Proximal suspensory desmitis in the hindlimb: 42 cases

Area of Science:

• Veterinary Medicine
• Equine Orthopedics
• Diagnostic Imaging

Background:

• Proximal suspensory desmitis is a common cause of hindlimb lameness in horses.
• Accurate diagnosis is crucial for effective treatment and prognosis.

Purpose of the Study:

• To evaluate the diagnostic utility of local analgesic techniques and ultrasonography for proximal suspensory desmitis in horses.
• To assess the correlation between diagnostic findings and treatment outcomes.

Main Methods:

• Forty-two horses with hindlimb lameness underwent diagnosis using local analgesia and ultrasonography.
• Specific analgesic techniques included subtarsal, tibial nerve, and tibial and fibular nerve blocks.
• Intra-articular analgesia of the tarso-metatarsal joint was also performed in a subset of horses.
• Ultrasonography focused on the proximal suspensory ligament and third metatarsal bone.

Main Results:

• Subtarsal analgesia improved lameness in 36 of 41 horses.
• Perineural analgesia of the tibial nerve (or both tibial and fibular nerves) improved lameness in the remaining five horses.
• Ultrasonographic abnormalities of the proximal suspensory ligament were detected in most unilaterally and all bilaterally lame horses.
• Radiographic abnormalities of the proximal third metatarsal bone were present in 23 horses.

Conclusions:

• Local analgesic techniques, particularly subtarsal analgesia, are valuable for diagnosing proximal suspensory desmitis in horses.
• Ultrasonography is effective in identifying abnormalities of the proximal suspensory ligament.
• Prognosis varies, with some horses returning to full work while others require retirement due to persistent lameness.