Ligaments Of Distal Interphalangeal Joint Research Articles

Desmopathy of the collateral ligaments of the equine distal interphalangeal joint - a prevalence in Poland between 2016-2019.

Desmopathy of the collateral ligaments of the equine interphalangeal joint is caused by a combination of factors, including hoof shape, excessive loading and ground surface. This complex problem poses a diagnostic challenge due to the non-specificity of perineural analgesia and the limitations associated with the most popular imaging methods such as radiography and ultrasonography. The aim of this study was to retrospectively determine the prevalence of desmopathy of the collateral ligaments of the equine distal interphalangeal joint in Poland between 2016 and 2019, and to establish the frequency and type of the associated pathologies. Desmopathy of the collateral ligaments of the distal interphalangeal joint was diagnosed in 14% of 152 horses examined by magnetic resonance imaging (MRI). In 64% of the cases, other changes were observed in the equine digit, and in 36% of the cases, desmopathy was the only diagnosed problem. Desmopathy of the collateral ligaments is not a frequently reported pathology in the distal part of the equine limb. The diagnostic difficulties described in this article suggest that considerable caution should be exercised when formulating the final diagnosis, prognosis and treatment options.

Influence of morphometric parameters on the size of collateral ligaments of the distal interphalangeal joint of equines.

The physiological measurements of collateral ligaments of distal interphalangeal joint (CL-DIPJ) differ in the literature. The factors that influence these differences are not well described. The aims of this study are to compare CL-DIPJ sizes in equines with different withers height, as well as to correlate body weight and hoof size to the size of these ligaments. In total, 52 horses were used in the study. They were divided into two groups according to wither height: Group 1 (G1) - 21 animals with up to 147cm - and group 2 (G2) - 21 animals with greater than 148cm. CL-DIPJ was ultrasonographically measured in order to find the mean of dorso-palmar (DPD) and latero-medial (LMD) diameters and the cross-sectional area (CSA). Hoof width and length were measured, and the results were used to calculate the hoof surface area. Withers height and body weight were also measured. Groups were statistically compared by Student's t test and Pearson's correlation application to each group. Groups were different in body size, HS and CL-DIPJ size when p<.05, except for the LMD of the medial collateral ligament of left thoracic limb. Withers height and body weight did not show significant correlations to CL-DIPJ size in G1, but they had little influence on the size of CL-DIPJ on G2. No correlation between the hoof size and the CL-DIPJ was noted in any of the two groups. In conclusion, the CL-DIPJ were larger in taller horses and their sizes were correlated to their height and weight, but they were not correlated to hoof size.

Risk of intra-articular injection with longitudinal ultrasound-guided injection of collateral ligaments of the equine distal interphalangeal joint.

Desmopathy of the collateral ligaments of the distal interphalangeal joint is a common cause of equine foot lameness and carries a poor prognosis with conservative management. Intralesional injections may improve healing, although accuracy of radiographically guided injections is significantly less than when guided by MRI, which requires special needles. Longitudinal ultrasound-guided injection of the distal collateral ligament has not been evaluated objectively. In this prospective, anatomic study, seven equine cadaver limbs (14 collateral ligaments) were injected with methylene blue dye and radiographic contrast medium using ultrasound to guide the needle longitudinally into the collateral ligaments until contacting bone. The insertion site of the needle proximal to the coronary band was measured on the limb and the needles left in place for radiography and CT to evaluate the needle angulation, location of the contrast medium, and whether the contrast entered the distal interphalangeal joint. The limbs were frozen and sectioned with a band saw to identify the location of the dye. Fifty percentage of injections were in or around the collateral ligaments. However, the percentage of "successful" injections, defined as in the collateral ligament but not in the joint, was only 36%. All legs had dye and contrast in the joint after both ligaments had been injected. There were no significant differences between the needle angle and entry site for "successful" and "unsuccessful" injections. Findings from this study indicates that the success rate is low for injecting the distal portions of the distal interphalangeal joint collateral ligaments using ultrasound guidance alone.

THE EFFECT OF VARYING ECHO TIME USING T2‐WEIGHTED FSE SEQUENCES ON THE MAGIC ANGLE EFFECT IN THE COLLATERAL LIGAMENTS OF THE DISTAL INTERPHALANGEAL JOINT IN HORSES

Eight skeletally mature equine cadaver distal forelimbs were imaged using T2-weighted fast spin echo (FSE) sequences in a 1.0 T horizontal bore magnet. Each limb was parallel to the main magnetic field and with 16° angulation of the limb relative to the main magnetic field, which places one of the collateral ligaments of the distal interphalangeal joint at or near the magic angle. Each limb was imaged using an echo time (TE) of 80, 100, 120, and 140 ms. Reversal of the magic angle effect was achieved at echo time of 140 ms. However, given the alterations in tissue contrast and subjective decrease in the signal-to-noise ratio at this TE, it may be preferable to use a shorter TE for clinical imaging. A T2-weighted FSE sequence with an echo time of 120 ms maintained image quality while subjectively minimizing the magic angle effect. A sequence with long TE can be used to aid in the differentiation of pathologic change from artifactual increases in signal intensity in collateral ligaments of the equine distal interphalangeal joint, but could decrease the sensitivity for small or low contrast lesions. Multiple factors should be considered when selecting the TE for a T2-weighted FSE sequence that will be utilized in a musculoskeletal protocol including evaluation of equine feet.