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Topic:Soft Tissue
Soft tissue in horses encompasses the non-bony structures that support and connect various parts of the body, including muscles, tendons, ligaments, and fascia. These tissues are essential for movement, stability, and overall musculoskeletal function. Injuries to soft tissue can result from trauma, overuse, or improper biomechanics, leading to conditions such as strains, sprains, and tears. Understanding the anatomy, healing processes, and rehabilitation strategies for soft tissue is important for managing equine health and performance. This page compiles peer-reviewed research studies and scholarly articles that explore the structure, function, and treatment of soft tissue injuries in horses.
High-field magnetic resonance imaging enables diagnosis of central tarsal bone fractures in performance horses with lameness localized to the proximal metatarsus and tarsus. Central tarsal bone (CTB) fractures are challenging to diagnose, and cross-sectional imaging is required for definitive characterization and surgical planning. This retrospective case series aims to provide the first description of high-field (3-T) MRI characteristics of CTB fractures, concurrent pathology, and clinical presentation in 8 performance horses. Unassigned: 8 horses (9 limbs) diagnosed with a CTB fracture on high-field MRI at one tertiary referral hospital between 2013 and 2023 were identified via electronic medical records search. Unassigned: Quarter Horses (6 of 8) used for Weste...
Does Low-Field MRI Tenography Improve the Detection of Naturally Occurring Manica Flexoria Tears in Horses? Diagnosing digital flexor tendon sheath (DFTS) pathologies, particularly manica flexoria (MF) tears, can be challenging with standard imaging modalities. Standing low-field MRI tenography (MRIt) may improve the detection rate of MF tears. This study aimed to compare ultrasonography, contrast radiography, pre-contrast MRI, and MRIt to detect naturally occurring MF lesions in horses undergoing tenoscopy. Ten horses with a positive DFTS block, which underwent contrast radiography, ultrasonography, MRI, MRIt, and tenoscopy were included. Two radiologists evaluated the images and recorded whether a...
Histological Study of the Normal Proximal Third Interosseus Muscle Enthesis in the Equine Pelvic Limb. In human medicine, the enthesis, or tendon-to-bone insertion, is generally considered a linked entity or 'enthesis organ' and plays a crucial biomechanical role. This study aimed to histologically assess the equine proximal third interosseus muscle (suspensory ligament) enthesis in 10 pelvic limbs from 7 horses. The area of the proximal third interosseus muscle enthesis was divided into 6 compartments based on post-mortem computed tomography and prepared for histology using haematoxylin/eosin and trichrome staining. The proximal third interosseus muscle enthesis showed a fibrocartilaginous nat...
Tendon/Ligaments: Structure and Composition. The mid-metacarpal SDFT, intrasynovial DDFT and suspensory ligament are frequently injured soft tissues in the equine athlete. The mid-metacarpal SDFT exhibits a hierarchical structure and encounters repetitive strains at its functional limit. The intrasynovial DDFT possesses fibrocartilage where opposing bony surfaces to facilitate resistance-free gliding and contains chondrocyte-like cells embedded in a proteoglycan-rich ECM. While suspensory ligament enthesis injuries are common, collagen and non-collagen ECM structure-function specializations at the bone-ligament interface are understudied...
Clinical Updates on Superficial Digital Flexor Tendon Injuries: Insights on Diagnostic and Therapeutic Advancements. Superficial digital flexor tendinopathy is one of the most common orthopedic soft tissue injuries in horses. The veterinary challenge for this condition is less related to identifying the presence of the injury (as it is usually readily evident clinically) but more related to improving the healing process so that the healed tendon is more like normal tendon in biology and function in order to reduce reinjury, which is the key adverse consequence of the injury. Diagnostic imaging has improved in recent years to aid with treatment choices and monitoring the healing process.
Normal MRI features of the manica flexoria in horses and evaluation of the anatomic variability between forelimbs and hindlimbs. Manica flexoria tears are increasingly recognized as a cause of lameness in horses resulting in a need for improved pre-operative diagnosis. Partial tears are difficult to pre-operatively diagnose and thus research for diagnostics of manica flexoria tears has been seen in increasing frequency over the past decade, though a deficit of information exists for the features of this structure on MRI, which is best suited for evaluation of soft tissues. The goal is to perform an observational study on the morphometry of the normal manica flexoria prospectively and describe it retrospectively on MRI. ...
Measurements of equine foot parameters show limited agreement between radiographs and low-field magnetic resonance imaging. Equine foot radiographs are commonly obtained to measure anatomical conformation parameters. Comparison of measurements between radiographs and low-field magnetic resonance imaging (MRI) has not been extensively explored. Objective: To compare foot parameter measurements between radiographs and low-field MRI, and assess the effect of hoof wall markers on visualising the hoof capsule (during MRI) and facilitating measurements. Methods: Comparative cadaveric analytical study. Methods: Radiography and MRI of nine equine cadaver front feet were performed with and without hoof wall markers, which w...
Adjunct Therapies for Tendon/Ligament Healing: Therapeutic Laser and Extracorporeal Shockwave Therapy. High-power laser therapy and extracorporeal shock wave therapy (ESWT) can be safely used to treat tendon and ligament injuries in horses, and the potential beneficial effects have been described. The power of low level lasers is not sufficient for treatment of tendon and ligament injuries in horses. ESWT is used more often to treat tendon and ligament injuries than it is for any other type of condition in horses, but there is limited supporting scientific evidence. Further research should focus on establishing dosage and treatment protocols for both laser therapy and ESWT in horses with clinic...
Suspensory Ligament Injuries: Diagnosis and Treatment. The location of a suspensory ligament (SL) injury heavily influences the clinical presentation, prognosis, and treatment options. Diagnostic imaging is necessary to provide an accurate diagnosis and is critical to ensure the institution of the most appropriate treatment. The hindlimb proximal SL in particular can be challenging to diagnosis, carries a guarded prognosis, and typically requires aggressive treatment to achieve soundness.
Current and Emerging Quantitative Imaging Modalities for Diagnosing and Monitoring Equine Tendon and Ligament Injuries. Technological developments in imaging modalities have advanced the diagnostic capabilities for equine tendon and ligament injuries beyond the traditional methods. This review examines elastography techniques in ultrasonography that assess tissue stiffness and strain properties, computed tomography (CT) innovations including PET/CT fusion and dual-energy CT, and emerging applications of diffusion-weighted MRI for evaluating fiber microstructure and functionality. These complementary approaches offer veterinarians improved means to detect early injuries, assess structural integrity, monitor heal...
Current Practices and Considerations in Therapeutic Farriery for Equine Tendon and Ligament Injuries. The overall objective of therapeutic farriery for equine tendon and ligament injuries is to provide a biomechanical environment conducive to healing by limiting excessive strain on the injured structure. With an understanding of equine limb anatomy and the pathophysiology of tendon/ligament injuries, the rationale used in therapeutic farriery for soft tissue injuries of the distal limb is quite logical. Through therapeutic farriery, foot manipulation is used to reduce the tension on the injured tendon(s) or ligament(s).
Desmitis of the palmar or plantar ligaments of the proximal interphalangeal joint: A descriptive case series. Limited reports in the literature are available regarding desmitis of the palmar/plantar ligaments of the proximal interphalangeal joint (PL-PIPJ); the clinical significance of such injuries is unknown. Objective: To describe the ability to differentiate the PL-PIPJ on low-field magnetic resonance (MR) examination. To describe the injury characteristics of the PL-PIPJ on MR examination and the correlation with clinical features and lameness. Methods: Retrospective case series. Methods: Data and MR images of 29 horses were collected from the databases of three institutions. Horses were included...
Western performance horses with fetlock lameness demonstrate radiographic evidence of chronic exercise remodelling. Pathological changes of the fetlock joint are well documented in Thoroughbreds, but little information is available describing the common radiographic findings in western performance horses with fetlock lameness. Objective: To describe radiographic findings in western performance horses with fetlock lameness. It was hypothesised that the degree of lameness would correlate with the severity of radiographic findings. Methods: Retrospective case series. Methods: Retrospective review (2012-2022) of horses with lameness isolated to the fetlock joint via intra-articular analgesia and corresponding r...
Sinonasal angiofibroma in a horse. A 34-year-old Haflinger gelding presented with a unilateral, expansile, intranasal mass that regrew after partial excision. After euthanasia, a large pedunculated mass that originated from the left caudal maxillary sinus and obliterated the left nasal cavity was seen by radiological and macroscopic examination. Histopathology revealed a poorly cellular, expansile, well-vascularized neoplasm composed of a loosely arranged meshwork of spindle cells and collagen fibres. Spindle cells were immunopositive for alpha-smooth muscle actin and occasionally for vimentin, whereas endothelial cells immunol...
Diagnostic performance of ultrasonography, bursography and standing magnetic resonance to detect navicular intrabursal pathology in horses with foot pain. Navicular intrabursal pathology (NIP) is a common cause of forelimb lameness in horses. An accurate diagnosis of which structure is involved is essential for therapy and prognosis. Objective: The study aimed to compare the diagnostic performance of ultrasonography, bursography and standing magnetic resonance (MRI) imaging as diagnostic tools of the proximal NIP using bursoscopy as the gold standard. Methods: Prospective blinded study. Methods: A total of 21 feet from 17 horses were included. The feet underwent ultrasonography, followed by MRI, and thereafter bursography and bursoscopy. The i...
Differentiation of equine paranasal sinus cysts and progressive ethmoid haematomas on computed tomographic images. Paranasal sinus cysts (PSC) and progressive ethmoid haematomas (PEH) are regularly observed in the paranasal sinus system. Due to their different prognosis and treatment options, differentiation of both lesions prior to surgery on computed tomographic (CT) images is important for guidance. It was hypothesised that PSC and PEH can be reliably differentiated on CT images. The database of four European equine referral centres were retrospectively searched for horses that had undergone a CT examination of the head and had a confirmed PSC or PEH. Additionally, cases with confirmed sinusitis were se...
Computed tomography of the equine temporohyoid joint: Association between imaging changes and potential risk factors. Temporohyoid osteoarthropathy (THO) is characterised by bone proliferation and cartilage ossification caused by infectious and degenerative conditions, amongst others. Objective: To describe the variable appearance of the temporohyoid joint (THJ) on computed tomography (CT) and investigate associations between CT changes and potential risk factors. Methods: Cross-sectional study. Methods: Head CT examinations were assessed. A grading system was developed for osseous proliferation (grade 0 [normal] to 3 [severe]) and tympanohyoid cartilage change (grade 0 [normal] to 3 [complete ossification])....
Forces on the Incisor Teeth During Odontoplasty of the Cheek Teeth in Sedated Horses. Mouth specula with incisor bite plates shift the pressure from all teeth exclusively to the incisors in the opening phase which leads to increased forces on dental, osseous, and soft tissue structures of the horse's head. The potentially pathological character of these forces is described clinically by single reports of maxilla and mandible fractures occurring during the use of opened mouth specula. This study describes these forces on incisor teeth in horses during odontoplasty of cheek teeth under sedation. Measurements were documented using a modified "Günther" mouth speculum fitted with a...
Computed tomographic measurements in 110 front hooves of non-lame Thoroughbred racehorses and Warmblood showjumpers. There are no published reference ranges on computed tomographic (CT) hoof wall and sole measurements. Objective: To establish reference ranges for CT measurements of the hoof wall and sole in non-lame horses, and to investigate associations between measurements and signalment, laterality, and medial or lateral sides. Methods: Retrospective, cross-sectional study. Methods: Soft tissue reconstructions of fan-beam CT studies of 110 front feet of 56 non-lame horses (30 Thoroughbred racehorses, 26 Warmblood showjumpers), performed in non- to semi-weightbearing positions, were analysed. Hoof wall th...
Gross anatomy, computed tomographic contrast tenography, and needle endoscopy of the equine medial digital flexor tendon sheath. To investigate the computed tomography (CT) and gross anatomy of the equine medial digital flexor tendon sheath (MDFTS), and the endoscopic anatomy and approach to the MDFTS. Methods: Ex vivo experimental study and one clinical case. Methods: Twelve clinically normal cadaveric hindlimbs. Methods: Dissection, native and contrast CT scans were conducted to evaluate the anatomy of the MDFTS. Based on these findings, the portal locations for the endoscopic approaches were determined. Six hindlimbs were used in the pilot phase and another six limbs were selected for the main study. Endoscopic image...
Major Salivary Gland Examinations of the Donkey (Equus asinus) Using Sectional Anatomy, Computed Tomography and Magnetic Resonance Imaging. Visualizing the major salivary glands (MSGs) in domestic mammals using plain radiology and identifying damaged their structures is impossible. To accurately display MSGs, the knowledge of normal sectional imaging anatomy is essential for veterinarians, aiding them significantly in identifying the exact relations and position of MSGs; however, no reports on the MSGs sectional imaging anatomy in this species have been made. Objective: This study aimed to evaluate computed tomography (CT), magnetic resonance imaging (MRI) and gross sections of MSGs. Methods: Seven healthy adult donkeys were used ...
Combined standing low-field magnetic resonance imaging and fan-beam computed tomographic diagnosis of fetlock region pain in 27 sports horses. There is no description of comparative magnetic resonance imaging (MRI) and fan-beam computed tomography (CT) findings in the fetlock of lame sports horses. Objective: To document low-field MRI and fan-beam CT diagnoses in the lame and nonlame limbs of sports horses with fetlock region pain, and to evaluate whether combined imaging provides superior information to either technique alone. Methods: Retrospective descriptive study. Methods: Clinical records of sports horses with pain causing lameness localised to the metacarpo/metatarsophalangeal joint region that had undergone fan-beam CT and lo...
Preoperative computed tomography imaging for accurate diagnosis and surgical planning in equine cranial disorders: two case reports of congenital malformations. Computed tomography (CT) offers high-resolution, three-dimensional imaging, making it particularly valuable for assessing complex structures, such as the head, especially when conventional radiography and endoscopy are insufficient for a definitive diagnosis. Herein, we present two cases of equine cranial disorders resulting from congenital malformations. In case 1, which had a dentigerous cyst, CT images confirmed the location of the ectopic tooth within the skull and a detailed fistula tube. In case 2, which had temporohyoid osteoarthropathy, CT examination revealed that the stylohyoid bone ...
Equine Distal Limb Wounds: Economic Impact and Short-Term Prognosis of Non-Synovial Versus Synovial Lesions in Southern Germany. Injuries to the distal limb are common in horses. The clinical aspect of the lesions is variable based on the structures that are involved. Synovial structures as well as tendons and/or ligaments may be involved in such injuries, affecting treatment modalities and costs, and prognosis. This retrospective study compares wounds involving synovial structures to wounds without such involvement in terms of treatment duration and costs, and prognosis. Synovial wounds were much more expensive to treat and carried a lower prognosis. Involvement of tendons and/or ligaments in the wounds resulted in mor...
Measuring Noseband Tightness on the Lateral Aspect of the Horse’s Face. Measuring tools designed to objectively determine equine noseband tightness are inserted on the dorsal nasal planum in a rostro-caudal direction. The lateral aspect of the horse's head has several areas where minimal soft tissue intervenes between the skin and underlying bone, which makes them potentially useful sites for measuring noseband tightness. One hundred horses were fitted with a snaffle bridle with a cavesson, Swedish or dropped noseband in random order. The tightness of each noseband type was adjusted sequentially to 2.0, 1.5, 1.0, 0.5 and 0.0 finger-equivalents using an ISES Taper ...
Congenital myofibroblastic fibrosarcoma of the temporal bone in a newborn Arabian foal. Myofibroblastic fibrosarcoma (MFS) is a malignant soft tissue tumour that is rare in domestic animals. Here we report a case of congenital MFS in an Arabian foal at birth. A large solitary subcutaneous mass arising in the left temporal region was found in the foal. On cut section, an unencapsulated hemispheric, white-yellowish, elastic fibrous mass was attached to the temporal bone. Histologically, the mass was composed of a neoplastic proliferation of spindle-shaped fibroblasts arranged in fasciculate or interwoven streams and bundles, with low nuclear atypia and mitotic rate, local invasion ...
Biomechanical Assessment of the Collateral Ligament of the Distal Interphalangeal Joint of the Horse Following Alterations to the Palmar Angle-A Cadaveric Study. 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...
Therapeutic Exercises for Rehabilitation of Muscle Injury. Successful rehabilitation of muscle injury requires a comprehensive understanding of the injury process, healing phases, and resources to be employed. The initial phase is characterized by acute inflammatory signs, followed by the regenerative and remodeling phases. Therapeutic exercises can be utilized in all 3 phases, progressing from isometric exercises to aquatic therapies. The classification and phase of injury and the individual response to the applied therapies will guide the progression of the therapeutic exercises through the rehabilitation program.
Use of full-thickness mesh grafts and full-thickness meek micrografts in five horses with ear skin defects caused by trauma or neoplasm resection. To report the management and outcomes of five horses with ear skin defects treated with the use of full-thickness mesh grafts and full-thickness Meek micrografts. Methods: Five horses with acute or granulating pinna skin wounds. Methods: Short case series. Methods: A full-thickness graft was harvested from the pectoral region under general anesthesia. The sheet graft was stretched on a sterile plastic board with the epidermal side facing down. The subcutaneous fat and fascia were removed by sharp dissection. The skin graft was then meshed by hand or using a block mesher, or manually cut into m...
Soft palate angle and basihyoid depth increase with tongue size and with body condition score in horses. Obesity has been associated with human obstructive sleep apnoea and canine brachycephalic obstructive airway syndrome. The effect of body condition score (BCS) on structures of the oropharynx, nasopharynx and upper airway of the horse has not been investigated. Objective: To investigate the effect of BCS on tongue measurements, soft palate angle and basihyoid depth in horses. Methods: Retrospective, analytical, cross-sectional. Methods: Computed tomographic (CT) images of the head of 58 horses were assessed. DICOM viewing software was used to measure head length, basihyoid-skin depth, soft pal...
