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Desmitis of the Distal Digital Annular Ligament in Seven Horses: MRI Diagnosis and Surgical Treatment

Authors

  • JENNIFER M. COHEN VMD,

    1. Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA
    2. Oakridge Equine Hospital, Edmond, OK.
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  • ROBERT K. SCHNEIDER DVM, MS, Diplomate ACVS,

    1. Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA
    2. Oakridge Equine Hospital, Edmond, OK.
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  • CHAD J. ZUBROD DVM, MS, Diplomate ACVS,

    1. Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA
    2. Oakridge Equine Hospital, Edmond, OK.
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  • SARAH N. SAMPSON DVM,

    1. Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA
    2. Oakridge Equine Hospital, Edmond, OK.
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  • RUSSELL L. TUCKER DVM, Diplomate ACVR

    1. Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA
    2. Oakridge Equine Hospital, Edmond, OK.
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  • Work performed at Washington State University and Oakridge Equine Hospital.

  • Study was partially funded by Victoria Cavallero.

Address reprint requests to Jennifer M. Cohen, DVM, Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, 382 West Street Road, Kennett Square, PA 19348. E-mail: cohenjm@vet.upenn.edu.

Abstract

Objective— (1) To describe the clinical signs and abnormalities observed on magnetic resonance imaging (MRI) in 7 horses with desmitis of the distal digital annular ligament (DDAL); (2) to describe the normal magnetic resonance (MR) appearance and thickness of the DDAL in health; and (3) to describe a tenoscopic surgical technique for treating horses with desmitis of the DDAL.

Study Design— Retrospective study.

Animals— Horses (n=7) with desmitis of the DDAL.

Methods— MR examinations of 20 sound horses were reviewed to determine the normal appearance of the DDAL. Dimensions obtained from these images were compared with MR findings from 7 horses with DDAL desmitis. Desmitis of the DDAL was treated by tenoscopic surgery and outcome assessed.

Results— Horses with DDAL desmitis had lameness (grade 2–3 out of 5) that improved after a palmar digital nerve block. The affected DDAL was enlarged and had an abnormal signal on MR images of the feet. After tenoscopy and DDAL transection, 5 horses returned to athletic performance, including 2 horses that failed to respond to medical treatment and rest before surgery.

Conclusion— Primary desmitis of the DDAL is a cause of lameness in horses. Transection of the DDAL allowed 5 horses with this injury to return to athletic performance.

Clinical Relevance— DDAL desmitis should be included in the differential diagnoses of horses with lameness that improves after a palmar digital nerve block but have no abnormalities observed on radiographs of the feet. Tenoscopic surgical transection of the DDAL is an effective treatment for some horses.

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