Preoperative diagnostic methods for digital flexor tendon sheath pathologyA.R. Fiske-Jackson and colleagues from the Royal Veterinary College, UK, have recently reported the findings of their study on the use of intrathecal analgesia and contrast radiography as preoperative diagnostic methods for digital flexor tendon sheath pathology.This study (Fiske-Jackson et al. 2012) found that contrast radiography is a useful tool for the diagnosis of pathology within the digital flexor tendon sheath. Currently, ultrasonography is the mainstay of diagnosis for manica flexoria and marginal tears of the deep digital flexor tendon (DDFT). However, the sensitivity of this technique is reported to be 38% and 71%, respectively. Use of a contrast tenogram increased the sensitivity for diagnosis of manica flexoria tears to 96% (specificity 80%). Marginal DDFT tears were diagnosed, using this technique, with a sensitivity of 57% (specificity 84%). This study also evaluated the response to intrathecal analgesia and found that horses with DDFT tears were significantly more likely to have a positive response to intrathecal analgesia than those with manica flexoria tears. This technique is a useful addition to the diagnostic evaluation of manica flexoria tears in horses.
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