Sport Horses Studies Centre, Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia, Italy
| | - L Antinori
- Clinica Veterinaria Roma Sud, Via Pilade Mazza, 24, Roma, Italy
| | - L Pascucci
- Sport Horses Studies Centre, Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia, Italy
| | - E Chiaradia
- Sport Horses Studies Centre, Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia, Italy
| | - M T Mandara
- Sport Horses Studies Centre, Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia, Italy
| |
Collapse
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
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
| |
Collapse
|
15
|
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
| |
Collapse
|
16
|
Barrett MF, Frisbie DD, King MR, Werpy NM, Kawcak CE. A review of how magnetic resonance imaging can aid in case management of common pathological conditions of the equine foot. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12542] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- M. F. Barrett
- Department of Environmental and Radiological Health Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins USA
| | - D. D. Frisbie
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins USA
| | - M. R. King
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins USA
| | - N. M. Werpy
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville USA
| | - C. E. Kawcak
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins USA
| |
Collapse
|
17
|
Magnetic resonance imaging assisted management in five cases of suspected quittor. Vet Comp Orthop Traumatol 2015; 29:75-82. [PMID: 26548698 DOI: 10.3415/vcot-15-02-0039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 09/07/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Assessment of the usefulness of magnetic resonance imaging (MRI) in treatment planning in suspected cases of quittor in the horse. METHODS Five horses with chronic discharging tracts at the level of the foot underwent MRI for treatment planning. RESULTS The MRI examination revealed variable involvement of soft tissue and osseous structures of the foot in addition to abnormalities of the ungular cartilages in all cases. In two cases, follow-up MRI examination was performed. Four of five horses had a successful outcome, with three of these undergoing only one surgical procedure and one being managed medically. CLINICAL SIGNIFICANCE We believe that the use of preoperative MRI facilitated accurate determination of the structures involved in cases of quittor, guiding the management, surgical approach and postoperative therapy.
Collapse
|
18
|
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.
Collapse
|
19
|
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
| |
Collapse
|
20
|
|