Equine Distal Limb Research Articles

The position of x‐ray beam‐centring affects radiographic measurements of palmar angle and sole thickness on radiographs of the equine thoracic distal limb

SummaryBackgroundDifferent locations of x‐ray beam centring on the equine distal limb for lateromedial and dorsopalmar radiographs of the equine digit may affect clinically relevant radiographic measurements.ObjectivesTo evaluate the effects of two different locations of x‐ray beam centring on lateromedial and dorsopalmar radiographic measurements of the equine digit and to assess intra‐ and inter‐observer variability of measurements.Study designProspective, observational and method comparison.MethodsComparisons were made of nine measurements on orthogonal radiographs acquired from 24 unshod equine feet at two locations of x‐ray beam centring: coronary band and hoof–ground interface. Radiographic measurements were obtained by three observers of varied equine veterinary experience and made in triplicate by a board‐certified veterinary radiologist.ResultsRadiographs acquired with x‐ray beam centred at the coronary band and hoof–ground interface produced differences in the mean measurements of palmar angle, defined as the angle created by the palmar processes of the distal phalanx relative to the ground surface, on the lateromedial projection (p = 0.002), and medial (p < 0.001) and lateral (p < 0.001) sole thickness on the dorsopalmar projection. There was less variability of palmar angle (p = 0.039) and more superimposition of the palmar processes (p < 0.001) with the x‐ray beam centred at the hoof–ground interface.Main limitationsThe study population was homogeneous and only included horses without outwardly visible abnormalities of the foot. Anatomic measurements were not used for comparison due to the nonterminal nature of the study.ConclusionsCentring the x‐ray beam at the hoof–ground interface produces more repeatable and smaller radiographic measurements of palmar angle and sole thickness when compared to centring the x‐ray beam centred at the coronary band. The distal phalangeal palmar processes are more superimposed with the more distal x‐ray beam centring. The strong inter‐ and intraobserver variability support the use of these nine radiographic measurements by practitioners of all levels of experience.

Limited added value of negative pressure wound therapy compared with calcium alginate dressings for second intention healing in a noncontaminated and contaminated equine distal limb wound model.

Distal limb wounds in horses often show aberrant healing due to a slow inflammatory response. In human medicine, negative pressure wound therapy (NPWT) is used for the treatment of chronic wounds with a similar inflammatory response. To compare the effect of NPWT to calcium alginate dressings on the healing of (non) contaminated equine distal limb wounds. Controlled experiment. Circular wounds were created on the left and right dorsomedial metacarpus of 10 horses. In five horses, the wounds were contaminated with Staphylococcus aureus and Pseudomonas aeruginosa. In all horses, one limb was treated with NPWT, the other with calcium alginate dressings. Treatments were applied during nine days for noncontaminated wounds and six days for contaminated wounds. Noninvasive (clinical assessment, bacteriology swabs, thermographic images and wound dimensions) and invasive (biopsies for histology and growth factor analysis) measurements were taken regularly for 71 and 29days respectively. Effects of selected parameters on continuous dependent variables were analysed using ANOVA, while for discrete dependent variables, logistic regression was applied. In noncontaminated wounds, there was significantly less wound retraction in the early healing stages when treated with NPWT (mean difference [95% CI]=19.2% [13.3%-25.1%]; P=.005), although wound size was not significantly different between NPWT and control wounds at later healing stages. Noncontaminated control wounds had a significantly higher neutrophil influx (OR [95% CI]=1.99 [1.49-2.66]; P<.001) and lower macrophage influx (OR [95% CI]=0.75 [0.60-0.93]; P=.008) compared with NPWT-treated wounds. Bacterial load and the presence of growth factors did not differ between treatments in noncontaminated wounds. In contaminated wounds, no differences between treatments were observed in wound size, histological parameters, bacterial load or growth factor concentration. Sample size is small. No long-term advantage was detected with NPWT compared with calcium alginate dressings in noncontaminated or contaminated equine distal limb wounds healing by second intention.

The Effect of Horse Shoeing with Egg Bar Shoes and Shoes with Wedge Pads on the Results of Thermal Imaging of the Equine Distal Limb.

Simple SummaryThermography is a non-invasive and contact-free imaging method that measures temperature on the surface of the body and determines temperature distribution across the examined surface. The aim of this study was to determine the effect of horse shoeing with egg bar shoes and shoes with wedge pads on hoof temperature measured by thermography. The authors decided to use egg bar shoes and shoes with wedge pads as they are commonly used in the treatment of navicular syndrome in horses. This study was conducted on 16 client-owned warmblood horses. The horses were directed for magnetic resonance imaging (MRI) according to unilateral front limb lameness, specifically associated with the hoof. For thermographic analysis, we took into consideration only one limb that was not lame and that showed no radiological changes. After the application of egg bar shoes, the temperature decreased on the palmar surface of the hoof. After shoeing with wedge pads, the temperature decreased in the dorsal and palmar views. Thermography, despite its great usefulness, is only an indirect method of assessing the blood supply in a given area, so we cannot uncritically conclude about the harmfulness of shoeing.The presented manuscript provides reference for practitioners when measuring normal hoof temperature, as well as controlling the temperature after shoeing with particular shoes. The aim of this study was to determine the effect of horse shoeing with egg bar shoes and shoes with wedge pads on hoof temperature measured by thermography. This was a prospective study conducted on 16 horses. The horses were divided into two groups: horses from group 1 were shod with egg bar shoes, while horses from group 2 were shod with shoes with wedge pads. Thermographic examination was performed below the metacarpophalangeal joint before and one month after shoeing. After shoeing with egg bar shoes, there was a decrease in the median of the minimal temperature in the palmar view. After shoeing with wedge pads, thermography revealed decreased hoof temperature in the dorsal and palmar views. Horse shoes may have a negative impact on the blood circulation and metabolism within the distal part of the limb; however, our study found this only to a minor extent.

How does bone strain vary between the third metacarpal and the proximal phalangeal bones of the equine distal limb?

Strain parameters at injury prone sites of the equine third metacarpal (MC3) and proximal phalangeal (P1) bones were investigated with the aim of improving understanding of injury pathogenesis. We hypothesized that dorsal principal and shear strain patterns, magnitudes and directions would differ from proximal-to-distal; and would be similar from medial-to-lateral across each bone. Unilateral limbs from nine equine cadavers were instrumented with rosette strain gauges during limb loading to 10,500 N. Gauges were attached at seven dorsal sites: middle MC3, distal MC3 (medial, middle, lateral) and proximal P1 (medial, middle, lateral). Outcome measures were analysed with repeated measures analysis of variance. Distal MC3 had the greatest, and proximal P1 the smallest magnitude of minimum principal and shear strains. Directions of maximum and minimum principal strain were similar at the middle and distal MC3 sites with a 20-40° direction difference compared to proximal P1. The patterns of strain magnitude and direction were similar from medial-to-lateral on distal MC3 but varied in pattern and magnitude among the P1 sites. Overall, as load reached maximum, direction of minimum principal strain became more axial in orientation, converging from opposite directions between bones, potentially maximising stability of the distal limb. The difference in strain parameters and strain ratio for adjacent anatomic sites on distal MC3 and proximal P1 was not anticipated, in light of the anatomic congruity of the metacarpophalangeal joint. Based on the predominance of shear strain across proximal P1, shear forces are likely the predominant biomechanical contributor to sagittal fractures of P1.

EquiSim: An Open-Source Articulatable Statistical Model of the Equine Distal Limb.

Most digital models of the equine distal limb that are available in the community are static and/or subject specific; hence, they have limited applications in veterinary research. In this paper, we present an articulatable model of the entire equine distal limb based on statistical shape modeling. The model describes the inter-subject variability in bone geometry while maintaining proper jointspace distances to support model articulation toward different poses. Shape variation modes are explained in terms of common biometrics in order to ease model interpretation from a veterinary point of view. The model is publicly available through a graphical user interface (https://github.com/jvhoutte/equisim) in order to facilitate future digitalization in veterinary research, such as computer-aided designs, three-dimensional printing of bone implants, bone fracture risk assessment through finite element methods, and data registration and segmentation problems for clinical practices.

Comparison of chlorhexidine and alcohol-based antisepsis of the distal limbs of horses.

An alcohol-based rub has been confirmed effective at reducing bacterial counts on equine skin. Skin sites with expected high bacterial burden have not been tested or has a comparison to a common protocol been performed. To determine if ethanol-based antisepsis reduces bacterial counts on the equine distal limb comparable to a current chlorhexidine scrub method and determine the most effective application technique for the product. Randomised trial. Forty-one horses were used in the study. By horse, each limb was randomly assigned to a treatment group: 5min scrub using 4% chlorhexidine gluconate to a clipped site (CHG); 90s scrub using 80% ethanol to a clipped site (ETC); 90s contact with 80% ethanol applied as a spray to a clipped site (ETS) and 90s scrub using 80% ethanol to an unclipped site (ETUC). Samples were collected pre- and post-treatment and plated in duplicate. Bacterial counts were log10 transformed and averaged between duplicates. A linear mixed model was used to compare mean log10 CFU/mL reduction between groups. A cost-benefit analysis was performed. There was no significant difference in mean log10 CFU/mL reduction between CHG and ETC in either fore- or hindlimbs. In forelimbs, there was no significant difference in mean log10 CFU/mL reduction between any groups. In hindlimbs, CHG had significantly greater mean log10 CFU/mL reduction than ETUC and ETS. No significant difference in cost-benefit was found between CHG and ETC. Significant differences were noted between CHG and both ETUC and ETS. Researchers were not blinded to treatment group during sample collection. This study showed no significant difference in reduction in bacterial counts on the distal limb of horses between CHG and ethonol (ET) when applied as a scrub to a clipped site and there was no significant difference in cost-benefit between these treatments.

Biomechanics of Wound Healing in an Equine Limb Model: Effect of Location and Treatment with a Peptide-Modified Collagen-Chitosan Hydrogel.

The equine distal limb wound healing model, characterized by delayed re-epithelialization and a fibroproliferative response to wounding similar to that observed in humans, is a valuable tool for the study of biomaterials poised for translation into both the veterinary and human medical markets. In the current study, we developed a novel method of biaxial biomechanical testing to assess the functional outcomes of healed wounds in a modified equine model and discovered significant functional and structural differences in both unwounded and injured skin at different locations on the distal limb that must be considered when using this model in future work. Namely, the medial skin was thicker and displayed earlier collagen engagement, medial wounds experienced a greater proportion of wound contraction during closure, and proximal wounds produced significantly more exuberant granulation tissue. Using this new knowledge of the equine model of aberrant wound healing, we then investigated the effect of a peptide-modified collagen-chitosan hydrogel on wound healing. Here, we found that a single treatment with the QHREDGS (glutamine-histidine-arginine-glutamic acid-aspartic acid-glycine-serine) peptide-modified hydrogel (Q-peptide hydrogel) resulted in a higher rate of wound closure and was able to modulate the biomechanical function toward a more compliant healed tissue without observable negative effects. Thus, we conclude that the use of a Q-peptide hydrogel provides a safe and effective means of improving the rate and quality of wound healing in a large animal model.

Standing computed tomography of the equine limb using a multi‐slice helical scanner: Technique and feasibility study

SummaryComputed tomography (CT) is an important cross‐sectional diagnostic modality for lameness localised to the equine distal limb. The necessity of general anaesthesia to perform CT scans has limited its use in the equine orthopaedic field. Therefore, many attempts have been made to perform CT of the distal limb in standing horses. This retrospective report aims to describe the technical set‐up and the feasibility of using a multi‐slice helical CT unit recently introduced into the equine market. The medical records of the patients undergoing a standing CT in the period between March 2019 and January 2020 were reviewed. The imaged anatomical region and the image quality were assessed. Thirty‐two horses met the inclusion criteria, and the following anatomical areas have been imaged: front foot/pastern (n = 14), metacarpophalangeal joint (n = 11), front proximal suspensory ligament (n = 2), carpus (n = 2), metatarsophalangeal joint (n = 2) and tarsus (n = 1). In 97% of the cases, excellent imaging quality was obtained. Motion artefact is the main cause of poor image quality. The feet and the metacarpophalangeal region can be easily imaged. Imaging the proximal anatomical regions of the limb is more challenging but achievable.

The Effect of Increasing Fracture Site Stiffness on Bone-Pin Interface Stress and Foot Contact Pressure within the Equine Distal Limb Transfixation Cast: A Finite Element Analysis.

The aim of this study was to determine how increasing stiffness of fracture site tissues distal to the pins in an equine distal limb transfixation cast influences stress at the bone-pin interface, within the bones distal to the transcortical pins, and contact pressure between the foot and the cast. A transfixation cast finite element model was used to compare the bone-pin interface stress, pin stress, bone stress distal to the pins and contact pressure between the foot and the cast, using six stiffness values for a composite tissue block representing progressive stages of fracture healing. Increasing stiffness of the composite tissue block resulted in a decrease in the maximum stresses at the bone-pin interface, an increase in stresses distal to the transcortical pins and a decrease in the maximum pin stresses. As the composite tissue block stiffness was increased, contact pressure between the bottom of the composite tissue block and the cast increased and the stress patterns surrounding the pin holes became less focal. The findings of this study illustrate that with good foot to cast contact within a transfixation cast, increases in tissue stiffness due to progressive fracture healing are expected to reduce bone-pin interface stresses, and increase fracture site loading and stress. Increasing the contact pressure between the foot and the cast could reduce transfixation casting complications such as pin loosening, pin hole fracture and poor fracture healing, if these results transfer to ex vivo and in vivo settings.

The evaluation of the effect of probiotics on the healing of equine distal limb wounds

The effect of dressings saturated with either a standardized suspension of probiotic bacteria or saline on healing of traumatic distal limb wounds in horses was evaluated for 24 days, and the systemic inflammatory effect was assessed. The wounds were divided in two groups based on the phase of healing: wounds with an incomplete (ICGB) or a complete granulation bed (CGB). The wound area was expressed as percentage of the wound area at day 0 and defined as relative wound area. The mean relative wound area decreased faster in probiotic than saline treated wounds. The difference was most obvious in CGB and increased rapidly from day 0 until day 12 up to 30%, and stabilized around 25% thereafter until the end of the observation period, but it was not statistically significant because of the large variation within the treatment groups. The mean wound area of CGB decreased to 28.4% (range: 6.3 to 49.3) with probiotic and to 51.9% (range: 29.3 to 81.7) with saline treatment at day 24. Additionally, the rate to 50% healing in CGB was 3.4 faster with probiotic compared to saline treatment, whereas in ICGB this was 1.9 faster. Topical probiotics did not increase serum amyloid A and white blood cell counts. Although the mentioned differences were not statistically significant, the clinical relevance of the effect of treatment with probiotics in CGB wounds is clear, supported by the differences in mean wound area in course of time and the time required to reach 50% healing (day 12 for probiotic vs more than day 24 for saline treated wounds). Thus the probiotic treated wounds reached 50% reduction in wound area in half of the time of the saline treated wounds. The topical use of probiotics can be considered as safe as it did not cause a systemic effect.

Effect of gallium maltolate on a model of chronic, infected equine distal limb wounds.

Distal limb wounds are common injuries sustained by horses and their healing is fraught with complications due to equine anatomy, prevalence of infection, and challenges associated with wound management. Gallium is a semi-metallic element that has been shown to possess antimicrobial properties and aid in wound healing in various preclinical models. The effects of Gallium have not been studied in equine wound healing. Therefore, the objective of this study was to compare healing rates between gallium-treated and untreated wounds of equine distal limbs and to demonstrate the antimicrobial effects of gallium on wounds inoculated with S. aureus. Using an established model of equine wound healing we demonstrated beneficial effects of 0.5% topical gallium maltolate on equine wound healing. Specifically we documented reduced healing times, reduced bioburden, and reduced formation of exuberant granulation tissue in wounds treated with gallium maltolate as compared with untreated wounds. Gallium appeared to exert its beneficial effects via its well-described antimicrobial actions as well as by altering the expression of specific genes known to be involved in wound healing of horses and other animals. Specifically, gallium maltolate appeared to increase expression of transforming growth factor-β in both infected and un-infected wounds. Further work is needed to document the effects of gallium on naturally occurring equine wounds and to compare the effects of gallium with other wound treatment options. These data, however, suggest that gallium may be an attractive and novel means of improving equine distal limb wound healing.

Contrast therapy: Tissue heating and cooling properties within the equine distal limb.

Rehabilitation of tendon injuries in horses often involves cryotherapy to reduce inflammation and occasionally tissue heating to increase collagen extensibility. The application of alternating cold and hot (ie contrast therapy) is widely used in human physical therapy; however, its utility in equine rehabilitation is largely unknown. The objectives of this study were to (a) assess if the equipment could achieve therapeutic tissue temperatures (<15 and >40°C) at different tissue depths relative to the digital flexor tendons and (b) evaluate the time-temperature profiles during serial heating and cooling cycles using a contrast therapy device. In vivo experiment. In 4 adult horses with normal forelimb digital flexor tendons, fine-wire temperature probes were placed superficially on the skin and implanted subcutaneously, deep to the superficial digital flexor tendon (SDFT) and deep to the deep digital flexor tendon (DDFT). Temperatures were recorded over three complete thermal (hot-cold) cycles. Minimum and maximum temperatures were recorded and the rate of temperature changes and the areas underneath the time-temperature curves (ie thermal load) were calculated. Minimum and maximum tissue temperatures (°C) included: superficial skin [12.6±1.0; 42.4±2.4], subcutaneous tissues [14.1±0.8; 42.3±2.2], deep to the SDFT [15.6±0.8; 41.7±2.6] and deep to DDFT [25.1±2.0; 38.0±3.5]. An initial rapid rate of tissue temperature change between 3.2 and 4.3°C/min occurred within tissues to the depth of the DDFT. Tissue thermal loads during heating ranged from 255 to 607°C*second and from 309 to 780°C*second during tissue cooling, with the lower values noted deep to the DDFT. Unknown clinical efficacy in diseased tissues. The applied contrast therapy was consistently able to induce cooling and heating of tissues to the depth of the DDFT.

Physiologic effects of long-term immobilization of the equine distal limb.

To describe the effects of distal limb immobilization and remobilization in the equine metacarpophalangeal joint. Randomized, prospective experimental study. Eight healthy, skeletally mature horses. One forelimb of each horse was immobilized in a fiberglass cast for 8 weeks; this was followed by 12 weeks of a treadmill-based training program after the cast had been removed. Clinical examinations, radiography, computed tomography (CT), nuclear scintigraphy, MRI, and histomorphometry were used to examine the third metacarpal (MC3), proximal phalanx, proximal sesamoid bones, and associated soft tissues in each horse. Serum and synovial fluid were collected for biomarker analyses. Distal limb immobilization resulted in persistent lameness (P < .001), effusion (P = .002), and a decreased range of motion (P = .012) as well as radiographically visible fragments (P = .036) in the cast forelimb. Bone density was decreased (P < .001) in MC3 according to CT, and trabecular bone fluid was increased (P < .001) according to MRI in the cast forelimb. The cast forelimbs had a change (P = .009) in the appearance of the deep digital flexor tendon according to MRI immediately after removal of the cast. Numerous clinical, radiographic, CT, and MR abnormalities were visible at the end of the study period. Eights weeks of cast immobilization induced changes in bone, cartilage, and periarticular soft tissues that were not reversed after 12 weeks of remobilization. Cast application should be used judiciously in horses with musculoskeletal injuries, balancing appropriate stabilization with potential morbidity secondary to cast placement.

Effects of topical treatment of cannabidiol extract in a unique manuka factor 5 manuka honey carrier on second intention wound healing on equine distal limb wounds: a preliminary study.

Evaluate the effect of topical 1% cannabidiol on second intention wound healing in distal limb wounds of horses. Experimental. Six Standardbred horses. A total of five 2.5 cm × 2.5 cm full thickness skin wounds were created on the dorsomedial aspect of the metacarpi of 6 horses. Wounds were contaminated with faeces on the day of wound creation. Each wound was then assigned to a treatment group; compounded 1% cannabidiol in unique manuka factor (UMF) 5 manuka honey, UMF 5 manuka honey, UMF 20 manuka honey or saline. Each treatment was applied topically daily for a total of 42 days. Legs were bandaged and bandages were changed, daily, for 13 days postoperatively. Digital photographs of each wound were taken on day 1 then weekly for 6 weeks. Wound size, daily healing rate and total time to healing were recorded and compared statistically. Irrespective of the treatment, wounds did not retract as expected in the first 7 days after wound creation. There was no difference in wound area, daily healing rate, days to complete healing between treatment groups. This preliminary study failed to demonstrate any difference in wound healing variables between treatment groups in this model of second intention wound healing. This was unexpected due to the established effects of UMF 20 manuka honey on wound healing using the same model. This may be due to systemic effects of cannabidiol and study design. Further research into the use of cannabidiol in equine wounds is warranted.

Magnetic resonance imaging and histopathological evaluation of equine oblique sesamoidean ligaments.

Pathology involving the oblique sesamoidean ligaments (OSLs) is commonly diagnosed during magnetic resonance imaging (MRI) of the equine distal limb. Presence of striations within the ligament and magic angle artefact can result in an incorrect diagnosis of pathological change. No studies have been performed using histopathology, the gold standard, to corroborate their imaging diagnosis. (a) To determine which MRI characteristics are associated with normal vs abnormal OSLs and (b) to evaluate the ability of MRI to correctly identify abnormal vs normal oblique sesamoidean ligaments using histopathology as the gold standard. Observational, cross-sectional study. Cadaver limbs (n=77) were obtained from horses (n=21) subjected to euthanasia at the hospital. MRI and histopathology was performed on each of the limbs. MRI scoring was performed for multiple MRI characteristics, and each limb was deemed normal or abnormal. Histopathology scoring was performed to give an overall score of normal or abnormal. Mixed model logistic regression was performed to evaluate which MRI characteristics were associated with normal vs abnormal OSLs using backwards elimination and a significance level of <0.1. Sensitivity and specificity were also calculated. The sensitivity and specificity of MRI to correctly identify abnormal OSLs was 81% (95% CI 54%-96%) and 90% (95% CI 79%-96%) respectively. Based on logistic regression, increased cross-sectional area at the origin (OR: 26.77, 95% CI 1.1-4640, P=.07), increased ligament hyperintensity (OR: 9.59, 95% CI 1.23-155; P=.04) and reduction in striations (increased hypointensity score) (OR: 7.8, 95% CI 0.72-218, P=.07) were associated with abnormal OSL. Lameness exam was not performed on any of the horses prior to euthanasia. Findings can only be applied to chronic, degenerative changes, rather than an acute injury. Increased cross-sectional area and changes in the signal intensity are associated with pathology within the OSLs. Medial to lateral size asymmetry and striation pattern variation can occur in histologically normal OSLs and should be interpreted with caution if other signs of pathology are absent.

Cell engraftment, vascularization, and inflammation after treatment of equine distal limb wounds with endothelial colony forming cells encapsulated within hydrogel microspheres

BackgroundEndothelial colony forming cells (ECFCs) may be useful therapeutically in conditions with poor blood supply, such as distal limb wounds in the horse. Encapsulation of ECFCs into injectable hydrogel microspheres may ensure cell survival and cell localization to improve neovascularization and healing. Autologous ECFCs were isolated from 6 horses, labeled with quantum nanodots (QD), and a subset were encapsulated in poly(ethylene) glycol fibrinogen microspheres (PEG-Fb MS). Full-thickness dermal wounds were created on each distal limb and injected with empty PEG-Fb MS, serum, ECFCs, or ECFCs encapsulated into PEG- Fb MS (ECFC/MS). Analysis included wound surface area (WSA), granulation tissue scoring (GS), thermography, collagen density staining, and immunohistochemical staining for endothelial and inflammatory cells. The purpose of this study was to track cell location and evaluate wound vascularization and inflammatory response after injection of ECFC/MS or naked ECFCs in equine distal limb wounds.ResultsECFCs were found near and within newly formed blood vessels up to 3 weeks after injection. ECFC and ECFC/MS groups had the greatest blood vessel quantity at week 1 in the wound periphery. Wounds treated with ECFCs and ECFC/MS had the lowest density of neutrophils and macrophages at week 4. There were no significant effects of ECFC or ECFC/MS treatment on other measured parameters.ConclusionsInjection of microsphere encapsulated ECFCs was practical for clinical use and well-tolerated. The positive ECFC treatment effects on blood vessel density and wound inflammation warrant further investigation.

Identification of Naturally Occurring Cartilage Damage in the Equine Distal Interphalangeal Joint Using Low-Field Magnetic Resonance Imaging and Magnetic Resonance Arthrography.

Objectives: To describe detectable and non-detectable naturally occurring cartilage damage of the equine distal interphalangeal (DIP) joint using plain magnetic resonance (MR) imaging and gadolinium and saline MR arthrography. The second objective was to quantify the sensitivity, specificity and accuracy in detection of cartilage damage.Methods: In a pilot study, the distal limbs of two horses with confirmed osteoarthritis of the DIP joint were imaged with low-field MR. Magnetic resonance images were assessed in consensus by three observers and compared to gross pathological findings. Subsequently, a prospective analytical cross-sectional study design was created to compare pre-contrast MR imaging and saline and gadolinium MR arthrography of isolated equine distal limbs to gross observation findings. Hallmarq® low-field MR (0.27T) scans were performed prior to DIP joint injection, saline/gadolinium post-injection scans were performed at 15 min intervals for 2 h. Joints were inspected and the articular cartilage graded subjectively for cartilage damage (0–3). The presence of detectable or non-detectable cartilage damage on MR images was identified, characterized and recorded in consensus by three observers. Sensitivity, specificity and accuracy in detection of cartilage damage related to gross pathology were calculated.Results: The two clinical cases from the pilot study with confirmed osteoarthritis had full thickness cartilage defects; however, only one of these was correctly identified using low-field MRI. In the prospective study, the majority of naturally occurring cartilage damage could not be identified on plain MR or MR arthrography including extensive partial thickness cartilage erosions. Saline and gadolinium MR arthrography did not improve the detection of cartilage damage. The accuracy of cartilage damage detection was 0.63 with a sensitivity of 0.14 and specificity of 0.92.Clinical Relevance: Both, plain low-field MRI and MR arthrography are not sensitive in detection of naturally occurring cartilage damage of the DIP joint. However, if an abnormal contour is seen in the articular cartilage, cartilage damage is likely to be present.

Finite Element Analysis of Six Transcortical Pin Parameters and Their Effect on Bone-Pin Interface Stresses in the Equine Third Metacarpal Bone.

The objectives of this study were to validate a finite element model of the equine distal limb transfixation cast and to determine the effect of six transcortical pin parameters on bone-pin interface (BPI) stresses in the third metacarpal bone. A transfixation cast finite element model was developed from a computed tomography scan of the third metacarpal bone and modelled pin elements. The model was validated by comparing strain measured around a 6.3-mm transfixation pin in the third metacarpal bone with the finite element model. The pin parameters of diameter, number, location, spacing, orientation and material were evaluated by comparing a variety of pin configurations within the model. Pin diameter and number had the greatest impact on BPI stress. Increasing the diameter and number of pins resulted in lower BPI stresses. Diaphyseal pin location and stainless-steel pins had lower BPI stresses than metaphyseal location and titanium alloy pins, respectively. Offset pin orientation and pin spacing had minimal impact on BPI stresses during axial loading. The results provide evidence that diameter and number are the main pin parameters affecting BPI stress in an equine distal limb transfixation cast. Configurations of various pin size and number may be proposed to reduce BPI stresses and minimize the risk of pin related complications. Further refinement of these models will be required to optimize pin configurations to account for pin hole size and its impact on overall bone strength.

Measuring Volumetric Changes of Equine Distal Limbs: A Pilot Study Examining Jumping Exercise.

Equine athletes can incur musculoskeletal injuries due to repetitive loading during training and competition. Prior to signs of lameness, horse trainers and veterinarians may observe swelling in the distal limbs, where injuries most frequently occur. Early observations may guide modulation of training to manage physiological stress and mitigate risk of injury. However, these observations of changing limb volume can be subjective and imprecise. The aim of this study was to assess the accuracy and applicability of a tablet-mounted, 3D scanner to measure and record distal limb volumes of horses before and after exercise. Users recorded scans of a cylinder of known volume with errors up to 8%. Experienced users' measures were biased (i.e., consistently overestimated). The scanner was able to detect statistically significant increases in volume for both fore and hind limbs after one jumping session (310-2058 cm3). Age and intensity of workload may play a role in magnitude of limb swelling, but had mixed conclusions between fore and hind limbs. More studies with additional horses must be performed to solidify these relationships. The evaluated 3D scanner is a low-cost, accessible tool that was able to detect changes in limb swelling as a result of exercise and mechanical stress. With continued research, this information may guide training programs to decrease injury and maximize performance of equine athletes in the future.

Immunohistochemical and morphological characterisation of equine recurrent laryngeal and distal limb nerves supports classification of recurrent laryngeal neuropathy as a polyneuropathy

Immunohistochemical and morphological characterisation of equine recurrent laryngeal and distal limb nerves supports classification of recurrent laryngeal neuropathy as a polyneuropathy