The distal interphalangeal joint, also known as the coffin joint, is a critical anatomical structure located in the lower limb of horses. This joint is formed by the articulation of the distal phalanx, the middle phalanx, and the distal sesamoid bone, commonly referred to as the navicular bone. It plays a significant role in the biomechanics of equine locomotion, facilitating movement and weight-bearing. The health and functionality of the distal interphalangeal joint are essential for maintaining a horse's performance and overall well-being. Conditions affecting this joint, such as osteoarthritis and laminitis, can lead to lameness and reduced mobility. This page compiles peer-reviewed research studies and scholarly articles that investigate the anatomy, pathology, and treatment options related to the distal interphalangeal joint in horses.
Compagnie E, Ter Braake F, de Heer N, Back W.Report long-term clinical and radiological follow-up in horses after removal of large extensor process fragments occupying >25% of the joint surface of the distal interphalangeal joint (DIJ). Methods: Retrospective case series. Methods: Friesian horses (n=18) that underwent arthroscopic removal of a large extensor process fragment. Methods: Arthroscopic examination of the DIJ was performed in dorsal recumbency with the affected foot in extension using routine portals. Visualization of the fragment was improved using motorized synovial resectors. A dissection plane between the common digital ex...
Kane-Smyth J, Taylor SE, García EC, Reardon RJ.To evaluate the frequency of inadvertent penetration of the digital flexor tendon sheath (DFTS) and/or distal interphalangeal joint (DIPJ) when using a direct endoscopic approach to the navicular bursa, and to evaluate an alternate direct approach to the navicular bursa. Methods: Cadaveric study. Methods: Equine cadaver limbs (n = 40 for direct; n = 12 for alternate approach). Methods: Four surgeons performed the direct endoscopic approach to the navicular bursa on 10 limbs each. Frequencies of inadvertent synovial penetration and iatrogenic damage were compared between surgeons. Use of an alt...
Tyrnenopoulou P, Diakakis N, Karayannopoulou M, Savvas I, Koliakos G.Regenerative medicine has become one of the most promising therapies of equine osteoarthritis. Platelet lysate (PL) is rich in bioactive proteins and growth factors that play a crucial role in tissue healing. Objective: To evaluate the efficacy of intra-articularly injected autologous PL in equine athletes with naturally occurring osteoarthritis. Methods: Fifteen warmblood geldings aged 8-19 years with osteoarthritis of the distal interphalangeal joint were included in this study. They were randomly divided into two groups; 10 horses received intra-articular injections of PL and 5 of normal s...
Rubio-Martínez LM, Bracamonte JL, Tompkins S, Villarino NF.To describe a transthecal approach to the palmar pouch of the distal interphalangeal joint (DIPJ) in horses and compare it with the conventional blind arthroscopic technique. Methods: Ex vivo study. Methods: Cadaver forelimbs (n = 26 pairs) from mature horses. Methods: One limb from each pair was randomly assigned to each arthroscopic approach (conventional or transthecal). The conventional arthroscopic approach was performed as previously described and the transthecal approach was performed through sharp dissection of the distal reflection of the digital flexor tendon sheath (DFTS). The propo...
Hunter BG, Duesterdieck-Zellmer KF, Larson MK.Anecdotal accounts of tiludronate administration via intravenous regional limb perfusion (IVRLP) exist despite a lack of information regarding safety for synovial structures in the perfused area. The objective of this study was to determine whether tiludronate concentrations in synovial structures after IVRLP with low dose (0.5 mg, LDT) or high dose (50 mg, HDT) tiludronate remain below a value demonstrated in vitro to be safe for articular cartilage (<19,000 ng/ml), and to determine effects of tiludronate on synovial fluid cytology variables compared to saline perfused control limbs. Using...
McGill SL, Gutierrez-Nibeyro SD, Schaeffer DJ, Hartman SK, O'Brien RT, Joslyn SK.Abnormalities of the deep digital flexor tendon, navicular bone, and collateral sesamoidean ligament can be difficult to visualize using magnetic resonance imaging (MRI) if bursal fluid is absent. The use of saline podotrochlear bursography improves podotrochlear apparatus evaluation, however, the technique has disadvantages. The objective of this prospective feasibility study was to describe saline arthrography of the distal interphalangeal joint as an alternative technique for improving MRI visualization of the deep digital flexor tendon, navicular bone, collateral sesamoidean ligament, and ...
de Zani D, Polidori C, di Giancamillo M, Zani DD.There are few studies on the correlations between radiographic measurements of the foot and abnormalities of specific structures found with magnetic resonance imaging (MRI). Objective: To document the relationship between radiographic measurements of the equine foot and the presence of lesions in the foot on MRI. We hypothesised that different radiographic measurements would be associated with specific lesions detected by MRI. Methods: Retrospective analysis of radiographs and MRI studies. Methods: Seventy-four feet from 52 lame horses were included. Twenty parameters were measured on radiogra...
Daniel AJ, Goodrich LR, Barrett MF, Werpy NM, Morley PS, McIlwraith CW.Injection of the navicular bursa is commonly performed from the palmar aspect of the limb, which results in penetration of the deep digital flexor tendon (DDFT). Objective: To report a radiographic guided injection from the lateral aspect of the limb that avoids puncture of the DDFT and to assess synovial and soft tissue penetration by the needle. Methods: Prospective clinical and cadaveric study. Methods: Prospective analysis of cadaver limbs and clinical cases in which the navicular bursa was injected from the lateral aspect. Cadaver limbs were placed in a stand to simulate weight bearing an...
Roach JM, Pfau T, Bryars J, Unt V, Channon SB, Weller R.Kinematic evaluation of the distal limb of the horse using standard methods is challenging, mainly due to the hoof capsule restricting visualisation, but the recent development of a high-speed fluoroscopy (HSF) system has allowed in vivo cineradiographic assessment of moving skeletal structures at high speeds. The application of this non-invasive method to the equine distal limb is used to describe 'internal' distal limb kinematics including intra-horse and inter-horse variability, and variability between walk and trot. Distal limb kinematic data were collected at walk and trot from six non-la...
Contino EK, Barrett MF, Werpy NM.To determine the effect of limb positioning on the radiographic appearance of the distal and proximal interphalangeal joint spaces of the forelimbs of horses during evaluation of dorsopalmar radiographs. Methods: Evaluation study. Methods: 14 forelimbs from 9 adult horses. Methods: Each horse was in standing position with its forelimbs positioned on blocks. Dorsopalmar radiographs of each foot were obtained with the forelimbs positioned squarely (the metacarpus of both forelimbs was perpendicular to the ground as determined by visual examination [abducted 0°]; baseline) and abducted 5° and 1...
Takahashi T, Mukai K, Ohmura H, Aida H, Hiraga A.The purpose of this study was to create a lower forelimb model of the Thoroughbred horse for measuring the force in the superficial and deep digital flexor tendons (SDFT and DDFT), and the suspensory ligament (SL) during a trot. The mass, centers of gravity, and inertial moments in the metacarpus, pastern, and hoof segments were measured in 4 Thoroughbred horses. The moment arms of the SDFT, DDFT, and SL in the metacarpophalangeal (fetlock) and distal interphalangeal (coffin) joints were measured in 7 Thoroughbred horses. The relationship between the fetlock joint angle and the force in the SL...
Olive J, Lambert N, Bubeck KA, Beauchamp G, Laverty S.To ultrasonographically quantify experimentally induced effusion of the distal interphalangeal (DIP) joint of horses and compare results with those obtained with palpation. Methods: 8 forelimbs from equine cadavers and forelimbs of 5 mares. Methods: Preliminary ex vivo experiments were performed to validate the methods. Then, the DIP joints of the forelimbs of standing horses were serially distended with saline (0.9% NaCl) solution (1, 4, and 10 mL) by injection through an intra-articular catheter. Two ultrasonographers measured distension of the dorsal recess of the DIP joint, and 2 surgeons,...
Lamb MM, Barrett JG, White NA, Werre SR.Desmopathy of the distal interphalangeal joint collateral ligament is a common cause of lameness in the horse and carries a variable prognosis for soundness. Intralesional treatment has been proposed for improving outcome; however, limited reports describe methods for injecting this ligament. The purpose of this study was to compare accuracy of low-field magnetic resonance imaging (MRI) vs. radiography for injecting the collateral ligament of the distal interphalangeal joint. Equine cadaver digit pairs (n = 10) were divided by random assignment to injection of the ligament by either technique....
Biggi M, Dyson S.The distribution of lesions detected using magnetic resonance imaging (MRI) of hind feet has not been reported. Objective: To evaluate type and distribution of lesions detected using MRI in hind feet of lame horses and to compare the findings with those reported in front feet; to document follow-up information. Methods: Horses were selected if hindlimb lameness was abolished by plantar nerve blocks performed at the base of the proximal sesamoid bones. Magnetic resonance images were acquired using either a low-field or a high-field magnet, and all images were evaluated retrospectively by both a...
Manfredi JM, Boyce M, Malone ED, Anderson C, Anderson LB, Trumble TN.Palmar foot pain is frequently treated by steroid injections into the distal interphalangeal joint (DIPJ) in the anticipation that the steroid will diffuse to the navicular bursa and palmar foot structures. The object of this study was to determine if triamcinolone acetonide (TA) would in fact be able to locally diffuse from the DIPJ into the navicular bursa in horses affected by palmar foot pain. Both forelimb DIPJs (nine horses) were injected with 10 mg of TA. Navicular bursa fluid samples, both forelimb and one hind limb (systemic control), were analysed for TA with high-performance liquid ...
Brommer H, Schipper P, Barneveld A, van Weeren PR.Records of lame horses (2004-2007) with (peri-)synovial pain of the metacarpophalangeal joint (MCPJ, n = 53), digital flexor tendon sheath (DFTS, n = 20), and distal interphalangeal joint (DIPJ, n = 31) were evaluated (n = 104). Cases were grouped according to the following treatments: (1) systemic administration of NSAIDs (n = 40); (2) intrasynovial administration of glucocorticosteroids (n = 30); (3) combination treatment (n = 34). Outcome was defined as successful when the owner reported that the horse had returned to its previous level of performance within a period of up to six months aft...
O'Grady SE, Dryden VC.A club foot or flexural deformity may affect a horse at any stage of life from neonate through adulthood. The emphasis of this article is on defining and recommending the appropriate farriery for flexural deformities involving the deep digital flexor tendon and the distal interphalangeal joint. Clinical management of the flexural deformity is influenced by the severity, duration, and etiology of the club foot as well as the degree and source of lameness. Also discussed is the management of mismatched hoof angles, which remains a controversial subject for both farrier and veterinarian.
Holroyd K, Dixon JJ, Mair T, Bolas N, Bolt DM, David F, Weller R.Foot conformation in the horse is commonly thought to be associated with lameness but scientific evidence is scarce although it has been shown in biomechanical studies that foot conformation does influence the forces acting on the deep digital flexor tendon (DDFT) and the navicular bone (NB). The aim of this study was to determine the relationships between foot conformation and different types of lesion within the foot in lame horses. It was hypothesised that certain conformation parameters differ significantly between different types of foot lesions. Conformation parameters were measured on m...
Werpy NM, Ho CP, Garcia EB, Kawcak CE.Eight skeletally mature equine cadaver distal forelimbs were imaged using T2-weighted fast spin echo (FSE) sequences in a 1.0 T horizontal bore magnet. Each limb was parallel to the main magnetic field and with 16° angulation of the limb relative to the main magnetic field, which places one of the collateral ligaments of the distal interphalangeal joint at or near the magic angle. Each limb was imaged using an echo time (TE) of 80, 100, 120, and 140 ms. Reversal of the magic angle effect was achieved at echo time of 140 ms. However, given the alterations in tissue contrast and subjective decr...
Gutierrez-Nibeyro S, Werpy N, White Ii N.Conventional imaging modalities can diagnose the source of foot pain in most cases, but have limitations in some horses, which can be overcome by using magnetic resonance imaging (MRI). However, there are no reports of the MRI appearance and prevalence of foot lesions of a large series of horses with chronic foot lameness. Methods: In the present study, 79 horses with unilateral or bilateral forelimb lameness because of chronic foot pain underwent standing low-field MRI to make a definitive diagnosis. Results: Of the 79 horses, 74 (94%) had alterations in >1 structure in the lame or lamest foo...
Lawson JS, Bolt DM, May S, Smith AJ, Felstead CW, Weller R.Joint effusion is one of the classic radiographic signs of osteoarthritis, but no information is available regarding clinicians' ability to detect joint effusion radiographically. This study determined the accuracy and precision of experienced and inexperienced observers in detecting joint effusion of the distal interphalangeal (DIP), metacarpophalangeal (MCP) and midcarpal joints on radiographs. Fresh cadaverous forelimbs were loaded in a material testing machine to mimic a standing horse. The joints were gradually distended and lateromedial and dorsopalmar radiographs were acquired. The imag...
Gutierrez-Nibeyro SD, Werpy NM, White NA, McCutcheon J, Weng HY, Christopher JM.High- and low-field magnetic resonance (MR) imaging systems are available for clinical diagnosis of collateral desmopathy of the equine distal interphalangeal joint (DIJ). Knowledge of the normal appearance, size, shape,and signal variation of these ligaments on high- and low-field MR images is essential when assessing desmopathy detected by MR imaging. However, there are no descriptions of the normal features of DIJ collateral ligaments on images obtained with a standing low-field MR system. Low-field MR imaging characteristics of normal collateral ligaments of the DIJ of cadaver feet were co...
Walmsley EA, Anderson GA, Adkins AR.Determine the long-term outcome for Thoroughbreds undergoing desmotomy of the accessory ligament of the deep digital flexor tendon (DAL-DDFT) for type 1 flexural deformity of the distal interphalangeal joint (DIPJ). Methods: Retrospective matched cohort study Methods: Medical records were retrieved over a 17-year period for Thoroughbreds that underwent DAL-DDFT for type 1 flexural deformity. Long-term outcome was determined by analysis of race records and comparison with maternal siblings. Comparisons between cases and controls included 2-year-old, 3-year-old and total career performance data....
Bolen GE, Haye D, Dondelinger RF, Massart L, Busoni V.To assess the impact of cycles of freezing and thawing on magnetic resonance (MR) images (obtained by use of a 3-T magnet) of equine feet examined ex vivo. Methods: 9 forelimbs from 9 horse cadavers. Methods: 9 forefeet underwent MR imaging first at ambient temperature within 12 hours after the horses' death and then after each freezing-thawing cycle. Three digits underwent freezing and thawing (at 4°C for 36 hours) 2 times, 3 digits underwent freezing and thawing (at 4°C for 36 hours) once and rescanning after 24 hours at ambient temperature, and 3 digits underwent freezing and thawing at a...
Vallance SA, Bell RJ, Spriet M, Kass PH, Puchalski SM.To date, few reports exist comparing magnetic resonance imaging (MRI) and computed tomography (CT) for imaging of the equine distal limb, yet clinicians are required to decide which modality to use regularly. Objective: To report and compare anatomic visualisation scores obtained for CT, contrast enhanced CT (CECT) and standing low-field MRI (LFMRI) in the equine foot. Objective: Anatomic visualisation score discrepancies would exist between CT, CECT and LFMRI. Methods: Images of 22 lame horses (31 limbs) undergoing both CT and LFMRI of the foot were reviewed. When available, CECT images were ...
Addis PR, Lawson SE.The flexor tendons support the metacarpophalangeal (MCP) and distal interphalangeal (DIP) joints during stance phase and since tendon stiffness and strain changes with age, it is likely that kinematics are also age-dependent. Objective: Maximum MCP and DIP angles decrease in the young horse, plateau in the mature horse and increase towards senescence. Methods: The distal limbs of 57 walking horses age 3-212 months were filmed and digitised with an automated tracking system. Maximum MCP and DIP angles during stance phase were used to calculate strain in the superficial and deep digital flexor t...
Alkabes SB, Adams SB, Moore GE, Alkabes KC.To determine whether joint lavage performed simultaneously with IV regional limb perfusion (IVRLP) reduces the effectiveness of IVRLP and to compare 2 types of tourniquets used for this procedure in horses. Methods: 11 adult horses. Methods: 2 groups of 6 horses were tested by use of a pneumatic or an Esmarch tourniquet (1 horse was tested twice [once in each group]). Standing IVRLP with amikacin (500 mg) was performed for 30 minutes. Simultaneously, the metacarpophalangeal joint was lavaged with 2 L of lactated Ringer's solution and the egress fluids were collected. Samples of the distal inte...
Yiannikouris S, Schneider RK, Sampson SN, Roberts G.To report outcome after desmotomy of the accessory ligament of the deep digital flexor tendon (ALDDFT) in adult horses (≥2 years) for treatment of desmitis of the ALDDFT or flexural deformity of the distal interphalangeal joint (FDDIJ). Methods: Case series. Methods: Horses with desmitis of the ALDDFT (n=9) and FDDIJ (n=15). Methods: Records (April 1996-July 2008) of 24 adult horses (mean age, 6.7 years) that had ALDDFT desmotomy were reviewed. Follow-up data was obtained 12-120 months after desmotomy. Results: Outcome was available for 22 horses; 18 (82%; 6 of 8 horses with desmitis of the ...
Rabba S, Bolen G, Verwilghen D, Salciccia A, Busoni V.Foot pain is an important cause of lameness in horses. When horses with foot pain have no detectable radiographic abnormalities, soft-tissue assessment remains a diagnostic challenge without magnetic resonance (MR) imaging. Ultrasonography can provide an alternative to MR imaging when that modality is not available but the extent of changes that might be seen has not been characterized. We reviewed the ultrasonographic findings in 39 horses with lameness responding positively to anesthesia of the palmar digital nerves and without radiographically detectable osseous abnormalities. Thirty of the...
Bischofberger AS, Fürst AE, Torgerson PR, Carstens A, Hilbe M, Kircher P.OBJECTIVE To characterize delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) features of healthy hyaline cartilage of the distal interphalangeal joint (DIPJ) of horses, to determine whether dGEMRIC can be used to differentiate various stages of naturally occurring osteoarthritis of the DIPJ, and to correlate relaxation times determined by dGEMRIC with the glycosaminoglycan concentration, water content, and macroscopic and histologic findings of hyaline cartilage of DIPJs with and without osteoarthritis. SAMPLE 1 cadaveric forelimb DIPJ from each of 12 adult warmblood horses. PROCEDURES T1-...
Pagliara E, Marenchino M, Antenucci L, Costantini M, Zoppi G, Giacobini MDL, Bullone M, Riccio B, Bertuglia A.Fetlock joint angle (FJA) pattern is a sensitive indicator of lameness. The first aim of this study is to describe a network of inertial measurement units system (IMUs) for quantifying FJA simultaneously in all limbs. The second aim is to evaluate the accuracy of IMUs for quantifying the sagittal plane FJA overground in comparison to bi-dimensional (2-D) optical motion capture (OMC). 14 horses (7 free from lameness and 7 lame) were enrolled and analyzed with both systems at walk and trot on a firm surface. All enrolled horses were instrumented with 8 IMUs (a pair for each limb) positioned at t...
Gutierrez-Nibeyro SD, White NA, Werpy NM, Tyrrell L, Allen KA, Sullins KE, Mitchell RD.We report the use of a low-field magnetic resonance (MR) imaging system for the detection of desmopathy of the collateral ligament of the distal interphalangeal joint and the long-term outcome. Twenty horses were studied and their medical records and MR images were reviewed retrospectively. Long-term follow-up information was obtained by telephonic questionnaires of owners, trainers, or referring veterinarians. Desmopathy of the medial collateral ligament (80%) and enthesopathy of the affected collateral ligament (80%) were common MR imaging features. Treatment consisted of stall rest followed...
Hobbs SJ, Richards J, Matuszewski B, Brigden C.To develop and evaluate a marker cluster set for measuring sagittal and extrasagittal movement of joints in the distal portion of the forelimb in ponies. Methods: 4 ponies. Methods: 5 infrared cameras were positioned on a concrete walkway in a frontal-sagittal arc and calibrated. Four segments were defined: hoof, middle phalanx, proximal phalanx, and metacarpus. Rigid clusters with 4 retroreflective markers were placed on each segment. A static trial was recorded with additional anatomic markers on the medial and lateral joint lines. Those anatomic markers were removed, and kinematic data were...
Clayton HM, White AD, Kaiser LJ, Nauwelaerts S, Lavagnino M, Stubbs NC.Lightweight tactile stimulators attached to the hind pasterns increase the height of the hind hoof flight arc but details of the induced changes in swing phase kinematics and kinetics have not been investigated. Objective: Stimulators on the hind pasterns are associated with increased hindlimb joint flexions and increased positive work performed by the hip and tarsal musculature. Methods: Nine nonlame horses trotted 4 times with and without 55 g tactile stimulators loosely attached around the hind pasterns. Height of the flight arc and peak flexion angles of the hindlimb joints were measured a...
Dyson SJ, Kidd L.Analgesia of the distal interphalangeal (DIP) joint and of the navicular bursa was performed independently in the lame or lamer forelimb of 59 horses, in which lameness was significantly improved by perineural analgesia of either the palmar digital or palmar (abaxial sesamoid) nerves. In 3 horses no improvement was detected. Lameness was improved by analgesia of the DIP joint but there was no response to analgesia of the navicular bursa in 3 horses. In 12 horses, lameness was improved by analgesia of the navicular bursa but intra-articular analgesia resulted in no change. Forty-one horses resp...
Chateau H, Degueurce C, Denoix JM.Understanding of the biomechanical effects of egg-bar shoes remains incomplete because kinematic studies are usually performed on hard tracks and with skin markers that do not measure the actual 3-dimensional (3D) movements of the 3 digital joints. Objective: To quantify the effects of egg-bar shoes on the 3D kinematics of the distal forelimb in horses walking on a sand track. Methods: Four healthy horses were equipped with ultrasonic markers fixed surgically to the 4 distal segments of the left forelimb. The 3D movements of these segments were recorded while the horses were walking on a sand ...
Sharp Y, Tabor G.Links between poor hind hoof balance, pathologies in the hind limb and associated altered posture have been suggested but not quantified. The hoof is proposed as a neuro-sensory organ responsible for informing equine stance with implications for musculoskeletal health in the hind limb and trunk of the horse. This study aims to quantify equine limb posture and its relationship with hoof balance. Twelve horses presenting with negative plantar angles were photographed and limb posture documented before and after the creation of positive plantar angles and improved three-dimensional proportions ar...
Dyson S, Brown V, Collins S, Murray R.Associations between degree of ossification of the cartilages of the foot and injuries to other structures of the foot have been suggested, but have not been investigated by large scale studies. Objective: To describe the frequency of grade >3 ossification of the cartilages of the foot (possibly significant ossification, PSO), mediolateral symmetry of ossification and left-right symmetry between feet; and to investigate associations between PSO and injury of either the collateral ligaments (CLs) of the distal interphalangeal (DIP) joint or the distal phalanx. Objective: Possibly significant os...
Schumacher J, Schumacher J, Gillette R, DeGraves F, Schramme M, Smith R, Perkins J, Coker M.Analgesia of the palmar digital (PD) nerves has been demonstrated to cause analgesia of the distal interphalangeal (DIP) joint as well as the sole. Because the PD nerves lie in close proximity to the navicular bursa, we suspected that that analgesia of the navicular bursa would anaesthetise the PD nerves, which would result in analgesia of the DIP joint. Objective: To determine the response of horses with pain in the DIP joint to instillation of local anaesthetic solution into the navicular bursa. Methods: Lameness was induced in 6 horses by creating painful synovitis in the DIP joint of one f...
Spriet M, Mai W, McKnight A.Increased signal intensity in one of the collateral ligaments of the distal interphalangeal (DIP) joint of sound horses in images acquired using a low-field magnet with vertical orientation of the magnetic field was investigated as a possible manifestation of the magic angle effect. Three isolated equine digits were imaged using the following pulse sequences: (1) spin echo TI, (2) turbo spin echo proton density and T2, and (3) 3D gradient echo T1, in different positions by mildly changing the orientation of the long axis of the digit, in the dorsal plane, relative to the magnetic field. The si...
Vacek JR, Welch RD, Honnas CM.An arthroscopic approach to the palmaroproximal or plantaroproximal pouch of the distal interphalangeal joint was developed in six cadaver limbs and seven limbs of three clinically normal horses. The dorsal aspect of the proximal border and the proximal articular margin of the distal sesamoid (navicular) bone, the palmar aspect of the distal articular margin of the middle phalanx, the collateral sesamoidean ligaments of the distal sesamoid bone, and the joint capsule attachments were readily accessible. Distending the joints with fluid gave access to portions of the articular surface between t...
Harper J, Schumacher J, Degraves F, Schramme M, Schumacher J.Specific analgesic techniques are required in diagnosis of lameness to isolate the exact origin of pain to the many structures of the foot that may be involved. Objective: To determine if analgesia of the digital flexor tendon sheath (DFTS) results in anaesthesia of other portions of the foot, such as the sole, distal interphalangeal joint (DIPJ), or navicular bursa (NB). Methods: Lameness caused by pain in the dorsal margin or heel region of the sole of the foot was induced in 18 horses by: using set-screws to create solar pressure (Trial 1: n = 5); or administering endotoxin intrasynovially ...
Martin GS, McIlwraith CW, Turner AS, Nixon AJ, Stashak TS.A retrospective study was made of 21 horses in which proximal interphalangeal arthrodesis had been performed. The right hindlimb was the most often affected (52%). Acute trauma was the most common reason for performing the surgery (62%). Follow-up data were obtained from the owners regarding return to serviceability . When available, follow-up radiographs and clinical examinations were reviewed. Of the 20 horses on which follow-up information was available, 16 were serviceable . Of the horses in which a hindlimb was arthrodesed , 86% were serviceable , whereas 67% of the horses affected in the...
Honnas CM, Welch RD, Ford TS, Vacek JR, Watkins JP.The medical records of 12 horses with septic arthritis of a distal interphalangeal joint were reviewed to determine clinical features and response to treatment. Sepsis was caused by trauma or an injection that resulted in an open or contaminated distal interphalangeal joint. All horses were severely lame. Treatment included broad-spectrum parenterally administered antimicrobial drugs (ten horses), percutaneous through-and-through joint lavage (eight horses), indwelling drains (three horses), immobilization of the limb in a cast (three horses), intraarticular injection of sodium hyaluronate (on...
Reeves MJ, Yovich JV, Turner AS.The etiology, clinical presentation, radiographic findings, diagnostic criteria, differential diagnoses, treatment, and prognosis are reviewed for several clinically important conditions of the equine foot. These include pedal osteitis, sheared heels, distal sesamoid bone (navicular) fractures, subchondral bone cyst of the distal phalanx, distal interphalangeal joint subluxation, congenital phalangeal hypoplasia, bipartite and tripartite distal sesamoid bones, keratoma, ossification of the cartilages of the distal phalanx (sidebones), necrosis of the cartilages of the distal phalanx (quittor),...
Schumacher J, Schumacher J, de Graves F, Steiger R, Schramme M, Smith R, Coker M.The response of horses, with solar pain in the dorsal or palmar aspect of the foot, to 6 or 10 ml local analgesic solution administered into the distal interphalangeal (DIP) joint was examined. Lameness was induced in 7 horses by creating solar pain in the dorsal aspect of one forefoot and, at another time, the palmar aspect of the other forefoot with set-screws inserted into a custom-made shoe. Horses were videotaped trotting before and after application of set-screws and, in separate trials, after 6 or 10 ml local analgesic solution was administered into the DIP joint. Lameness scores were a...
Chateau H, Degueurce C, Denoix JM.To develop a method that allows quantification of the 3 anatomic rotations in the digital joints of moving horses and measure these rotations when horses are walking in a straight line on a hard track. Methods: 4 healthy French Trotter horses. Methods: Triads of ultrasonic kinematic markers were surgically linked to the 4 distal segments of the digits of the left forelimb of each horse. Three-dimensional (3-D) coordinates of these markers were recorded in horses walking in a straight line. The three angles of rotation of each digital joint were calculated by use of a joint coordinate system as...
Pauwels FE, Schumacher J, Castro FA, Holder TE, Carroll RC, Sega GA, Rogers CW.To determine whether clinically effective concentrations of methylprednisolone or triamcinolone can be achieved in the navicular bursa after injection of methylprednisolone acetate (MPA) or triamcinolone acetonide (TA) into the distal interphalangeal joint (DIPJ) and whether clinically effective concentrations of these drugs can be achieved in the DIPJ after injecting the navicular bursa with the same doses of MPA or TA. Methods: 32 healthy horses. Methods: Horses in groups 1 through 4 received 40 mg of MPA in the DIPJ, 10 mg of TA in the DIPJ, 40 mg of MPA in the navicular bursa, and 10 mg of...
McGill SL, Gutierrez-Nibeyro SD, Schaeffer DJ, Hartman SK, O'Brien RT, Joslyn SK.Abnormalities of the deep digital flexor tendon, navicular bone, and collateral sesamoidean ligament can be difficult to visualize using magnetic resonance imaging (MRI) if bursal fluid is absent. The use of saline podotrochlear bursography improves podotrochlear apparatus evaluation, however, the technique has disadvantages. The objective of this prospective feasibility study was to describe saline arthrography of the distal interphalangeal joint as an alternative technique for improving MRI visualization of the deep digital flexor tendon, navicular bone, collateral sesamoidean ligament, and ...
Werpy NM, Ho CP, Garcia EB, Kawcak CE.Eight skeletally mature equine cadaver distal forelimbs were imaged using T2-weighted fast spin echo (FSE) sequences in a 1.0 T horizontal bore magnet. Each limb was parallel to the main magnetic field and with 16° angulation of the limb relative to the main magnetic field, which places one of the collateral ligaments of the distal interphalangeal joint at or near the magic angle. Each limb was imaged using an echo time (TE) of 80, 100, 120, and 140 ms. Reversal of the magic angle effect was achieved at echo time of 140 ms. However, given the alterations in tissue contrast and subjective decr...
Rabba S, Bolen G, Verwilghen D, Salciccia A, Busoni V.Foot pain is an important cause of lameness in horses. When horses with foot pain have no detectable radiographic abnormalities, soft-tissue assessment remains a diagnostic challenge without magnetic resonance (MR) imaging. Ultrasonography can provide an alternative to MR imaging when that modality is not available but the extent of changes that might be seen has not been characterized. We reviewed the ultrasonographic findings in 39 horses with lameness responding positively to anesthesia of the palmar digital nerves and without radiographically detectable osseous abnormalities. Thirty of the...
Fowlie JG, O'Neill HD, Bladon BM, O'Meara B, Prange T, Caron JP.The conventional arthroscopic approach to the palmar/plantar aspect of the distal interphalangeal joint (DIPJ) may result in the inadvertent penetration of the digital flexor tendon sheath (DFTS) and the navicular bursa (NB). This iatrogenic communication would be undesirable subsequent to arthroscopic lavage of a septic DIPJ. Objective: A lateral/medial approach to the palmar/plantar aspect of the DIPJ will result in a significantly lower rate of inadvertent penetration of the DFTS and NB, whilst still providing adequate intra-articular evaluation. Methods: The conventional palmar/plantar app...
Nottrott K, De Guio C, Khairoun A, Schramme M.Navicular disease in the horse often requires injection of the navicular bursa. We have developed an ultrasound-guided, lateral needle approach to navicular bursocentesis, which avoids penetration of the deep digital flexor tendon (DDFT) and the need for radiographic control. Objective: To describe and evaluate the feasibility and efficacy of an ultrasound-guided, lateral bursocentesis technique. Methods: Cadaveric and in vivo experiments. Methods: The navicular bursa in 62 cadaveric forelimbs of 31 horses and in both forelimbs of 26 live horses, positioned with the foot flexed in a navicular ...
Butcher MT, Bertram JE, Benzuidenhout AJ.The distal forelimb of the horse has a complex array of ligaments that play a critical role in determining function of the digit and are often associated with the initiation of foot pathologies. The collateral ligaments of the distal sesamoid bone (CLDS) play an important role in digit stabilization near the end of foot contact and there is also limited evidence to suggest that the CLDS stabilize the proximal interphalangeal joint (PIPJ) during weight bearing. By virtue of their anatomical attachments where the ligaments pass dorsal to the axis of rotation of the PIPJ, it is reasonable to assu...
Daniel AJ, Goodrich LR, Barrett MF, Werpy NM, Morley PS, McIlwraith CW.Injection of the navicular bursa is commonly performed from the palmar aspect of the limb, which results in penetration of the deep digital flexor tendon (DDFT). Objective: To report a radiographic guided injection from the lateral aspect of the limb that avoids puncture of the DDFT and to assess synovial and soft tissue penetration by the needle. Methods: Prospective clinical and cadaveric study. Methods: Prospective analysis of cadaver limbs and clinical cases in which the navicular bursa was injected from the lateral aspect. Cadaver limbs were placed in a stand to simulate weight bearing an...
Olive J.The suitability of low-field magnetic resonance (MR) imaging for assessment of articular cartilage has been questioned, based on insufficient image quality. The purposes of this study were to describe the MR anatomy of the normal distal interphalangeal (DIP) cartilage, and to evaluate the sensitivity and accuracy of low-field MR imaging for identification of cartilage erosions that were created ex vivo. Imaging sequences included sagittal and dorsal multiple-oblique T1-weighted gradient-recalled echo (GRE) and sagittal dual echo sequences. In the thickest regions, normal cartilage appeared as ...
Bolen G, Busoni V, Jacqmot O, Snaps F.Although ultrasonography is widely used in equine orthopedics, its use in the distal portion of the digit is still limited. The purpose of this descriptive study was to document the normal ultrasonographic appearance of the palmarodistal aspect of the digital area imaged between the bulbs of the heels. Ultrasonographic images were obtained with a 7.5 MHz microconvex transducer in 10 fresh equine cadaver forelimbs and five soundhorses. Sagittal, parasagittal, and transverse images were obtained from the proximal aspect of the middle phalanx to the distal sesamoid bone. Anatomic sections were ob...
Malacarne BD, Cota LO, Neto ACP, Paz CFR, Dias LA, Corrêa MG, Carvalho AM, Faleiros RR, Xavier ABS.With the hypothesis that equine dorsal lamellar tissue can be desensitized by anesthesia injection into distal interphalangeal joint (DIPJ), the objective was to assess the mechanical nociceptive threshold of hoof dorsal lamellae following intra-articular (IA) administration of lidocaine into this joint. Methods: The DIPJ of the forelimbs of six adult healthy horses were injected with either 5 mL of lidocaine, or 5 mL of lactated Ringer's solution. Treatments were randomly distributed, with each forelimb undergoing a single treatment. The hooves were evaluated pre- and post-injection at pre-se...
Bowker RM, Linder K, Van Wulfen KK, Sonea IM.The anatomy of the distal interphalangeal (DIP) joint in the adult horse is described in relationship to the suspensory ligaments of the navicular bone, the neurovascular bundle and the sensory nerves to these periarticular regions. Using polymer plastic injections, the synovial cavity of the DIP joint was observed to have a complex relationship to the proximal suspensory or collateral sesamoidean ligament (CSL) of the navicular bone with the cavity forming cranial and caudal compartments around the CSL abaxially. Sensory nerves, as identified by peptide immunocytochemistry and silver/gold chl...
