Straight Sesamoidean Ligament Research Articles

Complex pastern injuries involving the scutum medium in ten horses

SummaryNo description of injuries to the equine scutum medium exists in the veterinary literature. The purpose of this case series is to describe the clinical findings, diagnostic imaging findings, treatment and outcome of 10 horses with complex pastern injuries involving the scutum medium. Horses with scutum medium injury presented with septic synovial structures, acute lameness or chronic lameness. In all cases, scutum medium injury occurred with severe tendon, ligament or osseous injuries in the pastern region. The most common comorbidities were proximal interphalangeal joint sepsis, injuries to the straight sesamoidean ligament and/or the superficial digital flexor tendon branches. This case series also highlights that severe injuries to the scutum medium can be associated with proximal interphalangeal joint subluxation. Outcome and treatment are dependent upon concurrent injuries but proximal interphalangeal joint arthrodesis should be considered. Prognosis for return to athletic function is poor, and return to pasture soundness is guarded.

MRI Features of Fetlock and Pastern Regions in 30 Chronically, Un-Treated Lame Draft Horses Confirmed by Postmortem Examination

Lameness from fetlock and pastern regions is a big challenge to most equine practitioners and produces a detrimental effect on horses' activity and on owners' finances. Nuclear scintigraphy, radiography and ultrasonography are not conclusive when assessing of fetlock and pastern lameness. This study describes the magnetic resonance imaging (MRI) features in 30 draft horses with chronic, un-treated lameness attributable to fetlock and pastern regions as well as confirms these features by postmortem examination. Thirty-three cadaver limbs were collected after euthanasia, imaged by MR and lastly examined grossly. Seventeen lesions were recorded and described using MRI. MRI revealed injuries of both soft and osseous tissues in 24 horses (80%), soft tissue injuries in five horses (16.7%) and bone and cartilage injuries in one horse (3.3%). All horses had multiple MRI abnormalities. The most frequent MR lesions were digital tenosynovitis (n=13), straight sesamoidean desmitis (n=10), osteosclerosis in the distal part of third metacarpal bone (MCIII) or first phalanx (PI, n=10), adhesions between straight sesamoidean ligament (SSL) and deep digital flexor tendon (DDFT, n=9), oblique sesamoidean desmitis (n=7), cartilage erosions of fetlock or pastern joints (n=7), adhesions between proximal digital annular ligament and DDFT (n=6), DDFTendinitis at pre-navicular part (n=6), proximal digital annular desmitis (n=5), subchondral bone cyst of PI (n=3), and cyst like lesions in PI and PII (n=2). In conclusion, MRI played a pivotal role in comprehensive evaluation of fetlock and pastern regions and it is highly recommended for examination of all structures of fetlock and/or pastern regions in chronically lame draft horses.

Morphological, radiographic and computed tomographic evaluation of the metatarsophalangeal joint of the one-humped camel.

The camel digits have a complex structure with tendons, joints and ligaments. The objective of the study was to determine the anatomical features of the metatarsophalangeal joint and its puncture site in dromedary camel using anatomical dissection, radiography, computed tomography (CT) bone and soft tissue window scans and 3D reconstruction render volume of CT. The study used six adult camels of both sexes (three males and three females), aged 9-15years (Mean ± SD equal 11.80±2.59years). The camel fetlock possesses two metatarsophalangeal joints, left and right ones. The study described in detail the bony structures, ligaments and joint capsule of the metatarsophalangeal joint. The straight sesamoidean ligament was recorded in the studied one-humped camel joints. The joint capsule exhibited two recesses: dorsal and plantar recess. This is the first study to report the dorsal recess as triangular in outline with one proximal recess and two distal recesses, and the plantar recess as having two proximal recesses and one distal recess. The soft tissues examined around the fetlock were the proper extensor tendon, superficial, deep digital flexor tendon, digital scutum, collateral ligaments and sesamoidean ligaments. The plantar and dorsal pouches were the sites of joint injection. The present findings regarding joint injection indicate the plantar approach through plantar recess to fetlock to be preferable than the dorsal one as we used the proximal sesamoid bones and suspensory ligament as landmarks to inject easily.

Quadrilateral suspensory and straight sesamoidean ligament calcifying desmopathy in an Arabian mare

SummaryA 5‐year‐old Arabian mare was referred for the investigation of recent behavioural change, generalised stiffness, and owner‐reported polyuria and polydipsia. Clinical examination revealed severe pain associated with palpation along the entire length of the suspensory ligament (SL) and palmar soft tissues of the pastern regions of both forelimbs. Radiographs of the distal forelimbs demonstrated marked radiopaque striations within the straight sesamoidean ligaments (SSLs), and less severe but similar changes in the regions of the SL branches. Ultrasonography of both distal forelimbs revealed multifocal, hyperechoic lesions within the SSLs. The SL bodies and branches were enlarged and had mixed echogenicity on ultrasound scan. The horse was subjected to euthanasia at the owner's request and submitted for post‐mortem examination. Relevant gross findings were restricted to the SLs and SSLs of all four limbs, all of which contained severe mineralisation and irregularly arranged fibres. Histological examination revealed severe, multifocal to coalescing, dystrophic mineralisation with cartilaginous and osseous metaplasia, which suggested a primary calcifying desmopathy affecting all four SLs and SSLs. Clinical findings in the case reported here were similar to that of degenerative suspensory ligament desmitis previously reported by many authors, but diagnostic imaging and histopathological findings were significantly different.

MAGNETIC RESONANCE IMAGING OF DISTAL SESAMOIDEAN LIGAMENT INJURY

Distal sesamoidean ligament injury is a recognized cause of lameness but diagnosis using ultrasonography is sometimes difficult. Herein, we describe the normal appearance of the distal sesamoidean ligaments on magnetic resonance (MR) images and the changes that occur when the ligaments are injured. The appearance of the distal sesamoidean ligaments on MR images from 66 control horses and 58 horses with distal sesamoidean desmitis were described and the cross-sectional area and signal intensity of the ligaments measured. In control horses, the ligaments had a characteristic appearance and strong left-right symmetry, and the lateral oblique sesamoidean ligament was larger and had higher signal intensity than the medial ligament. Cross-sectional area and signal intensity were significantly greater in injured straight sesamoidean ligaments compared with the controls. Signal intensity increased significantly with oblique sesamoidean desmitis compared with the controls. Lesions of the distal sesamoidean ligaments were considered the sole cause of lameness in only 2 of 58 horses. Eighty percent of lesions in the distal sesamoidean ligaments were not detected using ultrasonography.

Proximal interphalangeal joint arthrodesis in a one‐month‐old foal for superficial digital flexor tendon and straight sesamoidean ligament disruption

Equine Veterinary EducationVolume 19, Issue 8 p. 407-412 Proximal interphalangeal joint arthrodesis in a one-month-old foal for superficial digital flexor tendon and straight sesamoidean ligament disruption A. E. Watts, Corresponding Author A. E. Watts Cornell University Hospital for Animals, Cornell University, Ithaca, New York 14853, USA.*Cornell University Hospital for Animals, Cornell University, Ithaca, New York 14853, USA.Search for more papers by this authorL. A. Fortier, L. A. Fortier Cornell University Hospital for Animals, Cornell University, Ithaca, New York 14853, USA.Search for more papers by this authorF. J. Caldwell, F. J. Caldwell College of Veterinary Medicine, Auburn University, Auburn, Alabama 36849, USA.Search for more papers by this author A. E. Watts, Corresponding Author A. E. Watts Cornell University Hospital for Animals, Cornell University, Ithaca, New York 14853, USA.*Cornell University Hospital for Animals, Cornell University, Ithaca, New York 14853, USA.Search for more papers by this authorL. A. Fortier, L. A. Fortier Cornell University Hospital for Animals, Cornell University, Ithaca, New York 14853, USA.Search for more papers by this authorF. J. Caldwell, F. J. Caldwell College of Veterinary Medicine, Auburn University, Auburn, Alabama 36849, USA.Search for more papers by this author First published: 05 January 2010 https://doi.org/10.2746/095777307X229453Citations: 8AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume19, Issue8September 2007Pages 407-412 RelatedInformation

Desmitis of the straight sesamoidean ligament and avulsion fragments of the proximal eminence of the middle phalanx in a horse imaged by radiographs, ultrasound, CT and MRI. A case report

Summary Objective: Description of the signalment, history, clinical signs and radiological findings of a horse with an acute severe lameness. Radiographs, ultrasonographic, CT and MRI images were taken to visualize the exact lesion. Material and methods: Based upon the history, clinical examination and diagnostic anaesthesia the region of pain was suspected to be the palmar aspect of the pastern joint region. After radiographic and ultrasonographic examination, CT and MRI were performed. A desmitis of the straight distal sesamoidean ligament and avulsion fragments from the proximal eminence of the middle phalanx (middle scutum) were diagnosed. Results: The horse was treated conservatively with oral administration of non-steroidal anti-inflammatory drugs and submitted to a controlled exercise program. Within two weeks significant improvement was evident. After three months the horse had improved both clinically and on the views obtained by ultrasonography. A year later the horse was sound and had returned to his previous athletic level. Conclusion and clinical relevance: This case demonstrates the additional value of CT combined with MRI to a clinical examination and standard diagnostic imaging tools. After clinical, ultrasonographic and radiographic examination the tentative diagnosis was a cyst-like lesion in the proximal region of the pastern joint. The ultrasonographic examination revealed an irregularity in shape and fibre lining of the straight sesamoidean ligament. However, no conclusions were made at this point, since ultrasonography of this region is difficult, and conclusions are hard to be made (4, 6, 7, 9). Arthroscopic diagnostic evaluation of the joint was optional; however, uncertainty remained on the exact localisation of the cyst-like lesion. Based on the CT and MRI it became clear that the horse was suffering of a desmitis of the straight distal sesamoidean ligament and extra-articular avulsion fragments from the proximal border of the middle phalanx. Surgical intervention seemed to be unnecessary, and a conservative treatment was initiated with a successful outcome.

Development of a 3D model of the equine distal forelimb and of a GRF shoe for noninvasive determination of in vivo tendon and ligament loads and strains

As critical locomotion events (e.g. high-speed and impacts during racing, jump landing) may contribute to tendinopathies, in vivo recording of gaits kinematic and dynamic parameters is essential for 3D reconstruction and analysis. To propose a 3D model of the forelimb and a ground reaction force recording shoe (GRF-S) for noninvasively quantifying tendon and ligament loads and strains. Bony segments trajectories of forelimbs placed under a power press were recorded using triads of ultrasonic kinematic markers linked to the bones. Compression cycles (from 500-6000 N) were applied for different hoof orientations. Locations of tendon and ligament insertions were recorded with regard to the triads. The GRF-S recorded GRF over the hoof wall and used four 3-axis force sensors sandwiched between a support shoe and the shoe to be tested. Validation of the model by comparing calculated and measured superficial digital flexor tendon strains, and evaluation of the role of proximal interphalangeal joint in straight sesamoidean ligament and oblique sesamoidean ligament strains, were successfully achieved. Objective comparisons of the 3 components of GRF over the hoof for soft and hard grounds could be recorded, where the s.d. of GRF norm was more important on hard ground at walk and trot. Soft grounds (sand and rubber) dissipate energy by lowering GRF amplitude and diminish bounces and vibrations at impact. At comparable speed, stance phase was longer on soft sand ground. The conjugate use of the GRF-S and the numerical model would help to quantify and analyse ground/shoe combination on comfort, propulsion efficiency or lameness recovery.