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Equine veterinary journal2025; doi: 10.1111/evj.70075

A longitudinal study of radiodensity and radiographic appearance of the proximal sesamoid bones in Thoroughbred racehorses.

Abstract: There are limited data on long-term follow-up of radiographic changes of the proximal sesamoid bones (PSBs) in Thoroughbred racehorses. The effect of training and racing on radiodensity of the PSBs in live Thoroughbreds has not been described. Objective: To follow radiographic changes of the PSBs in racehorses over 2 years and describe alterations in overall radiodensity. Methods: Prospective cohort study. Methods: Forty yearlings were enrolled at the first examination (T0). Re-examinations were performed four times, approximately 6 months apart, on 31 (T1), 23 (T2), 13 (T3) and 8 (T4) horses. Radiographic and fan-beam computed tomographic (CT) examinations of both metacarpophalangeal regions were performed. The PSBs were graded (0-3) based on the number of enlarged (width ≥2 mm) vascular channels. The presence of abaxial margin new bone formation, concavity, and irregularity were recorded. The mean Hounsfield Unit (HU) values of the PSBs were measured on multiplanar CT reconstructions. Multivariable mixed-effects regression models estimated the effect of horse signalment and radiographic appearance on mean HU (linear) and the association between radiographic appearance and horse signalment (logistic). Results: Mean HU was lowest at T0 (1064.0 ± 65.1) and highest at T3 (1194.5 ± 78.6). Increasing mean HU was associated with an increasing number of total starts (p < 0.001), increasing bodyweight: height ratio (p < 0.001) and was higher in medial vs. lateral PSBs (p = 0.01). Abaxial new bone formation was associated with a higher grade (p = 0.004) and lateral PSBs (p = 0.04). Abaxial margin concavity was more likely in younger horses (p = 0.01), medial PSBs (p = 0.03) and the left forelimb (p = 0.03). Abaxial margin surface irregularity was more likely in younger horses (p = 0.02) and medial PSBs (p < 0.001). Conclusions: Results may not be representative of all racehorse populations. A substantial number of horses were lost to follow-up. The PSBs were examined in isolation. Conclusions: Increasing PSB radiodensity in racehorses was associated with the number of race starts and related training. Abaxial margin concavities and irregularities may be normal developmental features. Radiographic improvement of PSB grades is possible. Unassigned: Es gibt nur begrenzte Daten zur langfristigen Nachverfolgung radiografischer Veränderungen der proximalen Sesambeine (PSBs) bei Vollblut‐Rennpferden. Der Einfluss von Training und Rennen auf die Röntgendichte der PSBs bei lebenden Vollblütern wurde bislang nicht beschrieben. Unassigned: Beobachtung radiografischer Veränderungen der PSBs bei Rennpferden über zwei Jahre und Beschreibung von Veränderungen in der gesamten Röntgendichte. Methods: Prospektive Kohortenstudie. Methods: Vierzig Jährlinge wurden bei der ersten Untersuchung (T0) eingeschlossen. Nachuntersuchungen erfolgten viermal im Abstand von etwa sechs Monaten bei 31 (T1), 23 (T2), 13 (T3) und 8 (T4) Pferden. Radiografische und fan‐beam‐CT‐Untersuchungen beider Vorderfuß‐Fesselgelenke wurden durchgeführt. Die PSBs wurden (0–3) nach der Anzahl verbreiterter (Breite ≥2 mm) Gefäßkanäle bewertet. Vorkommen von neuer Knochenbildung am abaxialen Rand, Konkavität und Unregelmäßigkeiten wurden dokumentiert. Die mittleren Hounsfield‐Einheiten (HU) der PSBs wurden anhand multiplanarer CT‐Rekonstruktionen gemessen. Multivariable gemischte Regressionsmodelle schätzten den Einfluss von Pferdeparametern und radiografischem Erscheinungsbild auf die mittleren HU‐Werte (linear) sowie den Zusammenhang zwischen radiografischem Erscheinungsbild und Pferdeparametern (logistisch). Results: Der mittlere HU‐Wert war bei T0 am niedrigsten (1064,0 ± 65,1) und bei T3 am höchsten (1194,5 ± 78,6). Ein Anstieg des mittleren HU‐Werts war mit einer höheren Anzahl an Rennstarts (p < 0,001), einem höheren Körpergewichts‐Größen‐Verhältnis (p < 0,001) und mit medialen im Vergleich zu lateralen PSBs (p = 0,011) assoziiert. Neue Knochenbildung am abaxialen Rand war mit einem höheren Grad (p = 0,004) und lateralen PSBs (p = 0,039) verbunden. Abaxiale Randkonkavitäten traten häufiger bei jüngeren Pferden (p = 0,01), medialen PSBs (p = 0,03) und der linken Vordergliedmaße (p = 0,03) auf. Oberflächenunregelmäßigkeiten des abaxialen Randes waren wahrscheinlicher bei jüngeren Pferden (p = 0,018) und medialen PSBs (p < 0,001). WICHTIGSTE EINSCHRÄNKUNGEN: Die Ergebnisse sind möglicherweise nicht auf alle Rennpferdepopulationen übertragbar. Ein erheblicher Teil der Pferde ging im Verlauf verloren. Die PSBs wurden isoliert untersucht. Unassigned: Eine zunehmende Röntgendichte der PSBs bei Rennpferden war mit der Anzahl an Rennstarts und dem zugehörigen Training assoziiert. Konkavitäten und Unregelmäßigkeiten am abaxialen Rand könnten normale entwicklungsbedingte Merkmale sein. Eine radiografische Verbesserung der PSB‐Bewertungen ist möglich.
© 2025 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2025-08-21 PubMed ID: 40841165DOI: 10.1111/evj.70075Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

  • This study tracked changes in the bone density and X-ray appearance of the proximal sesamoid bones (PSBs) in Thoroughbred racehorses over a two-year period to understand how training and racing affect these bones.

Background and Purpose

  • The proximal sesamoid bones (PSBs) are small bones in the lower limb of racehorses that support tendons and ligaments during movement.
  • Long-term data on how PSBs change over time in response to racing and training is scarce.
  • Radiodensity — the degree to which bones appear “dense” on imaging — and radiographic changes in live racehorses had not been comprehensively studied before.
  • The study’s objective was to follow radiographic changes and measure overall radiodensity of the PSBs over two years in a group of Thoroughbred racehorses.

Study Design and Methods

  • Type: Prospective cohort study following the same group of horses over time.
  • Subjects: 40 yearling Thoroughbred racehorses at the first examination (T0).
  • Re-examinations at approximately 6-month intervals, resulting in evaluations at T1 (31 horses), T2 (23 horses), T3 (13 horses), and T4 (8 horses).
  • Examinations included:
    • Radiographs (X-rays) of both metacarpophalangeal (fetlock) joints.
    • Fan-beam computed tomography (CT) scans for detailed imaging and measurement of radiodensity.
  • PSBs were graded on a scale from 0 to 3 based on the number of enlarged vascular channels (enlarged if width ≥2 mm).
  • Additional radiographic features recorded included:
    • New bone formation on the abaxial margin (outer edge of the bone).
    • Concavity of the abaxial margin.
    • Surface irregularities of the abaxial margin.
  • Radiodensity was quantified using mean Hounsfield Unit (HU) values derived from CT scans.
  • The study used multivariable mixed-effects regression models to analyze:
    • How horse demographics and radiographic features affected mean HU values.
    • Associations between radiographic changes and horse characteristics.

Key Findings

  • Radiodensity Changes:
    • The mean HU value was lowest at the initial exam (T0): approx. 1064 HU.
    • Radiodensity increased over time, peaking around T3 (~1195 HU).
    • Greater radiodensity correlated with:
      • A higher number of race starts (statistically significant, p < 0.001).
      • A higher bodyweight-to-height ratio (an indicator of body condition) (p < 0.001).
      • Medial PSBs (the bones on the inner side) showed higher HU values than lateral PSBs (p = 0.01).
  • Radiographic Features:
    • Abaxial new bone formation was linked to:
      • Higher PSB grades (p = 0.004), meaning more vascular channel enlargement.
      • Lateral PSBs (p = 0.04), i.e., outer side bones more often showed new bone growth.
    • Abaxial margin concavity was more common:
      • In younger horses (p = 0.01).
      • In medial PSBs (p = 0.03).
      • In the left forelimb (p = 0.03).
    • Surface irregularities at the abaxial margin were more likely:
      • In younger horses (p = 0.02).
      • On medial PSBs (p < 0.001).
  • Some radiographic features that might be considered abnormal could represent normal developmental variations, especially in younger horses.
  • In some cases, the radiographic grade of PSBs improved over time, indicating potential for healing or remodeling.

Limitations

  • Results may not generalize to all racehorse populations due to sample size and cohort characteristics.
  • Significant drop-out occurred over the 2 years, reducing the number of horses examined at later time points (from 40 to 8).
  • The PSBs were examined in isolation, without correlating findings to adjacent structures or clinical outcomes.

Conclusions and Implications

  • The study provides evidence that increased training and racing activity is associated with increased bone density in the PSBs, likely reflecting bone adaptation to mechanical stress.
  • Certain radiographic features such as abaxial margin concavities and irregularities may not be pathological but normal variations related to development.
  • Radiographic improvements over time suggest that PSBs can remodel or recover, which may be important for injury monitoring and management in racehorses.
  • The long-term monitoring approach combining radiographic grading with quantitative CT measurements offers a useful method to study bone health and adaptation in equine athletes.

Cite This Article

APA
Boros K, Dyson S, Pollard D, Nagy A. (2025). A longitudinal study of radiodensity and radiographic appearance of the proximal sesamoid bones in Thoroughbred racehorses. Equine Vet J. https://doi.org/10.1111/evj.70075

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Boros, Koppány
  • Department and Clinic of Equine Medicine, University of Veterinary Medicine Budapest, Üllő Dóra Major, Hungary.
Dyson, Sue
  • The Cottage, Diss, UK.
Pollard, Danica
  • The Rodhams, Wisbech, UK.
Nagy, Annamária
  • Department and Clinic of Equine Medicine, University of Veterinary Medicine Budapest, Üllő Dóra Major, Hungary.

Grant Funding

  • 2020-4.1.1-TKP2020 / National Research, Development and Innovation Fund of Hungary
  • FK 138825 / Ministry of Innovation and Technology Hungary
  • János Bolyai Research Scholarship, Hungarian Academy of Science

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