Musculoskeletal Lesions and Lameness in 121 Horses With Carpal Sheath Effusion (1999–2010)

Abstract

Equine carpal sheath effusion has multiple etiologies. The purpose of this retrospective study was to describe the prevalence of distinct musculoskeletal lesions lameness in a sample of horses with a clinical diagnosis of carpal sheath effusion. A total of 121 horses met inclusion criteria. Seventy-four percent (89/121) of horses were lame at presentation; middle-aged (9-18 years, 80%) and older (> 18 years, 85%) horses were lame more frequently than young horses (< 9 years, 44%). Ninety-three percent (113/121) were diagnosed with osseous and/or soft tissue abnormalities. Of these 113 horses, 10 exhibited osseous abnormalities, whereas 111 were diagnosed with soft tissue lesions. Eighty-four percent (93/111) of the soft tissue injuries extended from the caudodistal antebrachium to the palmar metacarpus. The superficial digital flexor tendon (98/111; 88%) and accessory ligament of the superficial digital flexor tendon (64/111; 58%) were the most commonly injured structures, with both structures affected in 41 (41/111; 37%) horses. Injuries within the caudodistal antebrachium included the superficial digital flexor musculotendinous junction (66), the accessory ligament of the superficial digital flexor tendon (64), and deep digital flexor muscle (21), in isolation or in combination with other structures. Increased echogenicity in the medial superficial digital flexor musculotendinous junction was detected in 40 horses and was significantly associated with increasing age (middle-aged, 19/40; old, 18/40). Findings from this study indicated that age should be taken into consideration for horses presented with carpal sheath effusion and that adjacent structures within the caudodistal antebrachium should be included in evaluations.

Diagnostic tenoscopy of the carpal sheath with a needle arthroscope in standing sedated horses

“…Pathologies affecting the carpal sheath have been recognized in horses for decades. However, large case series have not been reported until recently, and new pathological entities affecting the region continue to be recognized and described . This situation is likely a reflection of the low prevalence of carpal sheath pathologies.…”

“…This situation is likely a reflection of the low prevalence of carpal sheath pathologies. Jorgensen et al reported that only 2% to 3% of new ultrasounds per year are performed because of problems suspected within the carpal sheath. Thus, it is likely that the anatomic knowledge and diagnostic capabilities of most equine veterinarians are lower for the carpal sheath than for other regions.…”

“…Several pathological conditions have been associated with lameness originating in the carpal sheath, including caudal distal radial osteochondromata, exostoses of the caudal perimeter of the radial physis, fractures of the accessory carpal bone, tendinitis of the superficial digital flexor tendon (SDFT) and intrathecal tearing of its accessory ligament, tendinitis of the deep digital flexor tendon (DDFT), and tearing of its radial head . Tentative or definitive diagnosis of these pathologies can be obtained after radiography and ultrasonography . Nonetheless, precise ultrasonographic diagnosis requires training and experience.…”

“…In the past 10 years, surgical techniques, equipment used, and knowledge about carpal sheath pathologies and treatment have evolved considerably . However, carpal sheath tenoscopy remains exclusively performed under general anesthesia because of the size and temperament of horses and the required limb angle to carry out carpal sheath tenoscopy.…”

Normal Radiographic, Computed Tomography and Ultrasonographic Anatomy of the Carpal Region in Baladi Goats (Capra Hircus)

“…C arpal region is a compound part of the thoracic limb with various structures incorporated carpal joint, ligaments, tendons and muscles (Getty, 1975;Dyce et al, 2009). Carpal joint may be subjected to many pathological changes related to the joint structures, ligaments, tendons of the carpal region (Magnusson and Ekman, 2001;Malone et al, 2003;Vaughan et al, 2014;Jorgensen et al, 2015;Shields et al, 2015).…”