Sesamoid bones in horses are small, nodular bones embedded within tendons, typically located in areas subjected to high mechanical stress. In equines, the primary sesamoid bones of interest are the proximal sesamoid bones, found at the back of the fetlock joint, and the distal sesamoid bone, commonly known as the navicular bone, located within the hoof. These bones function to protect tendons, reduce friction, and enhance the mechanical advantage of tendons during locomotion. The health and integrity of sesamoid bones are essential for normal limb function, and they are often examined in cases of lameness or injury. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, physiological role, and pathologies associated with sesamoid bones in horses.
Northwood A, Berner D.Radiographic protocols for the metacarpo-/tarsophalangeal joint during pre-purchase examinations (PPE) vary internationally, but their impact on pathology detection remains unclear. Optimising imaging protocols is essential to balance diagnostic accuracy with workflow efficiency and radiation exposure. Objective: To evaluate the effect of different radiographic view combinations on fetlock pathology detection and observer agreement in a PPE context; hypothesising that detection rates vary with view selection. Methods: Retrospective observational study. Methods: Two observers reviewed fetlock r...
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...
Beck C, Hitchens PL, Whitton RC.Post-mortem studies have shown that fractures involving the metacarpophalangeal/metatarsophalangeal or fetlock joint are associated with focal areas of microdamage. Identification of computed tomography (CT) features consistent with microdamage and their association with fracture may aid in identification of horses at risk of fracture. Objective: To identify CT features associated with fracture of the metacarpophalangeal/metatarsophalangeal joint. Methods: Retrospective cohort study. Methods: Post-mortem CT images of 367 limbs from 157 Thoroughbred racehorses were graded for CT features. Multi...
de Preux M, Precht C, Travaglini AT, Propadalo LM, Farra D, Vidondo B, Easley JT, Koch C.To determine the effect of the Vertek aiming device (VAD) on the surgical accuracy of navigated drilling of the distal sesamoid bone (DSB). Methods: Experimental cadaveric study. Methods: A total of 30 paired equine cadaveric limbs from 15 horses. Methods: Each specimen was placed in a purpose-built frame (PBF). Preoperative cone beam computed tomography (CBCT) images were acquired with an imaging unit coupled with a surgical navigation system. In the DSB of each specimen, a 4.5 mm glide hole and a 3.2 mm thread hole were drilled under navigation guidance, to simulate drilling for the repa...
Osborne C, Elce YA, Byrant B, Meehan-Howard L.To determine with mechanical nociceptive threshold (MNT) testing whether distal limb skin sensation is affected by intra-articular anesthesia of the tarsometatarsal joint (TMTJ). Unassigned: This was a prospective cohort study. Ten client-owned horses that had intra-articular TMTJ anesthesia were included in the study. The MNT was measured at 6 sites on the distal limb at 3 time points: before anesthesia (T0) and at 10 min (T10) and 30 min (T30) post-injection. Linear mixed-model analyses were done, with the significance level set at P < 0.05. Unassigned: There was an increase in MNT (P = 0.00...
Okudaira M, Cresswell EN, Wollman CW, McDonough SP, Engiles JB, Reesink HL.To describe the development and maturation of equine proximal sesamoid bones (PSBs) in fetuses and young horses using radiography, microcomputed (micro)-CT, and histology. Methods: A descriptive study. Forelimb PSBs from 12 equids ranging in age from 105 days of gestation to 540 days postgestation were evaluated. Radiography was used for preliminary assessment of metacarpophalangeal joint and PSB mineralization, and micro-CT imaging was performed to assess mineralized PSBs. Tissue volume, bone volume fraction, height, width, depth, trabecular thickness, and anisotropy were quantified from midp...
Peat FJ, Kawcak CE, McIlwraith CW, Berk JT, Keenan DP.Changes in the proximal sesamoid bones (sesamoids) and the insertional region of the adjacent suspensory ligament branch (branch) are of particular importance in young Thoroughbreds sold at public auction. Little is known about the prevalence of concurrent ultrasonographical branch change, relative to the various grades of radiological sesamoid appearance. Objective: To examine the existence of concurrent radiological and ultrasonographical findings in individual sesamoid-branch units in sales horses; to determine whether there are any radiological findings that are consistently accompanied by...
Bierau J, Rott P, Röcken M, Staszyk C.This study aimed to delineate the detailed anatomy of the metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints in healthy horses using cone beam computed tomography (CBCT). The fetlock region of 15 cadaveric forelimbs and 14 cadaveric hindlimbs from nine adult horses without orthopaedic disease underwent CBCT scanning. Additionally, arthrography CBCT scans were conducted following intra-articular injection of a radiopaque contrast medium containing blue epoxy resin dye. Subsequently, limbs were frozen and sectioned to visualize anatomical structures in sectional planes corresponding ...
Peat FJ, Kawcak CE, McIlwraith CW, Keenan DP, Berk JT, Mork DS.Radiological findings in the proximal sesamoid bones (sesamoids) are a persistent source of controversy at Thoroughbred sales, due to inconsistent classification and conflicting assignment of potential clinical importance. Objective: To define the prevalence of sesamoid findings on sales repository radiographs in yearling and 2-year-old Thoroughbreds and to analyse associations with racing performance. To track the changes in sesamoid findings between 1 and 2 years of age in horses that present for sale at both ages. Methods: Prospective cohort study using an enrolled sample. Methods: Horses...
Guo L, Yu X, Thair A, Rideout A, Collins A, Wang ZJ, Hore M.The objective of this study was to develop a robust machine-learning approach for efficient detection and grading of sesamoiditis in horses using radiographs, specifically in data-limited conditions. Methods: A dataset of 255 dorsolateral-palmaromedial oblique (DLPMO) and dorsomedial-palmarolateral oblique (DMPLO) equine radiographs were retrospectively acquired from Hagyard Equine Medical Institute. These images were anonymized and classified into 3 categories of sesamoiditis severity (normal, mild, and moderate). Methods: This study was conducted from February 1, 2023, to August 31, 2023. Tw...
Dockery A, Beasley B, Goldberg M, Aguirre G, Moorman VJ.To determine the dose effect of peri-neural liposomal bupivacaine (LB) in an induced forelimb lameness model. Methods: 12 clinically normal adult horses. Methods: A randomized cross-over design was performed with 1 limb receiving saline and the other LB: low dose (6), high dose (6). Lameness was induced in 1 forelimb using a frog-pressure model. In the lame limb, peri-neural injection of the palmar nerves at the proximal sesamoid bones was performed using saline, low dose LB (0.25 mg/kg) (LDLB), or high dose LB (0.5mg/kg) (HDLB) in random order with a 1-week washout period between treatments. ...
Nocera I, Sorvillo B, Sgorbini M, Aliboni B, Citi S.Few studies have established the normal radiographic anatomical development of the donkey foal and, to date, no data are available for mules. Our aim was thus to evaluate the radiographic development of the fore digit and carpal joint in the mule foal from 0 to 3 months of age. Ten forelimbs of five healthy full-term mule foals were included. Radiographs of the fore digit lateromedial and dorsopalmar and the carpus dorsopalmar were performed weekly for the first month of age, and bi-monthly during the following two months. Fore digit growth plate closure times, morphological, angular, and line...
Noordwijk KJ, Chen L, Ruspi BD, Schurer S, Papa B, Fasanello DC, McDonough SP, Palmer SE, Porter IR, Basran PS, Donnelly E, Reesink HL.Proximal sesamoid bone (PSB) fracture is the leading cause of fatal musculoskeletal injury in Thoroughbred racehorses in Hong Kong and the US. Efforts are underway to investigate diagnostic modalities that could help identify racehorses at increased risk of fracture; however, features associated with PSB fracture risk are still poorly understood. The objectives of this study were to (1) investigate third metacarpal (MC3) and PSB density and mineral content using dual-energy X-ray absorptiometry (DXA), computed tomography (CT), Raman spectroscopy, and ash fraction measurements, and (2) investig...
Basran PS, McDonough S, Palmer S, Reesink HL.Proximal sesamoid bone (PSB) fractures are the most common musculoskeletal injury in race-horses. X-ray CT imaging can detect expressed radiological features in horses that experienced catastrophic fractures. Our objective was to assess whether expressed radiomic features in the PSBs of 50 horses can be used to develop machine learning models for predicting PSB fractures. The μCTs of intact contralateral PSBs from 50 horses, 30 of which suffered catastrophic fractures, and 20 controls were studied. From the 129 intact μCT images of PSBs, 102 radiomic features were computed using a variety of...
Spriet M, Arndt S, Pige C, Pye J, O'Brion J, Carpenter R, Blea J, Dowd JP.This retrospective, methods comparison study aimed to compare skeletal scintigraphy and F-NaF positron emission tomography (PET) for the detection of abnormalities in the fetlocks of Thoroughbred racehorses. Thirty-three horses (72 limbs) imaged with both scintigraphy and F-NaF PET, for investigation of lameness or poor performance related to the fetlock, were included. Seven observers, including experienced racetrack practitioners, surgery and imaging residents, and a board-certified veterinary radiologist, independently reviewed all data for evidence of increased radiopharmaceutical uptake...
Pye J, Spriet M, O'Brion J, Carpenter R, Blea JA, Dowd JP.To assess the repeatability of equine 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) findings, and to evaluate the ability of PET to monitor the progression of areas of increased radiopharmaceutical uptake (IRU) in the fetlocks of Thoroughbred racehorses. Methods: 25 racehorses with clinical signs related to fetlock injuries. Methods: This study is a prospective, longitudinal clinical study. Twenty-five racehorses (54 fetlocks) underwent three 18F-NaF PET scans 6 weeks apart. The first 18F-NaF PET scan was performed at the start of a 12-week period of rest from racing (lay-up...
Luedke LK, Ilevbare P, Noordwijk KJ, Palomino PM, McDonough SP, Palmer SE, Basran PS, Donnelly E, Reesink HL.To determine whether proximal sesamoid bone (PSB) microdamage and fracture toughness differ between Thoroughbred racehorses sustaining PSB fracture and controls. Methods: Cadaveric case-control. Methods: Twenty-four Thoroughbred racehorses (n = 12 PSB fracture, n = 12 control). Methods: Proximal sesamoid bones were dissected, and gross pathological changes and morphological measurements were documented. High-speed exercise history data were evaluated. Microdamage was assessed in fracture, fracture-contralateral limb (FXCL) and control PSBs using whole bone lead uranyl acetate (LUA) stainin...
Elane GL, Biedrzycki AH, McCarrel TM, Banks SA, Morton AJ.To quantify the translation and angular rotation of the distal sesamoid bone (DSB) using computed tomography (CT) and medical modeling software. Methods: 30 thoracic limbs from equine cadavers. Methods: Partial (n = 12), full (8), and matched full and subsequently transected (10) thoracic limbs were collected. Bone volume CT images were acquired in three positions: extension (200° metacarpophalangeal angle), neutral (180°), and maximal flexion (110°). Mean translation and angular rotation of each DSB were recorded. Differences were determined with two-way ANOVA and post hoc Tukey's tests fo...
Shaffer SK, Garcia TC, Stover SM, Fyhrie DP.Medial proximal sesamoid bones (PSBs) from Thoroughbred racehorses that did (Case) or did not (Control) experience unilateral biaxial PSB fracture were evaluated for bone volume fraction (BVF), apparent mineral density (AMD), tissue mineral density (TMD), and microdamage in Case fractured, Case contralateral limb intact, and Control bones. A majority of Case bones had a subchondral lesion with high microdamage density, and low BVF, AMD, and TMD. Lesion microdamage and densitometric measures were associated with training history by robust linear regression. Exercise intensity was negatively rel...
Journal of biomechanicsNovember 27, 2021
Volume 130 110888 doi: 10.1016/j.jbiomech.2021.110888
Shaffer SK, Shelly K, Garcia TC, Samol MA, Hill AE, Fyhrie DP, Stover SM.Proximal sesamoid bone (PSB) fractures in racehorses are likely fatigue fractures that occur due to repetitive loads and stress remodeling. The loading circumstances that may induce damage in the PSBs are not well understood. The goal of this study was to determine in three-dimensions, PSB motions relative to the opposing metacarpal condyle during simulated mid-stance loads. Seven equine cadaveric forelimbs were axially loaded in a material testing system to simulate standing and mid-stance walk, trot, and gallop load conditions (1.8-10.5 kN). Joint angles were determined by tracking the posit...
Stewart HL, Kawcak CE, Inscoe CR, Puett C, Lee YZ, Lu J, Zhou OZ, Selberg KT.To describe the technique and assess the diagnostic potential and limitations of tomosynthesis for imaging of the metacarpophalangeal joint (MCPJ) of equine cadavers; compare the tomosynthesis appearance of pathological lesions with their conventional radiographic, CT, and MRI appearances; and evaluate all imaging findings with gross lesions of a given MCPJ. Methods: Distal portions of 4 forelimbs from 4 equine cadavers. Methods: The MCPJs underwent radiography, tomosynthesis (with a purpose-built benchtop unit), CT, and MRI; thereafter, MCPJs were disarticulated and evaluated for the presence...
Merchán A, Voss JK, Dubois MS.The satisfactory outcome of fungal osteitis in an 8-year-old American Quarter Horse is described. The horse was admitted with a grade 4 out of 5 lameness and exhibited metacarpophalangeal synovial effusion, indicative of a mild suppurative inflammation. Results of initial radiographic and ultrasonographic examination were unremarkable. Intra-articular anesthesia of the metacarpophalangeal joint allowed localization of the insult. It was not until day 6 of hospitalization when lytic changes on the axial aspect were observed on radiographic examination. Arthroscopic examination permitted identif...
Samol MA, Uzal FA, Blanchard PC, Arthur RM, Stover SM.The most prevalent causes of death in racehorses are musculoskeletal injuries, causing ~83% of deaths within the racing industry in California and elsewhere. The vast majority of these injuries have preexisting lesions that predispose to fatal injury. A 4-y-old Thoroughbred colt suffered an acute suspensory apparatus failure, including biaxial proximal sesamoid bone fractures of the right front fetlock, causing loss of support of the fetlock joint and consequent fall with fractures of the cervical and sacral spine. Cervical fracture caused spinal cord damage that resulted in sudden death. A pr...
Cresswell EN, Ruspi BD, Wollman CW, Peal BT, Deng S, Toler AB, McDonough SP, Palmer SE, Reesink HL.To examine whether proximal sesamoid bone (PSB) articular cartilage and bone osteoarthritic changes or palmar osteochondral disease (POD) scores were associated with exercise history and catastrophic PSB fracture in Thoroughbred racehorses. Methods: PSBs from 16 Thoroughbred racehorses (8 with and 8 without PSB fracture). Methods: Exercise history was collected, and total career high-speed furlongs was used as the measure of total exercise per horse. At necropsy, medial and lateral condyles of the third metacarpus from each forelimb were assigned a POD score, followed by imaging with micro-CT ...
Shaffer SK, Sachs N, Garcia TC, Fyhrie DP, Stover SM.To assess the motion of the proximal sesamoid bones (PSBs) relative to the third metacarpal bone (MC3) of equine forelimbs during physiologic midstance loads. Methods: 8 musculoskeletally normal forelimbs (7 right and 1 left) from 8 adult equine cadavers. Methods: Each forelimb was harvested at the mid-radius level and mounted in a material testing system so the hoof could be moved in a dorsal direction while the radius and MC3 remained vertical. The PSBs were instrumented with 2 linear variable differential transformers to record movement between the 2 bones. The limb was sequentially loaded ...
Berner D, Mader D, Groß C, Gerlach K.In magnetic resonance imaging (MRI) examinations, moderate to severe changes of the distal sesamoidean impar ligament (DSIL) were found in horses with lameness localized to their feet. Histologic abnormalities were detected more commonly in lame horses. Because of its heterogeneity and small thickness, evaluation of the DSIL in MRI can be challenging. The aim of the study was to determine the optimal sequence and the ideal transverse perpendicular angle for visualization of the DSIL before and after arthrography of the distal interphalangeal joint (DIPJ). Twenty-five cadaver forelimbs were exa...
Basran PS, Gao J, Palmer S, Reesink HL.Proximal sesamoid bone (PSB) fractures are the most common fatal musculoskeletal injury in North American racehorses. Computed tomography has the potential to detect morphological changes in bone structure but can be challenging to analyse reliably and quantitatively. Objective: To develop a radiomics platform that allows the comparison of features from micro-CTs (µCT) of PSBs in horses that sustained catastrophic fractures with horses that did not. To compare features calculated with a radiomics approach with features calculated from a previously published study that used quantitative µCT i...
Shaffer SK, To C, Garcia TC, Fyhrie DP, Uzal FA, Stover SM.Proximal sesamoid bone (PSB) fracture is the most common fatal injury in Thoroughbred (TB) racehorses in the United States. Epidemiological and pathological evidence indicates PSB fracture is likely the acute culmination of a chronic stress-related process. However, the aetiopathogenesis of PSB fracture is poorly understood. Objective: To characterise bone abnormalities that precede PSB fracture. Methods: Two retrospective case-control groups of PSBs from TB racehorses with, and without, unilateral biaxial PSB fracture. Methods: Proximal sesamoid bones were harvested post-mortem from TB raceho...
Stewart HL, Werpy NM, McIlwraith CW, Kawcak CE.To describe the effects of distal limb immobilization and remobilization in the equine metacarpophalangeal joint. Methods: Randomized, prospective experimental study. Methods: Eight healthy, skeletally mature horses. Methods: One forelimb of each horse was immobilized in a fiberglass cast for 8 weeks; this was followed by 12 weeks of a treadmill-based training program after the cast had been removed. Clinical examinations, radiography, computed tomography (CT), nuclear scintigraphy, MRI, and histomorphometry were used to examine the third metacarpal (MC3), proximal phalanx, proximal sesamo...
Schumacher J, Cole RC, DeGraves FJ, Cofield LG.To compare the speed of onset and analgesic effect of mepivacaine deposited within or immediately outside the neurovascular bundle at the base of the proximal sesamoid bones in horses. Methods: 6 horses with naturally occurring forefoot-related lameness. Methods: In a crossover study design, horses were randomly assigned to receive 1 of 2 treatments first, with the second treatment administered 3 to 7 days later. Trotting gait was analyzed with an inertial sensor-based motion analysis system immediately before treatment to determine degree of lameness. Afterward, ultrasound guidance was used t...
Parkin TD, Clegg PD, French NP, Proudman CJ, Riggs CM, Singer ER, Webbon PM, Morgan KL.The risk of fatal distal limb fractures in thoroughbreds racing in the UK was calculated and shown to vary considerably between the different types of race. Flat turf racing was associated with the lowest risk (0.4 per 1000 starts) and national hunt flat racing was associated with the highest risk (2.2 per 1000 starts). The types of fracture were classified by detailed radiographic and postmortem examinations of all the cases recorded over two years, and the distribution of the different types of fracture in the five main types of racing was examined. Overall, lateral condylar fractures of the...
Anthenill LA, Stover SM, Gardner IA, Hill AE.To assess individual and combined associations of high-speed exercise and horseshoe characteristics with risk of forelimb proximal sesamoid bone fractures and proximal sesamoid bone midbody fractures in Thoroughbred racehorses. Methods: 269 deceased Thoroughbred racehorses. Methods: A case-control study design was used to compare 121 horses with a fracture of at least 1 of 4 forelimb proximal sesamoid bones (75 horses had a midbody fracture) and 148 horses without a forelimb proximal sesamoid bone fracture. Univariable and multivariable logistic regression analyses were used to evaluate potent...
Kummer M, Geyer H, Imboden I, Auer J, Lischer C.The understanding of the normal position of the third phalanx (P3) and the distal sesamoid bone in relation to the size and shape of the hoof capsule in sound horses is helpful in the diagnosis of equine foot lameness. Some measurements on radiographs used to define the position of the pedal bone within the hoof capsule are significantly influenced by hoof trimming and the height of the withers. In this study, the front hooves of 40 Warmblood horses were radiographed twice, eight weeks apart, both before and after their hooves were trimmed by an experienced farrier. Using the software programm...
Brama PA, Tekoppele JM, Bank RA, Karssenberg D, Barneveld A, van Weeren PR.The aim of this study was to evaluate topographical differences in the biochemical composition of the extracellular matrix of articular cartilage of the normal equine fetlock joint. Water content, DNA content, glycosaminoglycan (GAG) content and a number of characteristics of the collagen network (total collagen content, levels of hydroxylysine- (Hyl) and the crosslink hydroxylysylpyridinoline, (HP) of articular cartilage in the proximal 1st phalanx (P1), distal 3rd metacarpal bone (MC), and proximal sesamoid bones (PSB) were determined in the left and right fetlock joint of 6 mature horses (a...
Kane AJ, Park RD, McIlwraith CW, Rantanen NW, Morehead JP, Bramlage LR.Radiography in presale examinations of TB yearlings has become standard practice in recent years. Objective: To describe the prevalence and distribution of radiographic changes in the fetlocks, carpi, tarsi, stifles and fore feet of Thoroughbred yearlings in central Kentucky when these joints were examined as part of routine pre- and post sale evaluations. Methods: Horses subjected to radiographs included the fore (n = 1127) and hind (n = 1102) fetlocks, carpi (n = 1130), tarsi (n = 1101), stifles (n = 660) and fore feet (n = 300). Radiographic changes were categorised by location and type of ...
Cresswell EN, McDonough SP, Palmer SE, Hernandez CJ, Reesink HL.Fracture of the proximal sesamoid bones continues to be the most common fatal musculoskeletal injury in US racehorses. Identifying factors that influence fracture risk could lead to screening techniques to reduce catastrophic injury rates and improve animal welfare. Objective: To identify morphological differences between proximal sesamoid bones of the contralateral limb of fracture and control horses and assess the feasibility of computed tomography (CT) to detect traits associated with proximal sesamoid bone fracture. We hypothesised that horses with proximal sesamoid bone fracture would hav...
Kane AJ, McIlwraith CW, Park RD, Rantanen NW, Morehead JP, Bramlage LR.Although the radiographic examination of yearlings has become commonplace at some large Thoroughbred sales, there are few data to support the decisions facing veterinarians who are asked to evaluate future racing potential. Objective: To identify radiographic changes in the fetlocks, proximal sesamoid bones, carpi, tarsi, stifles and fore feet of Thoroughbred yearlings associated with future racing performance during ages 2 and 3 years. Methods: Radiographs from routine pre- and post sale examinations of 1162 yearlings were used to identify individual radiographic changes in sale yearlings. St...
Gonzalez LM, Schramme MC, Robertson ID, Thrall DE, Redding RW.Lameness originating from the metacarpo(tarso)phalangeal (MP) joint has a significant effect on the use and athletic competitiveness of a horse. The identification of the cause of lameness originating from the MP joint can be challenging, given the limitations of radiography, ultrasonography, and nuclear scintigraphy. Our purpose was to describe the injury types and incidence in magnetic resonance imaging (MRI) studies from 40 horses with lameness attributable to the MP joint region where it was not possible to reach a clinically plausible diagnosis using other imaging modalities. Horses were ...
Garrett KS, Bramlage LR, Spike-Pierce DL, Cohen ND.To determine the effects of treatment with platelet- and leukocyte-rich plasma (PRP) on future 2-, 3-, and 4-year-old racing performance of yearling Thoroughbreds with proximal sesamoid bone inflammation and associated suspensory ligament branch (SLB) desmitis. Methods: Randomized clinical trial. Methods: 39 yearling Thoroughbreds. Methods: Yearling Thoroughbreds with radiographic evidence of performance-limiting proximal sesamoid bone inflammation and ultrasonographic evidence of associated SLB desmitis were identified and randomly assigned to undergo PRP (treatment group) or saline (0.9% NaC...
Kristoffersen M, Parkin TD, Singer ER.Catastrophic biaxial proximal sesamoid bone fractures (PSBF) have not yet been described in detail in the UK racing population. Objective: To determine the incidence and relative risk (RR) of PSBF in different types of racing in the UK; and to describe horse-level characteristics and racing histories of horses sustaining these injuries. Methods: Distal limbs were collected from all racehorses suffering catastrophic fractures during racing at all 59 racecourses in the UK, in a prospective study from February 1999 to December 2004. Post mortem investigation identified the anatomical location and...
Busoni V, Heimann M, Trenteseaux J, Snaps F, Dondelinger RF.We describe the abnormal magnetic resonance (MR) imaging findings in the deep digital flexor tendon (DDFT) and distal sesamoid bone in horses with radiographic changes compatible with navicular syndrome. Thirteen postmortem specimens were examined using a 1.5-T magnetic field, with spin echo (SE) T1-weighted, turbo SE (TSE) proton density-weighted (with and without fat saturation), and fat saturation TSE T2-weighted sequences. The limbs were then dissected to compare the MR findings with the gross assessment and histologic examination of the DDFT and distal sesamoid bones. Tendonous abnormalit...
Vallance SA, Bell RJ, Spriet M, Kass PH, Puchalski SM.No previous study compares computed tomography (CT), contrast-enhanced computed tomography (CECT) and standing low-field magnetic resonance imaging (LFMRI) to detect lesions in horses with lameness localised to the foot. This study will help clinicians understand the limitations of these techniques. Objective: To determine if CT, CECT and LFMRI would identify lesions within the distal limb and document discrepancies with lesion distribution and lesion classification. Methods: Lesions in specific structures identified on CT and MR images of feet (31 limbs) from the same horse were reviewed and ...
Pool RR, Meagher DM, Stover SM.Navicular syndrome is a degenerative disorder of the distal half of the flexor surface of the proximal sesamoid bone that is predisposed by faulty foot conformation. In horses that become symptomatic, the faulty conformation results in sustained application of nonphysiologic pressure by the deep digital flexor tendon against the flexor cortex of the bone. This force stimulates an intense bone remodeling response in order to attenuate the pressure. An unfortunate sequela of this response is active hyperemia and edema formation in the medullary cavity of the bone. The edema is organized by fibro...
Shaffer SK, To C, Garcia TC, Fyhrie DP, Uzal FA, Stover SM.Proximal sesamoid bone (PSB) fracture is the most common fatal injury in Thoroughbred (TB) racehorses in the United States. Epidemiological and pathological evidence indicates PSB fracture is likely the acute culmination of a chronic stress-related process. However, the aetiopathogenesis of PSB fracture is poorly understood. Objective: To characterise bone abnormalities that precede PSB fracture. Methods: Two retrospective case-control groups of PSBs from TB racehorses with, and without, unilateral biaxial PSB fracture. Methods: Proximal sesamoid bones were harvested post-mortem from TB raceho...
McLellan J, Plevin S.Sesamoiditis is believed to be associated with injury to the suspensory branch attachment and is a common radiographic finding in yearling Thoroughbreds. No study has investigated relationships between yearling sesamoiditis and subsequent development of suspensory ligament branch injury (SLBI) in early racehorse training. Objective: To establish the prevalence of SLBI within a population of juvenile training racehorses and retrospectively investigate relationships between clinical signs of SLBI and sesamoiditis to determine if sesamoiditis is a risk factor for clinical suspensory branch injury...
Peloso JG, Vogler JB, Cohen ND, Marquis P, Hilt L.To compare bony changes in the metacarpophalangeal joint (MCPJ) of racehorses with (cases) and without (controls) biaxial proximal sesamoid bone (PSB) fracture as determined by 2 grading scales applied to images of cadaveric forelimbs obtained by means of standing MRI (sMRI). Methods: Case-control study. Methods: Forelimbs from 74 Thoroughbred racehorses (21 cases and 53 controls) that were euthanized at a Florida racetrack. Methods: Both forelimbs were harvested from cases and controls. Each forelimb underwent sMRI to obtain images of the MCPJ. Two grading scales were described and used for i...
Basran PS, Gao J, Palmer S, Reesink HL.Proximal sesamoid bone (PSB) fractures are the most common fatal musculoskeletal injury in North American racehorses. Computed tomography has the potential to detect morphological changes in bone structure but can be challenging to analyse reliably and quantitatively. Objective: To develop a radiomics platform that allows the comparison of features from micro-CTs (µCT) of PSBs in horses that sustained catastrophic fractures with horses that did not. To compare features calculated with a radiomics approach with features calculated from a previously published study that used quantitative µCT i...
Merritt JS, Davies HM, Burvill C, Pandy MG.The equine distal forelimb is a common location of injuries related to mechanical overload. In this study, a two-dimensional model of the musculoskeletal system of the region was developed and applied to kinematic and kinetic data from walking and trotting horses. The forces in major tendons and joint reaction forces were calculated. The components of the joint reaction forces caused by wrapping of tendons around sesamoid bones were found to be of similar magnitude to the reaction forces between the long bones at each joint. This finding highlighted the importance of taking into account muscle...
Vanderperren K, Ghaye B, Snaps FR, Saunders JH.To determine the detailed computed tomography (CT) anatomy of the metacarpophalangeal (MCP) joint in healthy horses. Methods: 10 cadaveric forelimbs from 10 adult horses without orthopedic disease. Methods: CT of the MCP joint was performed on 4 forelimbs. In 1 of the limbs, CT was also performed after intra-articular injection of 30 mL of contrast medium (40 mg of iodine/mL). Transverse slices 1-mm thick were obtained, and sagittal and dorsal planes were reformatted with a slice thickness of 2 mm. The CT images were matched with corresponding anatomic slices from 6 additional forelimbs. Resul...
Hyde RM, Lynch TM, Clark CK, Slone DE, Hughes FE.This study investigated the influence of perfusate volume on antimicrobial concentration in synovial fluid following intravenous regional limb perfusion (IVRLP) and assessed the efficacy of low volume IVRLP. The front limbs of 9 horses were randomly assigned to 1 of 3 volume groups: 10 mL (Group 1), 30 mL (Group 2), or 60 mL (Group 3). A tourniquet was applied distal to the carpus and the limbs were perfused with 500 mg genta-micin diluted to the assigned volume via a catheter placed in the lateral palmar digital vein at the level of the proximal sesamoid bones. Synovial fluid samples were col...
Alrtib AM, Philip CJ, Abdunnabi AH, Davies HM.There are many reports describing fractures in the bony elements of the equine fetlock joint and a few of these discuss possible relationships of these fractures to the mechanical loading of these bones. The likelihood of fracture must be related to the size and shape of bones involved, but information concerning the normal range in size and shape of these bones in horses is lacking. This study aimed to identify morphometrical variations of these bones within different groups of horses. Right and left metacarpal, proximal phalangeal and proximal sesamoid bones were collected from 10 Thoroughbr...
Rothaug PG, Boston RC, Richardson DW, Nunamaker DM.To compare the monotonic tensile and fatigue strength of 16-gauge stainless steel wire (SSW) to ultra-high-molecular weight polyethylene (UHMWPE) cable using a transfixed cerclage technique in an in vitro midbody sesamoid osteotomy model. Endoscopic modifications to Martins transfixed cerclage technique were developed. A new suture technique of fixation was compared with the transfixed cerclage technique by measuring gap formation after cyclic testing. Methods: An in vitro biomechanical paired equine cadaver limb study. Methods: Twenty-one paired cadaveric adult equine forelimbs. Methods: Unia...
Mattson S, Bouré L, Pearce S, Hurtig M, Burger J, Black W.To report tissue gentamicin concentrations after intraosseous (IO) perfusion in standing horses. Methods: In vivo study. Methods: Twelve horses. Methods: Sedated horses had a cannulated cortical bone screw inserted into the dorsolateral aspect of the treated metacarpus and a tourniquet applied proximally. Gentamicin (2.2 mg/kg) diluted in sterile saline solution (0.1 mL/kg) was infused through the screw. Two horses were euthanatized at each time interval: 0, 2, 6, 12, 24, and 36 hours. Synovial fluid and bone samples were collected distal to the screw from both forelimbs. Gentamicin concentrat...
Cresswell EN, Ruspi BD, Wollman CW, Peal BT, Deng S, Toler AB, McDonough SP, Palmer SE, Reesink HL.To examine whether proximal sesamoid bone (PSB) articular cartilage and bone osteoarthritic changes or palmar osteochondral disease (POD) scores were associated with exercise history and catastrophic PSB fracture in Thoroughbred racehorses. Methods: PSBs from 16 Thoroughbred racehorses (8 with and 8 without PSB fracture). Methods: Exercise history was collected, and total career high-speed furlongs was used as the measure of total exercise per horse. At necropsy, medial and lateral condyles of the third metacarpus from each forelimb were assigned a POD score, followed by imaging with micro-CT ...
Spike-Pierce DL, Bramlage LR.Proximal sesamoiditis has been a common and confusing radiographic diagnosis in Thoroughbred yearling surveys. This study categorised the radiographic appearance of yearling proximal sesamoid bones and determined their effect on the number of races started and earning potential for racing at ages 2 and 3 years. Objective: Yearlings with moderate to severe proximal sesamoiditis have decreased performance at age 2 and 3 years. Methods: Survey radiographs of 487 Thoroughbred yearlings were reviewed. Proximal sesamoid bones were examined and findings placed into 7 categories, 5 of which measured s...
Barr ED, Clegg PD, Mark Senior J, Singer ER.To describe focal destructive lesions of the proximal sesamoid bones (PSBs) as a complication of dorsal metatarsal artery catheterization performed for direct blood pressure monitoring during equine general anesthesia. Methods: Retrospective study. Methods: Three client-owned horses. Methods: A dorsal metatarsal artery was catheterized in each of 3 horses for direct blood pressure monitoring during anesthesia. Radiography, ultrasonography, synoviocentesis, and arthroscopy were used to diagnose postoperative lameness that occurred in the limb used for blood pressure monitoring. Results: Horses ...
Spargo KE, Rubio-Martinez LM, Wheeler DP, Fletcher L, Carstens A.The incidence and types of catastrophic musculoskeletal injuries in Thoroughbreds that resulted in euthanasia on selected racetracks in South Africa between 1998 and 2012 were investigated by an observational retrospective investigation. Data from the National Horseracing Authority of Southern Africa for these racetracks were used to calculate incidence rates in Thoroughbreds (n = 114) that sustained catastrophic musculoskeletal injuries during racing that required immediate euthanasia, based on the diagnosis made by the on-site veterinarian as well as on fetlock radiographs and dissections o...
Plevin S, McLellan J, O'Keeffe T.Sesamoiditis is a common radiological finding in yearling Thoroughbreds. The condition is believed to be associated with suspensory ligament branch injury (SLBI), which is known to affect racing performance. The presence of subclinical suspensory ligament branch change (SSLBC) in untrained yearlings has not been investigated. Associations between sesamoiditis, SSLBC and subsequent SLBI would allow more accurate prognoses to be made regarding the development of SLBI. They could also provide opportunity for intervention and prevention of SLBI. Objective: To test our hypotheses that untrained yea...
Nixon AJ, Cummings JF.Serial sections of bone and soft tissue from the metacarpophalangeal joints of 2 mature and 2 immature horses were evaluated for substance P immunoreactive sensory nerve fibers. Formalin-fixed specimens were sectioned, either nondemineralized or demineralized with formic acid or EDTA. Rabbit antiserum to substance P (SP) was used in the streptavidin-biotin-peroxidase complex method for immunolocalization of SP antigen, and staining with 3,3'-diaminobenzidine was used for permanent identification of SP fibers. Abundant sensory nerve fibers were identified in the joint capsule, synovial membrane...
Martinelli MJ, Kuriashkin IV, Carragher BO, Clarkson RB, Baker GJ.Magnetic resonance imaging was used to examine the equine metacarpophalangeal joint. Thirty-two saggital images generated by partial volume imaging were transferred to a computer for three-dimensional reconstruction and analysis. All the tissues constituting the metacarpophalangeal joint were readily identified. The most significant increase finding regarded the soft tissues on the palmar aspect of the metacarpophalangeal joint and their interactions with the proximal sesamoid bones. The equine metacarpophalangeal joint has not previously been evaluated using 3-dimensional imaging software.
