A Rare Case of Deep Digital Flexor Tendinopathy following Centesis of the Navicular Bursa.
Abstract: Navicular bursa (NB) centesis is a common diagnostic and therapeutic procedure in equine practice. This case report documents the clinical, diagnostic imaging and histological findings in a horse with a suspected iatrogenic deep digital flexor tendon (DDFT) injury following centesis of the NB a modified distal plantar approach (placement of two needles in a weight bearing position). Although it cannot be proven with absolute certainty, the authors believe that this is the first reported case where NB centesis is the likely cause of a DDFT lesion, and with magnetic resonance imaging performed both pre- and post-centesis. With this potential, though rare, complication of the procedure, alternative tendon sparing injection techniques should be considered prior to NB centesis in certain cases.
Publication Date: 2017-10-16 PubMed ID: 29085826PubMed Central: PMC5650637DOI: 10.3389/fvets.2017.00169Google Scholar: Lookup
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Summary
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This research article presents a unique case of a horse experiencing an injury to its deep digital flexor tendon likely caused by a common diagnostic procedure, known as Navicular bursa (NB) centesis. The authors suggest that this rare event should prompt consideration for alternative techniques that spare the tendon.
Introduction
- The paper discusses a unique case where Navicular bursa (NB) centesis, which is a commonly conducted diagnostic and therapeutic procedure in veterinary medicine dealing with horses, led to a rare complication.
- Centesis of the NB is done as part of diagnosis and treatment processes in equine practice.
Case Presentation
- In this specific case, a horse developed a deep digital flexor tendon (DDFT) injury, post-NB centesis.
- The centesis was performed using a modified distal plantar approach, which involved placing two needles in a weight-bearing position.
Findings and Observations
- The authors document the clinical, diagnostic imaging and histological findings in the horse.
- Though it is impossible to prove with absolute certainty, it was proposed that the NB centesis likely led to the DDFT injury in the horse.
- This hypothesis is supported by the fact that magnetic resonance imaging (MRI) was done both pre- and post-NB centesis. The imaging likely helped the authors track and trace the origin of the DDFT injury back to the NB centesis procedure.
Implications and Recommendations
- The report concludes that while the complication is rare, it should prompt veterinary professionals to consider alternative injection techniques that spare the tendon when performing NB centesis in certain situations.
- This case serves as a reminder of the potential risks involved in commonly performed veterinary procedures and encourages a cautious approach.
Cite This Article
APA
Froydenlund TJ, Meehan LJ, Morrison LR, Labens R.
(2017).
A Rare Case of Deep Digital Flexor Tendinopathy following Centesis of the Navicular Bursa.
Front Vet Sci, 4, 169.
https://doi.org/10.3389/fvets.2017.00169 Publication
Researcher Affiliations
- Fyrnwy Equine Group, Shrewsbury, United Kingdom.
- Diagnostic Imaging, School of Veterinary Sciences, University of Bristol, Langford, United Kingdom.
- Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The Roslin Institute, The University of Edinburgh, Midlothian, United Kingdom.
- Faculty of Science, School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.
References
This article includes 23 references
- Bassage LH, Ross MW. diagnostic analgesia. 2011 p. 100–35.
- Schramme MC, Boswell JC, Hamhougias K, Toulson K, Viitanen M. An in vitro study to compare 5 different techniques for injection of the navicular bursa in the horse.. Equine Vet J 2000 May;32(3):263-7.
- Piccot-Crézollet C, Cauvin ER, Lepage OM. Comparison of two techniques for injection of the podotrochlear bursa in horses.. J Am Vet Med Assoc 2005 May 1;226(9):1524-8.
- Labens R, Redding WR. The dilemma of whether to inject the navicular bursa.. Vet Rec 2012 Dec 22-29;171(25):641-2.
- Dabareiner RM, Carter GK, Honnas CM. Injection of corticosteroids, hyaluronate, and amikacin into the navicular bursa in horses with signs of navicular area pain unresponsive to other treatments: 25 cases (1999-2002).. J Am Vet Med Assoc 2003 Nov 15;223(10):1469-74.
- Nichols AW. Complications associated with the use of corticosteroids in the treatment of athletic injuries.. Clin J Sport Med 2005 Sep;15(5):370-5.
- Cheng J, Abdi S. COMPLICATIONS OF JOINT, TENDON, AND MUSCLE INJECTIONS.. Tech Reg Anesth Pain Manag 2007 Jul;11(3):141-147.
- Daniel AJ, Goodrich LR, Barrett MF, Werpy NM, Morley PS, McIlwraith CW. An optimised injection technique for the navicular bursa that avoids the deep digital flexor tendon.. Equine Vet J 2016 Mar;48(2):159-64.
- Moyer W, Schumacher J, Schumacher J. A guide to Equine Joint Injection and Regional Anaesthesia. 2007 p. 12–5.
- Tremaine H. Infection of equine joints and tendon sheaths. In Pract 2000 22:262–74.
- Frisbie DD. synovial joint biology and pathobiology. 2012 p. 1096–114.
- Blunden A, Dyson S, Murray R, Schramme M. Histopathology in horses with chronic palmar foot pain and age-matched controls. Part 2: The deep digital flexor tendon.. Equine Vet J 2006 Jan;38(1):23-7.
- Blunden A, Murray R, Dyson S. Lesions of the deep digital flexor tendon in the digit: a correlative MRI and post mortem study in control and lame horses.. Equine Vet J 2009 Jan;41(1):25-33.
- Crişan MI, Damian A, Gal A, Miclăuş V, Cernea CL, Denoix JM. Vascular abnormalities of the distal deep digital flexor tendon in 8 draught horses identified on histological examination.. Res Vet Sci 2013 Aug;95(1):23-6.
- van Hamel SE, Bergman HJ, Puchalski SM, de Groot MW, van Weeren PR. Contrast-enhanced computed tomographic evaluation of the deep digital flexor tendon in the equine foot compared to macroscopic and histological findings in 23 limbs.. Equine Vet J 2014 May;46(3):300-5.
- Murray RC, Mair TS, Sherlock CE, Blunden AS. Comparison of high-field and low-field magnetic resonance images of cadaver limbs of horses.. Vet Rec 2009 Sep 5;165(10):281-8.
- Kinns J, Mair TS. Use of magnetic resonance imaging to assess soft tissue damage in the foot following penetrating injury in 3 horses. Equine Vet Educ 2005 17:69–73.
- Biggi M, Dyson S. Hind foot lameness: results of magnetic resonance imaging in 38 horses (2001-2011).. Equine Vet J 2013 Jul;45(4):427-34.
- Dyson SJ. primary lesions of the deep digital flexor tendon within the hoof capsule. 2011 p. 344–8.
- Schumacher J, Schramme MC, Schumacher J, DeGraves FJ. Diagnostic analgesia of the equine digit. Equine Vet Educ 2013 25:408–21.
- Fortier LA. Indications and techniques for tenoscopic surgery of the digital flexor tendon sheath. Equine Vet Educ 2005 17:218–24.
- Fiske-Jackson AR, Barker WH, Eliashar E, Foy K, Smith RK. The use of intrathecal analgesia and contrast radiography as preoperative diagnostic methods for digital flexor tendon sheath pathology.. Equine Vet J 2013 Jan;45(1):36-40.
- Schramme MC. Deep digital flexor tendonopathy in the foot. Equine Vet Educ 2011 23:403–15.
Citations
This article has been cited 1 times.- Larsen EA, Williams MR, Schoonover MJ, Jurek KA, Young JM, Duddy HR. Navicular bone fracture and severe deep digital flexor tendinopathy after palmar digital neurectomy in two horses. Open Vet J 2023 Dec;13(12):1752-1759.
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