Axial sesamoiditis in the horse: A review.
Abstract: Axial sesamoiditis or osteitis of the proximal sesamoid bones (PSBs) in the horse is described as a rare condition. The cause remains unknown and speculative, with vascular, infectious, and traumatic aetiologies implicated. It is specifically associated with injury of the palmar or plantar ligament (PL), also known as the intersesamoidean ligament. Imaging findings are generally rewarding and radiological changes are typical, if not pathognomonic, for the condition. Lesions consist of bone lysis at the apical to mid-body axial margins of the PSBs, with variable degrees of joint effusion. Radiographic technique warrants careful attention to make a diagnosis, and exposure factors may need to be adjusted. Perineural, intra-articular and intra-thecal anaesthesia does not seem to provide consistent improvement of lameness in these cases, with literature reporting inconsistent findings. Ultrasonographic findings include digital flexor sheath effusion, loss of the normal fibre structure of the PL at its attachment to the PSBs, abnormal echogenicity or change in thickness of the PL, and irregular hyperechoic cortical margins of the axial margins of the PSBs. Scintigraphy, computed tomography and magnetic resonance imaging, although not necessary to make a diagnosis, may add valuable information regarding the location and extent of lesions. The prognosis remains guarded to poor for return to athletic function. The focus of this paper is a comprehensive review of the proposed aetiopathogenesis of the condition, the prognosis, and a summary of the literature findings with focus on the notable diagnostic imaging features, including radiography, ultrasonography, scintigraphy, computed tomography and magnetic resonance imaging.
Publication Date: 2018-03-29 PubMed ID: 29781675PubMed Central: PMC6138204DOI: 10.4102/jsava.v89i0.1544Google Scholar: Lookup
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- Journal Article
- Review
Summary
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The study is a comprehensive review of Axial sesamoiditis, a rare and poorly understood condition in horses affecting the proximal sesamoid bones (PSBs) and associated with injury to the palmar or plantar ligament. The authors explore the possible causes, diagnosis, prognosis, and treatments based on existing literature data.
Sesamoiditis Overview and Causes
- Axial sesamoiditis or osteitis of the proximal sesamoid bones (PSBs) in the horse is described as a rare and poorly understood condition.
- The causes of this disease are unknown but speculation suggest potential vascular, infectious, and traumatic triggers.
- It is prominently related to injuries of the palmar or plantar ligament (PL), also known as the intersesamoidean ligament.
Recognition and Diagnosis
- The research suggests that imaging findings offer a substantial aid in diagnosing this condition, with distinctive radiological changes unique to this ailment.
- These modifications include bone lysis at the axial margins of the PSBs and varying degrees of joint effusion.
- Successful diagnosis requires scrupulous attention to radiographic technique and potential adjustment of exposure factors.
- Contrarily, anesthetic methods (perineural, intra-articular and intra-thecal anaesthesia) do not yield consistent improvements in mitigating lameness associated with the condition.
Ultrasonographic Findings
- The use of ultrasonography has been observed to pinpoint signs of this disease. These may include digital flexor sheath effusion, loss of the normal fibre structure of the PL at its attachment to the PSBs, abnormal echogenicity or change in thickness of the PL, and irregular hyperechoic cortical margins of the axial margins of the PSBs.
- Scintigraphy, computed tomography, and magnetic resonance imaging can also supplement diagnostic information, providing details related to the location and extent of the lesions. Although they are not necessary for diagnoses, these techniques can enrich the understanding of the disease.
Prognosis and Future Research
- The prognosis of the condition is uncertain to bad for horses to return to athletic function after the disease.
- The paper covers an extensive review of the possible causes of the disease, prognosis, and the literature findings, focusing on diagnostic imaging features uncovered through radiography, ultrasonography, scintigraphy, computed tomography, and magnetic resonance imaging.
- Enhancing our understanding of axial sesamoiditis can help develop more effective treatments and improve the chances of maintaining or returning the horse to its prior level of functionality.
Cite This Article
APA
Le Roux C, Carstens A.
(2018).
Axial sesamoiditis in the horse: A review.
J S Afr Vet Assoc, 89, e1-e8.
https://doi.org/10.4102/jsava.v89i0.1544 Publication
Researcher Affiliations
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, Onderstepoort, University of Pretoria. drchristelle@gmail.com.
MeSH Terms
- Animals
- Bone Diseases, Infectious / diagnostic imaging
- Bone Diseases, Infectious / physiopathology
- Bone Diseases, Infectious / veterinary
- Horse Diseases / diagnostic imaging
- Horse Diseases / physiopathology
- Horses
- Lameness, Animal / diagnostic imaging
- Lameness, Animal / etiology
- Lameness, Animal / physiopathology
- Osteitis / physiopathology
- Osteitis / veterinary
- Prognosis
- Sesamoid Bones / physiopathology
Conflict of Interest Statement
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
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