Computed tomographic evaluation of the distal aspect of the deep digital flexor tendon (DDFT) in horses

Abstract

Computed tomographic evaluation of the distal aspect of the deep digital flexor tendon (DDFT) in horsesThe objective of this study was to image the deep digital flexor tendon (DDFT) in its normal position by means of computed tomography from distal aspect of the proximal phalanx (P1) down to the flexor surface of the distal phalanx (P3) in 10 predefined cutting planes. A total of 30 front extremities of randomly selected Warmblood horses were used. Criteria for evaluation were differntiation of the DDFT from surrounding structures, definition of its shape, contour and structure as well as determination of its density and measurements. The density of DDFT was determined at three sites in all transversal planes, the depth was determined at three locations in palmar to dorsal and the width in medial to lateral direction. The mean values for density amounted to 106.8 HU (s 12.7 HU), for depth 5.04 mm (s 0.66 mm) and for width to 35.05 mm (s 2.99 mm). Significant differences were demonstrated in between planes as well as within planes comparing measurements by statistical analysis, thus demonstrating that the data predominantly follow distinct rules. Within the transversal plane (distal navicular to proximal) lowest values for density were found in the axial region of interest with significantly lower values for depth axially. Also a distal to proximal increase in values for depth and a decrease for width were noted. Apart from determining standard values, CT-images of pathological DDFT were shown based on four samples. This was done in comparison to sonographic images and to specific postmortem findings. Measured values found in regions with pathological lesions were evaluated by referring to the mean of standard values plus/minus two standard deviations. The importance and high value of computed tomography in imaging the distal aspect of the DDFT was not only confirmed by comparing different images by means of subjective criteria but also by objectively collected data for density and distance.

Use of Contrast‐enhanced Computed Tomography to Assess Angiogenesis in Deep Digital Flexor Tendonopathy in a Horse

“…Magnetic resonance (MR) imaging allows assessment of soft tissues within the hoof capsule and findings have been associated with histopathologic abnormalities 5–10 . Computed tomography (CT) is also useful for evaluation of bone and soft tissue abnormalities within the foot 11–13 . Contrast‐enhanced CT has been proposed as a means of evaluating osseous and soft tissue structures of the foot for diagnosing the cause of heel pain 14,15 …”

Ultrasonographic diagnosis of injuries to the deep digital flexor tendon and associated structures in the equine foot (suprasesamoidean area)

“…2008). Nevertheless, several studies in the past decade have shown increasing interest in CT for soft tissue assessment as well (Tietje et al . 2001; Nowak 2002; Eliashar et al .…”

“…Lesions of the PTA have been widely documented using histology (Blunden et al ,b, 2009, radiography (Wright 1993;Dik et al 2001;Dyson 2008), nuclear scintigraphy (Dyson and Murray 2007b,c), computed tomography (CT) (Tietje et al 2001;Nowak 2002;Eliashar et al 2006;Desbrosse et al 2008) and magnetic resonance imaging (MRI) Dyson et al 2003aDyson et al ,b, 2005Busoni et al 2004Busoni et al , 2005Mair et al 2005;Murray et al 2006a,b;Dyson and Murray 2007a;Sherlock et al 2008;Bell et al 2009;Blunden et al 2009). The routine use of ultrasonography and now MRI has demonstrated the importance of soft tissue lesions in horses presenting with PTS.…”

“…rather than soft tissue injuries (Widmer et al 2000;Desbrosse et al 2008). Nevertheless, several studies in the past decade have shown increasing interest in CT for soft tissue assessment as well (Tietje et al 2001;Nowak 2002;Eliashar et al 2006;Smith et al 2007). Four main lesion types of the DDFT have been described using MRI; these can also be detected ultrasonographically: core lesions, focal and diffuse dorsal surface lesions, sagittal or parasagittal plane splits and insertional lesions (enthesopathy) (Dyson 2003b;Dyson et al 2003a,b;Mair and Kinns 2005;Blunden et al 2009).…”

Comparison of the Navicular Region of Newborn Foals and Adult Horses by Magnetic Resonance Imaging

“…Ultrasonography of the foot is limited to the sagittal midline and off incidence artefacts may confuse interpretation (Denoix, 2000; Sage and Turner, 2000; Busoni and Denoix, 2001;). 3D computed tomographic (CT) studies enable more accurate evaluation of both osseous and soft tissue lesions, but require general anaesthesia (Tietje, 1995; Ruohoniemi and Tevahartiala, 1999; Tietje et al., 2001; Tucker, 2001). Nuclear scintigraphy provides highly sensitive information about abnormal bone activity, but anatomical localization is limited and there is a relative high incidence of false‐positive results (Dyson, 2002).…”