Bilateral hindlimb superficial digital flexor tendinopathy in a sports horse

Superficial digital flexor tendinopathy is a common cause of forelimb lameness in Thoroughbred racehorses and sports horses; however, this condition is rarely observed in the hindlimb. A 16-year-old Irish sports horse gelding was presented with bilateral swelling in the plantar metatarsal region and severe bilateral hindlimb lameness visible at the walk. The lameness occurred after the cross-country phase of an eventing competition. The clinical suspicion of superficial digital flexor tendon (SDFT) injury was confirmed after ultrasonographic examination, which revealed an extensive core lesion in both hindlimb SDFTs. Ultrasound-guided intralesional injection of autologous bone marrow aspirate concentrate (BMAC) was performed in association with controlled exercise. Following a rehabilitation period of eight months, the horse was able to resume showjumping. Follow-up was available for 44 months, and no recurrence of the previous SDFT injury was noted. To the authors' knowledge, this is the first case report describing bilateral hindlimb SDF tendinopathy in the metatarsal region of a sports horse.