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.
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...
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...
Honnas CM, Schumacher J, Kuesis BS.A 6-month-old 300-kg Quarter Horse filly was treated for septic arthritis of the distal interphalangeal joint and septic navicular bursitis that developed as a result of a deep puncture to the foot. Initial treatment consisted of establishing ventral drainage for the navicular bursa, lavage of the distal interphalangeal joint, and administration of broad-spectrum antimicrobial drugs and non-steroidal anti-inflammatory drugs. Because of continuing sepsis in the distal interphalangeal joint, subsequent treatment included packing the defect in the bottom of the foot with cancellous bone in an att...
Jann H, Henry G, Berry A, Cash L.Twenty cadaver limbs of adult horses were examined by arthrographic examination of the distal interphalangeal joint. The joint capsule and space is described. Comparison is made with existing descriptions.
Dyson SJ.This paper describes the clinical and radiographic features, and response to treatment, of 45 horses which showed lameness that was improved by intra-articular anaesthesia of the distal interphalangeal (DIP) joint. Although many horses had poor conformation of the foot of the lame limb, the majority showed no localising clinical signs suggestive of involvement of the DIP joint. Lameness was usually unilateral. No horse with bilateral lameness responded to treatment. Palmar digital nerve blocks frequently improved or alleviated lameness, although in some horses palmar (abaxial sesamoid) nerve b...
Riley CB, Yovich JV, Huxtable CR.A fusion defect of the proximal and middle phalanges of both hindlimbs, osteochondrosis dissecans of the distal interphalangeal joints of the forelimbs, and subluxation of all 4 distal interphalangeal joints occurred in a Standardbred filly. Lameness was the first abnormality noted and was observed at one week of age in the left forelimb and progressed until all 4 limbs were affected by 5 weeks of age. On radiographs of both forelimbs, the distal interphalangeal joints were subluxated with irregularity and lucency of subchondral bone. On radiographs of the distal hindlimbs, there was a subluxa...
McIlwraith CW, Goodman NL.The various conditions of the interphalangeal joint are presented; these include degenerative joint disease and osteochondral chip fractures of the proximal interphalangeal joint, fractures of the middle phalanx affecting proximal and/or distal interphalangeal joints, subluxation and osteochondrosis of the proximal interphalangeal joint, and arthrosis of the distal interphalangeal joint.
Turner TA.Navicular syndrome can be treated in a variety of ways. This is related to the fact that it has a variety of causes. Prognostically, most horses will improve with treatment. One can expect about 50 per cent of the horses to become useably sound for 1 year, no matter what treatment is used. The disease is progressive, and affected horses eventually will need to be retired because of lameness. The author's therapeutic approach is to utilize shoeing as the primary therapy. Shoeing is performed to correct structural problems and to ensure that shoeing is physiologically sound. Nonsteroidal anti-in...
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),...
Yovich JV, Stashak TS, DeBowes RM, Ducharme NG.Fractures of the distal phalanx of the forelimb were diagnosed in 5 colts and 3 fillies ranging in age from 2 weeks to 5 1/2 months at the time of fracture. Three fractures entered the distal interphalangeal joint and 6 fractures (one foal had bilateral fractures) were nonarticular. All foals with articular fractures became sound with conservative treatment. Four of 5 foals with nonarticular fractures became sound with conservative treatment and 1 foal developed separation of the hoof at the coronary band after application of acrylic around the hoof. On the basis of our observations in these f...
Wagner PC, Grant BD, Kaneps AJ, Watrous BJ.After desmotomy of the accessory ligament of the deep digital flexor tendon (distal check ligament) had been performed in 40 horses with flexural deformity of the distal interphalangeal joint (contracture of the deep digital flexor tendon), the horses' records were evaluated retrospectively. Information concerning soundness, return to intended purpose, and cosmetic appearance of the limb and hoof was obtained. The condition had been diagnosed and treated in 26 horses before they were one year old (group A, acute) and in 14 horses greater than one year of age (group B, chronic). Nine months to ...
Mackey VS, Pool RR.Fracture of the lateral wing of the third phalanx with secondary infection of the distal interphalangeal joint occurred in a neurectomized mare. Puncture of the sole may have been the inciting cause, emphasizing the need for careful daily foot care in neurectomized horses.
Bernard-Strother S, Mansmann RA, Beckstead C.A 6-month-old Quarter Horse colt, with severe left foreleg lameness of 6 weeks' duration, had swelling of the distal interphalangeal joint and a smaller-than-normal left front foot. Radiographs revealed a nondisplaced, midsagittal, intraarticular fracture of P3, which was treated with an eggbar shoe with 2 quarter clips, and stall rest for 10 weeks. The colt was sound after 10 weeks.
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...
Viitanen M, Bird J, Makela O, Schramme M, Smith R, Tulamo RM, May S.The purpose of this study was to investigate biochemical changes in synovial fluid in navicular disease, and to establish if synovial fluid from the distal interphalangeal joint (DIP) could be used diagnostically to assess alterations in the synovial fluid of the navicular bursa. Cartilage oligomeric matrix protein (COMP), total glycosaminoglycans (GAG), hyaluronan (HA), metalloproteinases 2 and -9 (MMP-2 and MMP-9) and total protein (TP) levels were determined in synovial fluids obtained from 18 navicular bursae and 35 DIP -joints from animals suffering from navicular disease, and the same sy...
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...
Rowan C, Puggioni A, Hoey SE, O'Leary JM, Kearney C, Connolly SE, Skelly C.The requirement to pack the sulcus of the equine foot as an aid to diagnostic interpretation before acquisition of dorsoproximal-palmarodistal oblique projections is debatable. The purpose of this study was to investigate the benefit of packing the sulcus in the assessment of normal anatomy. 23 cadaver limbs were radiographed in a podoblock (https://www.podoblock.com/products-page/podoblock/podoblock/) A non-packed image (NP) and a packed image (P) of the same foot were acquired. The image quality of P was graded against the reference NP by five observers, where -1=P was superior, 0=no differe...
Jacobs CC, O'Neil EK.To determine if equine cadavers modified with joint distension would yield higher fluid volumes, require fewer needle redirects, and improve student self-efficacy. Methods: 19 third-year veterinary students. Methods: Voluntary participation was sought during 4 sessions of an equine arthrocentesis and diagnostic analgesia laboratory. Half of the sessions were provided with unmodified cadavers and half were provided with cadavers modified with joint distention. Prior to and after the laboratory, participating students completed surveys regarding their self-efficacy with arthrocentesis of the met...
Larsen EA, Williams MR, Schoonover MJ, Jurek KA, Young JM, Duddy HR.Navicular syndrome is a common cause of forelimb lameness in horses. Beyond changes to the navicular bone itself, horses with a clinical diagnosis of navicular syndrome often have pathology associated with other components of the navicular apparatus, including the navicular bursa, deep digital flexor (DDF) tendon, collateral sesamoidean ligaments, and impar ligament. Palmar digital neurectomy (PDN) is often used as a salvage procedure for horses diagnosed with navicular syndrome that become unresponsive to medical management. There are many potential complications associated with PDN, some of ...
Gisler J, Chiavaccini L, Blum S, Montavon S, Spadavecchia C.Osteoarthritis is a prevalent degenerative joint disease initiating chronic pain and lameness in horses. While several objective gait analysis systems have been developed and validated to quantify lameness severity in horses, methods to evaluate whether peripheral sensitization contributes to the pain experienced are missing. Unassigned: To evaluate whether periarticular pressure pain mapping could be proposed as an auxiliary assessment tool in horses. Specific aims were to evaluate the feasibility and intra- and inter-rater reliability of pressure pain thresholds (PPT) determination at sites ...
Argue BJ, Ahern BJ.The veterinary yearling pre-sale repository radiographs have the potential to impact both vendor and prospective purchaser. The primary aim of this study was to determine inter-observer agreement for orthopaedic lesions identified in thoroughbred yearling repository radiographs. A secondary goal was to determine agreement when using a pre-defined risk rating classification. Unassigned: Three experienced specialist equine surgeons (2 ACVS & 1 FANZCVS) interpreted thirty repository radiographs once each for radiographic abnormalities. Each radiographic abnormality was given an associated ris...
Orozco Lopez D, Garcia-Lopez JM, Carpenter R, Bras JJ, Richardson DW, Ortved KF.To describe the outcome of metacarpophalangeal (MCPJ) and proximal interphalangeal joint (PIPJ) arthrodesis using a locking compression-distal femur plate (LCP-DFP) in Thoroughbred racehorses with traumatic disruption of the suspensory apparatus (TDSA) at risk of PIPJ subluxation. Methods: Multicenter retrospective study. Methods: Twenty-six Thoroughbred racehorses. Methods: Records of Thoroughbred racehorses with TDSA that had undergone MCPJ and PIPJ arthrodesis using an LCP-DFP at three referral hospitals between 2020 and 2024 were reviewed for inclusion. The preoperative data collected incl...
Colla S, Johnson JW, McGilvray KC, Zanotto GM, Seabaugh KA.Therapeutic shoeing for horses is used to affect the palmar angle (PA) of the distal phalanx. These changes may influence the strain on the distal interphalangeal joint collateral ligaments (DIJCLs). This cadaveric study aimed to assess DIJCL strain under varying loads and PA adjustments. Using 26 cadaver forelimbs, eight optical markers were placed on one DIJCL for strain measurement under five different loads (1000-5000 newtons) at a neutral PA, followed by PA increases of 2°, 4°, and 6° and decreases of -2° and -4°. The results indicate that increases in PA corresponded to significantl...
Kirkpatrick CJ, Ernst NS, Trumble TN.Injury to the collateral ligament (CL) of the distal interphalangeal joint (DIPJ) is recognized as a source of lameness in horses. Intralesional injection has been advocated to increase return to performance. This study was a proof-of-concept study in standing horses to evaluate success of a palmar radiographic-guided approach for injecting insertions of the DIPJ CLs previously described in cadaver limbs. Horses were sedated, nerve blocked, and placed on wooden blocks with the limb to be injected staggered approximately 20cm cranially to the other limb. The DIPJ CL insertion was injected, usin...
Argue BJ, Labens R.Campdrafting is a unique Australian cow horse sport, which evolved from mustering cattle and is one of Australia's fastest growing equine sports. This discipline is associated with its own unique set of musculoskeletal injuries yet to be reported. Objective: To describe the prevalence, anatomical location, and diagnostic modality used to localise lameness in campdrafting horses to better assist efficient orthopaedic management of the campdraft horse. Methods: Retrospective case series. Methods: Medical records were examined from one private practice equine group and one university veterinary h...
Terlinden A, Jacquet S, Manivong S, Coudry V, Tallaj A, Cullier A, Legendre F, Garcia AA, Moldovan F, Sirois P, Banquy X, Galéra P, Audigié F....Intra-articular drug delivery systems (DDS) are emerging as promising therapies for osteoarthritis (OA), yet their efficacy in spontaneous clinical cases remains largely untested. This uncontrolled, descriptive pilot study was designed to provide a proof of concept for the feasibility, safety, and preliminary clinical effects of intra-articular administration in sport horses with naturally occurring OA. The study involved a peptide-functionalized nanogel composed of chitosan and hyaluronic acid, delivering endothelin type A (BQ-123) and bradykinin B1 (R-954) receptor antagonists, which have pr...
Giessen EJM, Stas EKL, Grinwis GCM, Veraa S.A 3-month-old Friesian colt presented with severe, progressive distal limb lameness in two limbs. Radiographic and postmortem full-body CT imaging revealed severe articular deforming osteolysis and osteoproliferation at the dorsodistal navicular bone margin and the adjacent distal phalanx proximo-palmar/proximo-plantar margin in two limbs, with the remainder of the distal interphalangeal joint being unaffected. Multiple other joints showed small osteolytic subchondral defects. Postmortem histopathological examination confirmed focal joint disease of both distal interphalangeal joints, without ...
Samol MA, Barrett MF, Frisbie DD.Significant distal interphalangeal joint (DIPJ) pathology, particularly affecting soft tissue and articular cartilage, is often not identifiable on radiographs but can be accompanied by joint capsule enthesopathy on the middle phalanx (P2), which can be readily identified. Objective: To explore frequency and correlations between DIPJ capsule enthesopathy identified on magnetic resonance imaging (MRI) and radiographs and DIPJ articular cartilage abnormalities and other concurrent soft tissue or osseous pathology within the foot found on MRI. Methods: Retrospective descriptive case series. Metho...
Shaw KA, Brounts SH.To evaluate the effect of heel elevation on measurement of stiffness gradients by means of acoustoelastography in the digital flexor tendons of clinically normal horses. Unassigned: 15 clinically normal horses. Unassigned: For each horse, stiffness gradient index (SGI) for superficial digital flexor tendons (SDFT) and deep digital flexor tendons (DDFT) were evaluated in both forelimbs at 0, 4 and 8 degrees of heel elevation. Acoustoelastography (AEG) was used for data acquisition at three sites, approximately 6, 12, and 18 cm distal to the accessory carpal bone in the metacarpal region. Lif...
van Veggel ECS, Cokelaere SM, Vanderperren K, Selberg KT, Rasmussen J, Bergman HJ, Vernooij JCM, Hoogelander B.To report low-field standing MRI findings and, when available, postmortem findings of 25 thoracic limbs with degenerative joint disease of the distal interphalangeal joint (DIPJ) characterized by narrowing of the joint space suggestive of cartilage loss. Unassigned: Medical records from September 2015 to July 2022 were reviewed for clinical history, signalment, MRI, and postmortem findings. The study retrospectively analyzed cases in which lameness was linked to DIPJ joint space narrowing using a partially nested comparative design. Width was measured at 4 DIPJ sites, as well as a ratio to the...
Góss GC, Mozzaquatro FD, Machado IRL, Gomes EM, Martins NR, Duarte CA.The collateral ligaments of the distal interphalangeal joint (CL-DIPJ) are important structures for athletic horses. Ligament injuries can cause lameness, but ultrasound imaging can detect such lesions, which usually present with changes in echogenicity and an increase in the cross-sectional area (CSA) of the ligament. Measurements of these structures vary among authors, which complicates the diagnosis. Thus, this study aimed to describe the ultrasound measurements (dorsopalmar diameter [DPD], lateromedial diameter [LMD], and CSA) of the CL-DIPJ in Argentine Polo horses. We measured the CL-DIP...
Honnas DH, Fiske-Jackson AR, Fulkerson CV, Wilhite DR.An injury of a tendon or ligament of the equine foot is frequently a cause of lameness. The optimal radiographic projections delineating the entheses of five commonly injured tendons and ligaments of the foot should be described. Methods: The entheses of the collateral ligaments of the distal interphalangeal joint, the collateral sesamoidean ligaments of the navicular bone, the deep digital flexor tendon, the common digital extensor tendon and the distal sesamoidean impar ligament were isolated from a thoracic foot of three cadavers. Three standard radiographic projections (60-degree, dorsopro...
