Tendonitis of the deep digital flexor tendon in the distal metacarpal/metatarsal region associated with tenosynovitis of the digital sheath in the horse

Abstract

Summary Twenty‐four horses with ultrasonographic evidence of tendonitis of the deep digital flexor tendon in the metacarpal/metatarsal region were seen over a 7 year period. Most horses had mild to moderate lameness and distension of the digital flexor tendon sheath in the affected limb. Intrasynovial analgesia of the digital flexor tendon sheath consistently improved the degree of lameness. Ultrasonography most commonly revealed small, distinct, often circular, focal hypoechoic areas within the deep digital flexor tendon which usually extended less than 1 cm proximodistally. The degree of lameness and swelling generally improved with box rest and controlled exercise, however, exacerbation of the clinical signs and ultrasonographic lesions was common when affected horses were returned to work or allowed free exercise at pasture. Of 24 cases, only 7 horses made a full recovery and returned to their intended athletic activity.

Palmar-plantar axial sesamoidean approach to the digital flexor tendon sheath in horses

“…When traumatic or septic tenosynovitis of the digital flexor sheath is present, chronic synovitis, substantial fibrosis, adhesion formation, and accumulation of fibrin and debris may develop within the proximal recess of the tendon sheath. 3,7,9,13,15,16,18 These inflammatory changes may be associated with increases in blood supply, capsular fibrosis, and intimal proliferation, resulting in reduction in sheath volume and making access to the lumen difficult. 14 Hemorrhage from inflamed synovium or occlusion of the needle by synovial villi may occur during synoviocentesis of the proximal pouch.…”

“…In addition to septic processes, other reasons to gain access to the tendon sheath have been described for diagnostic intrathecal anesthesia, synovial fluid sampling, intrathecal contrast radiography, tenoscopy, through-and-through lavage, and therapeutic infusion of anti-inflammatory agents. 6,7,[13][14][15][16] Commonly, synoviocentesis is performed by penetration of the proximolateral pouch proximal to the palmar or plantar annular ligament and palmar or plantar to the lateral or medial suspensory branch. When prominent synovial fluid distention is present, this is a useful location for obtaining synovial fluid samples or medicating the sheath.…”

Palmar annular ligament desmotomy in horses with the Arthrex-Centerline™ : An <i>ex-vivo</i> study

“…With the blind technique, the surgeon cannot be sure whether the manica flexoria has been accidentally incised during surgery. The tenoscopy definitely offers the advantage of better visualization within the operative field, a better diagnosis and a reduction in both the surgical wound and risks of complications (Nixon et al, 1993;Barr et al, 1995;Dik et al, 1995;Wright and McMahon, 1999). Since the advent of tenoscopy, reported cases of tendon fistulas and post-operative infections compared to those reported in the use of the open technique are definitely less frequent (Gerring and Webbon, 1984;Wright and McMahon, 1999).…”

Rupture of the Vinculum in Association with Tendon Injury within the Digital Flexor Tendon Sheath in Two Horses

“…AT-DFTS is a commonly encountered condition characterized by a palpable effusion of the DFTS proximal and distal to the PAL. A number of different clinical entities have been attributed to the development of AT-DFTS, including pathology of the SDFT [4], constriction of the DFTS by a normal or an abnormal PAL [8,13,14], and idiopathic tenosynovitis [15]. More recently, tears of the manica flexoria, longitudinal tears of the DDFT [10,12], tears of the DFTS wall, the proximal mesotendon of the DDFT, and the SDFT branches [11] have all been recognized as one of the potential causes of AT-DFTS.…”