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Topic:Musculoskeletal System

The musculoskeletal system in horses encompasses the bones, muscles, tendons, ligaments, and joints that facilitate movement and provide structural support. This system is essential for locomotion, athletic performance, and overall health in equine species. The equine skeleton consists of approximately 205 bones, which are connected by joints and supported by a network of muscles and connective tissues. Tendons connect muscles to bones, while ligaments link bones to other bones, contributing to joint stability. The musculoskeletal system is subject to various conditions, including injuries, degenerative diseases, and developmental disorders, which can impact a horse's mobility and performance. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, physiology, pathology, and treatment of musculoskeletal conditions in horses.
Clinical application and prognostic value of computed tomography examination in foals diagnosed with osteomyelitis: Forty-four cases. Buyck C, Zani DD, Robert M, Gustafsson K.Computed tomography (CT) is increasingly recognized as superior to conventional imaging methods for diagnosing osteomyelitis in foals. However, comprehensive studies in this area are limited. This study aims to report on clinical cases of osteomyelitis in foals, establishing a relationship between CT findings and survival outcomes. Additionally, it compares CT imaging with conventional methods such as radiography and ultrasound. We hypothesized that CT variables would more accurately predict survival than other clinical factors and provide more detailed information about osteomyelitis lesions....
Clinical application and prognostic value of computed tomography examination in foals diagnosed with osteomyelitis: Forty-four cases. Buyck C, Zani DD, Robert M, Gustafsson K.Computed tomography (CT) is increasingly recognized as superior to conventional imaging methods for diagnosing osteomyelitis in foals. However, comprehensive studies in this area are limited. This study aims to report on clinical cases of osteomyelitis in foals, establishing a relationship between CT findings and survival outcomes. Additionally, it compares CT imaging with conventional methods such as radiography and ultrasound. We hypothesized that CT variables would more accurately predict survival than other clinical factors and provide more detailed information about osteomyelitis lesions....
Analgesic efficacy of tapentadol in chronic joint disorders in horses: plasma serotonin concentration and adrenocortical response as biomarkers of pain-induced stress.
Frontiers in veterinary science    December 17, 2024   Volume 11 1505398 doi: 10.3389/fvets.2024.1505398
Costa GL, Tabbì M, Bruschetta G, Spadola F, Leonardi F, Bruno F, Iannelli NM, Licata P, Macrì F, Passino ES, Macrì D, Interlandi C.The study aimed to evaluate the analgesic efficacy of tapentadol in horses, by determining plasma serotonin concentration and adrenocortical response, as biomarkers of pain stress in chronic joint disorders. Thirty-six horses (20 females and 16 males) were divided into three groups of 12 subjects each: group A, osteoarthritis (OA), grade 3-4 lameness; group B, OA, grade 5 lameness; and group C, no OA, no lameness, were enrolled. The orthopedic examination included flexion tests, and radiological and ultrasound examinations. The degree of lameness has been estimated from 0 to 5 according to the...
Traumatic Hemothorax With Rib Fixation in a Professional Jockey Following a Horse Stomping Incident.
Cureus    December 8, 2024   Volume 16, Issue 12 e75349 doi: 10.7759/cureus.75349
Cervantes-Sevilla JR, Ramírez-Cervera M, Guzman-Ruvalcaba MJ.Traumatic hemothorax is a serious condition requiring immediate intervention. We present a case of a 48-year-old male professional jockey who suffered traumatic hemothorax, bilateral pulmonary contusions, and multiple rib fractures after being stomped by a horse. Management included intercostal drainage placement, costal fixation from the 5th to the 10th rib, and intensive care unit admission. Postoperative complications included, acute kidney injury, rhabdomyolysis, and severe acute respiratory distress syndrome. This case highlights the importance of a multidisciplinary approach in managing ...
Effect of hay nets on subluxations, pain-pressure thresholds, and cervical range of motion in the axial skeleton of adult horses.
Journal of equine veterinary science    December 5, 2024   Volume 145 105256 doi: 10.1016/j.jevs.2024.105256
DeBoer M, Rieck T, Johnson L, Redenius H, Martinson K.Horses have become more intensively managed, including the use of hay nets to increase intake time and reduce hay waste, but their impact on health is not well known. The objectives were to compare changes in subluxations, range of motion, and the pain-pressure threshold in the axial skeleton of horses fed hay with (NET) or without (CON) hay nets. In September 2021, 13 adult horses were blocked by bodyweight (BW) and randomly assigned to the NET or CON treatments for one year. After one year, horses switched treatments and the trial concluded in September 2023. Horses were housed in dry lots w...
Performance of Warmblood horses following tenoscopic desmotomy of the main part of the accessory ligament of the superficial digital flexor tendon for treatment of tendinopathy: 62 cases.
Equine veterinary journal    December 5, 2024   doi: 10.1111/evj.14437
Blatter M, Chapman HS, Heinzel-Gutenbrunner M, von Plato G, Rijkenhuizen A.Desmotomy of the accessory ligament of the superficial digital flexor tendon (AL-SDFT) has been described for the treatment of superficial digital flexor tendon (SDFT) tendinopathy in Thoroughbred and Standardbred racehorses, and in event horses. To our knowledge, the outcome of this procedure has not been described in a population of warmblood horses. Objective: To report on the outcome of treatment of SDFT tendinopathy in warmblood horses using tenoscopic desmotomy of the main part of the AL-SDFT. Methods: Prospective observational case series. Methods: All 62 horses included in the case ser...
Bilateral coxofemoral dysplasia in a Mangalarga Marchador foal.
Journal of equine veterinary science    December 4, 2024   Volume 144 105253 doi: 10.1016/j.jevs.2024.105253
Kneipp MLA, Sousa LN, Cota LO, Malacarne BD, Winter IC, Santana CH, Santos RL, Xavier ABS, Faleiros RR, Carvalho AM.Coxofemoral dysplasia is a condition characterized by the abnormal development and flattening of the femoral head and deformities in the acetabulum, leading to joint instability. Although described in various animal species, it is uncommon and rarely reported in horses. This article presents a case of incapacitating coxofemoral dysplasia diagnosed in a four-month-old foal Mangalarga Marchador, which exhibited lameness in the hind limbs, thoracolumbar kyphosis, gluteal muscle atrophy, and pronounced sensitivity during pelvic limb flexion. The clinical diagnosis indicative of bilateral coxofemor...
Quantitative lameness assessment in horses by using an accelerometer-based simple device: A preliminary study.
Open veterinary journal    November 30, 2024   Volume 14, Issue 11 3089-3099 doi: 10.5455/OVJ.2024.v14.i11.38
Crecan CM, Ciulu-Angelescu V, Morar IA, Lupșan AF, Tripon MA, Tripon MA, Bungărdean D, Daradics Z, Peștean CP.Global technological advancements have shifted equine lameness diagnostics from purely subjective assessment toward more objective, quantitative methods. Traditional gait evaluations are increasingly being supplemented by innovative technologies to enhance diagnostic accuracy. Unassigned: This study aimed to determine if traditional gait assessment could be effectively complemented by quantitative measurements using an affordable, self-constructed device, the Lameness Detector 0.1, which incorporates inertial motion sensors. Unassigned: A total of 42 adult sport horses diagnosed with hindleg l...
Skeletal Muscle Biopsy.
The Veterinary clinics of North America. Equine practice    November 28, 2024   Volume 41, Issue 1 31-45 doi: 10.1016/j.cveq.2024.10.003
Valberg SJ, Porter A.Muscle biopsy is often required to provide a definitive diagnosis for neuromuscular disorders and can be performed using open surgical or percutaneous needle biopsy techniques. Fresh samples that are subsequently frozen in the laboratory are preferred by laboratories engaged in research, whereas formalin-fixed muscle is processed by diagnostic laboratories with specialized tinctorial and immunohistochemical techniques. Interpretation by an experienced histopathologist, combined with the signalment, history, and clinical input, is essential for establishing a diagnosis. This article outlines be...
A review of the equine suspensory ligament: Injury prone yet understudied.
Equine veterinary journal    November 27, 2024   doi: 10.1111/evj.14447
Guest DJ, Birch HL, Thorpe CT.The suspensory ligament (SL) is a key component of the elaborate and highly adapted suspensory apparatus in the horse. In addition to contributing to stabilisation of the metacarpophalangeal joint, the SL has a spring like function to reduce the energetic cost of locomotion. Although the SL is highly prone to injury in horses of all ages and competing in a wide range of disciplines, knowledge regarding fundamental structure-function relationships in the SL is lacking, particularly compared with other injury-prone tendinous structures such as the superficial digital flexor tendon. In this revie...
Injury Patterns and Associated Demographic Characteristics in Children with a Fracture from Equines: A US National Based Study.
Children (Basel, Switzerland)    November 27, 2024   Volume 11, Issue 12 1443 doi: 10.3390/children11121443
Loder RT, Walker AL, Blakemore LC.Fractures often occur due to equestrian activities with injury patterns varying by age. The purpose of this study was to investigate in detail fracture patterns and associated demographics in children due to equine activities. Methods: The US National Electronic Injury Surveillance System was queried for all injuries with the consumer product code 1239 (horseback riding) from 2000 to 2023. Those <16 years old with fractures were extracted. Statistical analyses were performed with SUDAAN 11.0.01™ software to obtain national estimates. Results: There were an estimated 101,677 patients with a f...
A Pilot Study to Assess the Safety and Efficacy of Umbilical Cord Blood-Derived Mesenchymal Stromal Cells for the Treatment of Synovitis in Horses.
Animals : an open access journal from MDPI    November 26, 2024   Volume 14, Issue 23 3406 doi: 10.3390/ani14233406
Seabaugh K, Rao S, Koenig JB, Pezzanite L, Dow S, Koch TG, Russell KA, Mehrpouyan S, Alizadeh AH, Goodrich LR.Synovitis is present before and during osteoarthritis in horses and can result in performance-limiting lameness. Twenty-four horses with lameness localized to the metacarpo-/metatarsophalangeal joint or a single joint of the carpus were enrolled in this study. We evaluated the response of intra-articular injection with 10 million activated (aMSC) or non-activated (naMSC) allogeneic equine umbilical cord blood-derived mesenchymal stromal cells (MSCs). Subjective and objective lameness was assessed on Days 0, 1, 21, and 42. The treatment injection was randomly assigned and performed following th...
A machine learning approach to identify stride characteristics predictive of musculoskeletal injury, enforced rest and retirement in Thoroughbred racehorses.
Scientific reports    November 22, 2024   Volume 14, Issue 1 28967 doi: 10.1038/s41598-024-79071-1
Bogossian PM, Nattala U, Wong ASM, Morrice-West AV, Zhang GZ, Rana P, Whitton RC, Hitchens PL.Decreasing speed and stride length over successive races have been shown to be associated with musculoskeletal injury (MSI) in racehorses, demonstrating the potential for early detection of MSI through longitudinal monitoring of changes in stride characteristics. A machine learning (ML) approach for early detection of MSI, enforced rest, and retirement events using this same horse-level, race-level, and stride characteristic data across all race sectionals was investigated. A CatBoost model using features from the two races prior to an event had the highest classification performance (sensitiv...
Evaluation of digital radiographic measurements for the diagnosis of acute laminitis.
Equine veterinary journal    November 20, 2024   Volume 57, Issue 4 931-942 doi: 10.1111/evj.14436
Skelton G, Acutt E, Stefanovski D, van Eps A.Traditional radiographic measurements of distal phalanx (Pd) displacement based on the outer hoof wall are not useful for diagnosis of acute laminitis. Objective: We hypothesised that the distance between the inner hoof wall and Pd ('lamellar lucent zone'; LLZ) measured on lateromedial digital radiographs would be increased in horses with acute and subacute laminitis compared with healthy horses. Methods: Retrospective cohort study and in vivo experimental study. Methods: Forelimb radiographs from 32 healthy and 18 laminitic mixed-breed horses were analysed retrospectively. Laminitis was defin...
Extracellular Vesicles: A Novel Diagnostic Tool and Potential Therapeutic Approach for Equine Osteoarthritis.
Current issues in molecular biology    November 17, 2024   Volume 46, Issue 11 13078-13104 doi: 10.3390/cimb46110780
Elashry MI, Speer J, De Marco I, Klymiuk MC, Wenisch S, Arnhold S.Osteoarthritis (OA) is a chronic progressive degenerative joint disease that affects a significant portion of the equine population and humans worldwide. Current treatment options for equine OA are limited and incompletely curative. Horses provide an excellent large-animal model for studying human OA. Recent advances in the field of regenerative medicine have led to the exploration of extracellular vesicles (EVs)-cargoes of microRNA, proteins, lipids, and nucleic acids-to evaluate their diagnostic value in terms of disease progression and severity, as well as a potential cell-free therapeutic ...
Twelve-year review of horse-related trauma registry presentations to a regional Australian Emergency Department.
ANZ journal of surgery    November 16, 2024   Volume 94, Issue 12 2245-2250 doi: 10.1111/ans.19304
Neville EK, Neville CC, Hicks H.The size, strength, and unpredictability of horses, makes any interaction a potential situation for minor to severe injury. Despite this, horses continue to be popular for work and recreational activities. There have been five recent Australian publications that have examined various aspects of horse-related trauma, but none have been conducted in regional New South Wales (NSW). This study aims to report on the pattern of horse-related trauma that met the Institute of Trauma Injury Management's (ITIM) Trauma Registry criteria for people who presented to the emergency department at a regional N...
Quantifying head and withers movement asymmetry in sound and naturally forelimb lame horses trotting on a circle on hard and soft surfaces.
Equine veterinary journal    November 12, 2024   Volume 57, Issue 5 1219-1230 doi: 10.1111/evj.14430
Taddey CM, Roecken M, Kreling KM, Cruz AM.Reliable lameness thresholds for vertical head displacement for trotting on a circular path and on different surfaces have yet to be defined. Withers movement in lame horses could help improve the diagnostic accuracy of sensor technology. Objective: To define head movement lameness threshold ranges and describe the relationship between head and withers movement during trotting under different circumstances in sound and forelimb lame horses. Methods: Retrospective analysis of clinical data and comparison with control group. Methods: Fifty-five sound and thirty-four naturally lame horses were tr...
Monitoring of Non-Lame Horses and Horses with Unilateral Hindlimb Lameness at Rest with the Aid of Accelerometers.
Sensors (Basel, Switzerland)    November 11, 2024   Volume 24, Issue 22 7203 doi: 10.3390/s24227203
Uellendahl A, Schramel JP, Tichy A, Peham C.The aim of this study was to determine whether horses exhibiting unilateral hindlimb lameness unload (rest) the lame limb more than the contralateral limb. The resting/unloading of the hindlimbs and the time spent lying down were measured using accelerometers. Ten non-lame horses and 20 lame horses were recruited for participation and monitored for 11 h overnight with accelerometers (MSR145, sampling rate: 1 Hz, and measuring range: ±15 g) attached to the lateral metatarsal and metacarpal regions of each limb. Metatarsal and metacarpal orientation were used to determine whether the limb was u...
Visualization of anatomical structures in the carpal region of the horse using cone beam computed tomography in comparison with conventional multidetector computed tomography.
Frontiers in veterinary science    November 11, 2024   Volume 11 1431777 doi: 10.3389/fvets.2024.1431777
Hagenbach M, Bierau J, Cruz AM, Koch C, Manso-Díaz G, Büttner K, Staszyk C, Röcken M.In the diagnostics of orthopedic diseases in the horse, diagnostic imaging often plays a decisive role. Cone beam computed tomography (CBCT) imaging is used in both human and small animal medicine and becoming increasingly popular. To see whether CBCT imaging can be useful in the diagnosis of orthopedic diseases of the carpal region of the horse and to explore possible limitations we compared CBCT images with multidetector computed tomography (MDCT) images of the carpal region of equine cadaveric specimens. Unassigned: Twenty-eight forelimbs from fifteen horses, slaughtered for reasons unrelat...
Visualization of anatomical structures in the carpal region of the horse using cone beam computed tomography in comparison with conventional multidetector computed tomography.
Frontiers in veterinary science    November 11, 2024   Volume 11 1431777 doi: 10.3389/fvets.2024.1431777
Hagenbach M, Bierau J, Cruz AM, Koch C, Manso-Díaz G, Büttner K, Staszyk C, Röcken M.In the diagnostics of orthopedic diseases in the horse, diagnostic imaging often plays a decisive role. Cone beam computed tomography (CBCT) imaging is used in both human and small animal medicine and becoming increasingly popular. To see whether CBCT imaging can be useful in the diagnosis of orthopedic diseases of the carpal region of the horse and to explore possible limitations we compared CBCT images with multidetector computed tomography (MDCT) images of the carpal region of equine cadaveric specimens. Unassigned: Twenty-eight forelimbs from fifteen horses, slaughtered for reasons unrelat...
Intrathecal enalapril reduces adhesion formation in experimentally induced digital flexor tendon sheath injuries in horses.
Veterinary surgery : VS    November 5, 2024   doi: 10.1111/vsu.14186
Willette JA, Tsoi M, Frobish D, VanderBroek AR.The objectives of the study were to describe a standing percutaneous adhesion induction model in the digital flexor tendon sheath (DFTS) of horses and to evaluate the effect of intrathecal administration of the angiotensin-converting enzyme (ACE) inhibitor enalapril on tendon healing and adhesion formation. Methods: Randomized, blinded, controlled experimental study. Methods: Eight healthy horses. Methods: A collagenase-induced adhesion model was implemented in the deep digital flexor tendon (DDFT) of both forelimbs under standing ultrasonographic guidance. Daily intrathecal injections of 5 ...
Administration of sodium hyaluronate to adult horses prior to and immediately after exercise does not alter the range of motion in either the tarsus or metacarpophalangeal joints.
Translational animal science    November 2, 2024   Volume 8 txae153 doi: 10.1093/tas/txae153
Riley JW, Chance LM, Barshick MR, Johnson SE.Hyaluronic acid (HA), a glycosaminoglycan found in joint synovial fluid, is administered to horses as an anti-inflammatory with lubrication properties. This experiment examined the effects of HA administered before and shortly after an exercise test on metacarpophalangeal (MCP; fetlock) and tibiotarsal (hock) joint range of motion (ROM). Horses were injected intravenously (IV) with placebo (4 mL, saline) or HA (4 mL, 40 mg) 24 h before performing a standardized exercise test (SET) on a high-speed treadmill and again at 6-h post-SET. Passive fetlock flexion was measured at 4 and 24 h post-...
Matrikine stimulation of equine synovial fibroblasts and chondrocytes results in an in vitro osteoarthritis phenotype. Gagliardi R, Koch DW, Loeser R, Schnabel LV.Osteoarthritis (OA) is a debilitating disease that impacts millions of individuals and has limited therapeutic options. A significant hindrance to therapeutic discovery is the lack of in vitro OA models that translate reliably to in vivo preclinical animal models. An alternative to traditional inflammatory cytokine models is the matrikine stimulation model, in which fragments of matrix proteins naturally found in OA tissues and synovial fluid, are used to stimulate cells of the joint. The objective of this study was to determine if matrikine stimulation of equine synovial fibroblasts and chond...
Gross Anatomy of the Equine Masseter Muscle: Lamination and Intramuscular Course of the N. Massetericus.
Anatomia, histologia, embryologia    October 27, 2024   Volume 53, Issue 6 e70000 doi: 10.1111/ahe.70000
Süß F, Guth S, Müller-Ehrenberg H, Röcken M, Staszyk C.The masticatory muscles of the horse are arranged in an asymmetrical pattern. Four individual muscles on the medial side of the mandible are opposed by one muscle (M. masseter) on the lateral side. However, recent studies on various herbivorous mammals indicate that the masseter muscle features a complex stratigraphic structure that might account for a functional diversity resembling an arrangement of several individual muscles. The functional consideration of the multidirectional equine masticatory movements leads to a similar hypothesis. In order to elucidate the detailed anatomy of the equi...
Osseous pathologic changes in the thoracic region of the equine vertebral column: A descriptive post-mortem study in three breeds.
Equine veterinary journal    October 21, 2024   Volume 57, Issue 5 1290-1301 doi: 10.1111/evj.14429
Spoormakers TJP, Veraa S, Graat EAM, van Weeren PR, Brommer H.Data on equine thoracic pathology hardly exist in breeds other than Thoroughbreds. Objective: To describe pathological changes of the osseous thoracic vertebral column in Warmblood horses, Shetland ponies and Konik horses, and to compare prevalence and severity. Methods: Descriptive post-mortem study. Methods: Computed tomography was used to examine the thoracic vertebral column of 34 Warmblood horses, 28 Shetland ponies, and 18 Konik horses. Osteoarthritis (OA), periarticular osteolysis, osseous cyst-like lesions and fragments of articular processes (APJs), costovertebral and costotransverse ...
Genetic Factors of Equine Osteochondrosis and Fetlock Osteochondral Fragments: A Scoping Review – Part 2.
Veterinary journal (London, England : 1997)    October 21, 2024   106258 doi: 10.1016/j.tvjl.2024.106258
Van Mol B, Janssens S, Oosterlinck M, Pille F, Buys N.Equine osteochondrosis and osteochondral fragments in the fetlock joint are linked to various environmental and genetic risk factors. To assess the scope of the literature linking these risk factors to the development of these osteochondral disorders, while identifying knowledge gaps and challenges to guide future research, a scoping review was performed. This article constitutes the second part of this scoping review and focuses on genetic factors, with the first part addressing environmental factors. To identify potentially relevant papers, online bibliographical databases PubMed and Web of ...
Computed tomography of the equine caudal spine and pelvis. Pathological findings in 56 clinical cases (2018-2023).
Equine veterinary journal    October 20, 2024   Volume 57, Issue 5 1279-1289 doi: 10.1111/evj.14426
Ogden NKE, Winderickx K, Stack JD.Computed tomography (CT) of the axial skeleton is increasing across many equine hospitals. CT of the pelvis and caudal spine in a large group of clinical cases has not been reported previously. Objective: To describe the pathological lesions identified in the caudal spine/pelvis in horses and ponies undergoing CT spine of this region. Methods: A retrospective case series. Methods: Horses with CT imaging of the caudal spine/pelvis were included. Horses aged under 6 months and those with CT examinations performed post-mortem were excluded. Results: Fifty-six horses met the inclusion criteria. ...
Sex hormone-binding globulin promotes the osteogenic differentiation potential of equine adipose-derived stromal cells by activating the BMP signaling pathway.
Frontiers in endocrinology    October 17, 2024   Volume 15 1424873 doi: 10.3389/fendo.2024.1424873
Irwin-Huston JM, Bourebaba L, Bourebaba N, Tomal A, Marycz K.Musculoskeletal injuries and chronic degenerative diseases pose significant challenges in equine health, impacting performance and overall well-being. Sex Hormone-Binding Globulin (SHBG) is a glycoprotein determining the bioavailability of sex hormones in the bloodstream, and exerting critical metabolic functions, thus impacting the homeostasis of many tissues including the bone. Unassigned: In this study, we investigated the potential role of SHBG in promoting osteogenesis and its underlying mechanisms in a model of equine adipose-derived stromal cells (ASCs). An SHBG-knocked down model has b...
Accessory Ligament of the Deep Digital Flexor Tendon of the Horse Forelimb and Its Relationship with the Superficial Digital Flexor Tendon: A Plastination, Histological, and Morphometry Study.
Animals : an open access journal from MDPI    October 14, 2024   Volume 14, Issue 20 2952 doi: 10.3390/ani14202952
Eren G, López-Albors O, Guilabert Segura R, Jordan Montesinos J, Latorre R.The accessory ligament of the deep digital flexor tendon (AL-DDFT) plays a crucial role in the stay apparatus of the horse. This study aimed to investigate the anatomical relationship between the AL-DDFT, the superficial digital flexor tendon (SDFT), and other structures in the metacarpal region. Sixteen distal forelimbs from eight horses, aged 1 to 6 years, were evaluated through macroscopic, microscopic, and morphometric analyses, utilizing detailed dissection, E12 plastinated sections, and histological analysis. During lateral dissection, a connection was observed between the AL-DDFT and th...
Computed tomography of the equine caudal spine and pelvis: Technique, image quality and anatomical variation in 56 clinical cases (2018-2023).
Equine veterinary journal    October 10, 2024   Volume 57, Issue 5 1265-1278 doi: 10.1111/evj.14422
Ogden NKE, Winderickx K, Bennell A, Stack JD.Cross-sectional imaging improves the diagnostic accuracy of complex anatomical regions. Computed tomography (CT) of the pelvis and caudal spine in a large group of live horses and ponies has not been previously reported. Objective: To describe the procedure for acquiring CT images of horses' caudal spine/pelvis under general anaesthesia (GA) and to detail the image quality, artefacts and anatomical variations in this region. Methods: Retrospective case series. Methods: Horses with CT of the caudal spine/pelvis were included. Horses under 6 months and CT examination performed post-mortem were...
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