FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Equine Vet J / Deep digital flexor tendon lesions in the pastern are associ...
Equine veterinary journal2021; 54(3); 502-512; doi: 10.1111/evj.13470

Deep digital flexor tendon lesions in the pastern are associated with the presence of distal tendinopathy.

Abstract: Correct diagnosis and characterisation of deep digital flexor tendon (DDFT) lesions in equine athletes allows targeted treatment and improved prognostication. Objective: To assess the prevalence and character of pathological change within the DDFT in the pastern with concurrent tendon injury distally. It is hypothesised that tendon lesions in the pastern will be associated with tendinopathy within the hoof capsule. Methods: Retrospective descriptive case series. Methods: Cases with DDFT lesions in the pastern and magnetic resonance imaging (MRI) or ultrasonography of the foot were evaluated retrospectively. Lesion location and type were recorded. Odds ratios were calculated to determine the associations between more distal tendinopathy and the presence of different DDFT lesion types in the pastern. Results: Thirty-four MRI scans of 33 horses and 64 ultrasonographic exams of 58 horses were analysed. Lesion location and type were recorded. Distal DDFT lesions were found in 75% (95% CI: 66.0-84.0) of total cases of pastern DDF tendinopathy and in 97% (95% CI: 91.6-100.0) of cases with core lesions of the DDFT in the pastern. A core lesion in the pastern was significantly more likely (OR = 20.7, 95% CI: 2.2-191.0; P = .008) to be associated with injury in the foot than other types of pastern lesion. Conclusions: MRIs of the foot were not obtained on all included limbs which did not allow for fully inclusive evaluation of DDFT lesions distal to the navicular bone. Conclusions: DDFT pathological change in the pastern, particularly core lesions, is associated with additional tendinopathy within the hoof capsule. When a DDFT lesion is found in the pastern, further imaging of the tendon within the foot is indicated to direct appropriate treatment and improve prognostication.
© 2021 EVJ Ltd.
Get Full Text
Publication Date: 2021-06-28 PubMed ID: 34050982DOI: 10.1111/evj.13470Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

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.

The research paper examines the prevalence and nature of injuries to the deep digital flexor tendon (DDFT) in horse tendons, particularly in the pastern region, with a focus on their association with tendon injuries within the hoof capsule.

Research Objectives

  • The main motive of this study was to understand the prevalence and nature of pathological changes in DDFT in the pasterns of horses in cases of concurrent tendon injury at other locations.
  • The study hypothesized that tendon lesions in the pastern would be associated with tendinopathy within the hoof capsule.

Methods

  • The researchers performed a retrospective evaluation of cases with DDFT lesions in the pastern, using magnetic resonance imaging (MRI) or ultrasonography of the horse’s foot meticulously.
  • The location and type of DDFT lesions were recorded and odds ratios were computed to determine the associations between more distal tendinopathy and the presence of different DDFT lesion types in the pastern.

Results

  • They analyzed a total of 34 MRI scans from 33 horses and 64 ultrasonographic exams from 58 horses.
  • The analysis showed that distal DDFT lesions were found in 75% of total cases exhibiting pastern DDFT tendinopathy, and in 97% of cases with core lesions of DDFT in the pastern.
  • They also found that a core lesion in the pastern was significantly more likely to be associated with an injury in the foot as compared to other types of pastern lesions.

Conclusion

  • The study concluded that DDFT pathological changes in the pastern, particularly core lesions, are linked to additional tendinopathy in the hoof capsule.
  • The authors recommend that further imaging of the tendon within the foot is necessary when a DDFT lesion in the pastern is identified to direct appropriate treatment and improve prognostication.
  • However, it is important to note that MRIs of the foot were not obtained on all included limbs, which might limit the scope of a fully inclusive evaluation of DDFT lesions distal to the navicular bone.

Cite This Article

APA
Acutt EV, Contino EK, Frisbie DD, Barrett MF. (2021). Deep digital flexor tendon lesions in the pastern are associated with the presence of distal tendinopathy. Equine Vet J, 54(3), 502-512. https://doi.org/10.1111/evj.13470

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 54
Issue: 3
Pages: 502-512

Researcher Affiliations

Acutt, Elizabeth V
  • Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado, USA.
Contino, Erin K
  • Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado, USA.
Frisbie, David D
  • Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado, USA.
Barrett, Myra F
  • Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado, USA.

MeSH Terms

  • Animals
  • Foot Diseases / diagnostic imaging
  • Foot Diseases / veterinary
  • Horse Diseases / pathology
  • Horses
  • Humans
  • Lameness, Animal / diagnosis
  • Magnetic Resonance Imaging / methods
  • Magnetic Resonance Imaging / veterinary
  • Retrospective Studies
  • Tendinopathy / complications
  • Tendinopathy / diagnostic imaging
  • Tendinopathy / veterinary
  • Tendons / pathology

References

This article includes 41 references
  1. Dyson S, Murray R, Schramme M. Lameness in 46 horses associated with deep digital flexor tendonitis in the digit: diagnosis confirmed with magnetic resonance imaging. Equine Vet J 2003;35:681-90.
  2. Dyson S, Murray R, Schramme M. Lameness associated with foot pain: results of MRI in 199 horses (January 2001-December 2003) and response to treatment. Equine Vet J 2005;37:113-21.
  3. Dyson S, Murray R. Magnetic resonance imaging evaluation of 264 horses with foot pain: the podotrochlear apparatus, deep digital flexor tendon and collateral ligaments of the distal interphalangeal joint. Equine Vet J 2007;39:340-3.
  4. Sampson SN, Schneider RK, Gavin PR. Magnetic resonance imaging findings in horses with recent onset navicular syndrome but without radiographic abnormalities. Vet Radiol Ultrasound 2009;50:339-46.
  5. Mair T, Kinns J. Deep digital flexor tendonitis in the equine foot diagnosed by low-field magnetic resonance imaging in the standing patient: 18 cases. Vet Radiol Ultrasound 2005;46:458-66.
  6. Gutierrez-Nibeyro SD, Werpy NM, Gold SJ. Standing MRI lesions of the distal interphalangeal joint and podotrochlear apparatus occur with a high frequency in warmblood horses. Vet Radiol Ultrasound 2020;61:336-45.
  7. Whitcomb MB. How to perform a complete ultrasonographic evaluation of the pastern. Proc Am Ass Equine Practnrs 2005;51:465-72.
  8. Whitcomb MB. Ultrasonographic appearance and distribution of deep digital flexor injuries in the pastern region. Proc Am Ass Equine Practnrs 2008;54:452-4.
  9. Lutter JD, Schneider RK, Sampson SN. Medical treatment of horses with deep digital flexor tendon injuries diagnosed with high-field-strength magnetic resonance imaging: 118 cases (2000-2010). J Am Vet Med Assoc 2015;247:1309-18.
  10. Murray RC, Schramme MC, Dyson SJ. Magnetic resonance imaging characteristics of the foot in horses with palmar foot pain and control horses. Vet Radiol Ultrasound 2006;47:1-16.
  11. Cillán-Garcia E, Milner PI, Talbot A. Deep digital flexor tendon injury within the hoof capsule; does lesion type or location predict prognosis?. Vet Rec 2013;173:70.
  12. Vanel M, Olive J, Gold S. Clinical significance and prognosis of deep digital flexor tendinopathy assessed over time using MRI. Vet Radiol Ultrasound 2012;53:621-7.
  13. Busoni V, Heimann M, Trenteseaux J. Magnetic resonance imaging findings in the equine deep digital flexor tendon and distal sesamoid bone in advanced navicular disease-an ex vivo study. Vet Radiol Ultrasound 2005;46:279-86.
  14. Schramme MC. Deep digital flexor tendinopathy in the foot. Equine Vet Educ 2011;23:403-15.
  15. Bell CD, Howard RD, Taylor DS. Outcomes of podotrochlear (navicular) bursa injections for signs of foot pain in horses evaluated via magnetic resonance imaging: 23 cases (2005-2007). J Am Vet Med Assoc 2009;234:920-5.
  16. Smith MR, Wright IM. Endoscopic evaluation of the navicular bursa: observations, treatment and outcome in 92 cases with identified pathology. Equine Vet J 2012;44:339-45.
  17. Groom LM, White NA II, Adams MN. Accuracy of open magnetic resonance imaging for guiding injection of the equine deep digital flexor tendon within the hoof. Vet Radiol Ultrasound 2017;58:671-8.
  18. Puchalski SM, Snyder JR, Hornof WJ. Contrast-enhanced computed tomography of the equine distal extremity. Proc Am Assoc Equine Practnrs 2005;51:389-94.
  19. Anderson JD, Delco ML, Puchalski SM. Injection of the insertion of the deep digital flexor tendon in horses using radiographic guidance. Equine Vet Educ 2008;20:383-8.
  20. Marsh CA, Schneider RK, Sampson SN. Response to injection of the navicular bursa with corticosteroid and hyaluronan following high-field magnetic resonance imaging in horses with signs of navicular syndrome: 101 cases (2000-2008). J Am Vet Med Assoc 2012;241:1353-64.
  21. Smith MR, Wright IM, Smith RK. Endoscopic assessment and treatment of lesions of the deep digital flexor tendon in the navicular bursae of 20 lame horses. Equine Vet J 2007;39:18-24.
  22. McClellan PD, Colby J. Ultrasonic structure of the pastern. J Eq Vet Sci 1986;6:99.
  23. Rabba S, Bolen G, Verwilghen D. Ultrasonographic findings in horses with foot pain but without radiographically detectable osseous abnormalities. Vet Radiol Ultrasound 2011;52:95-102.
  24. Bolen G, Busoni V, Jacqmot O. Sonographic anatomy of the palmarodistal aspect of the equine digit. Vet Radiol Ultrasound 2007;48:270-5.
  25. Sage AM, Turner TA. Ultrasonography of the soft tissue structures of the equine foot. Equine Vet Educ 2002;14:221-4.
  26. Denoix JM, Crevier N, Azevedo C. Ultrasound examination of the pastern in horses. Proc Am Ass Equine Practnrs 1991;37:363-80.
  27. Reimer J. Ultrasonography of the pastern. 1. Anatomy and pathology. 2. Outcome of selected injuries in racehorses. Proc Am Ass Equine Practnrs 1997;43:123-5.
  28. Cauvin ERJ. Ultrasonography of the distal digit in horses. Proceedings 18th ECVS Congress 2009;203-10.
  29. Van Thielen B, Murray R, De Ridder F. Comparison of ultrasonography and MRI in the evaluation of palmar foot pain. Proceedings 14th ESVOT Congress 2008;320.
  30. Busoni V, Denoix JM. Ultrasonography of the podotrochlear apparatus in the horse using a transcuneal approach: technique and reference images. Vet Radiol Ultrasound 2001;42:534-40.
  31. Boswell JC. Does a DDFT injury in the foot mean the end of a horse’s athletic career?. In Proceedings 48th British Equine Veterinary Association Congress 2009;20.
  32. Gutierrez-Nibeyro SD, McCoy AM, Selberg KT. Recent advances in conservative and surgical treatment options of common equine foot problems. Vet J 2018;237:9-15.
  33. Ellis KL, King MR. Review of current literature of common rehabilitation modalities. Proc Am Ass Equine Practnrs 2019;65:281-92.
  34. Smith RKW. Mesenchymal stem cell therapy for equine tendinopathy. Disabil Rehabil 2008;30:20-22.
  35. Trela JM, Spriet M, Padgett KA. Scintigraphic comparison of intra-arterial injection and distal intravenous regional limb perfusion for administration of mesenchymal stem cells to the equine foot. Equine Vet J 2014;46:479-83.
  36. Seignour M, Pasquet H, Coudry V. Ultrasonographic diagnosis of injuries to the deep digital flexor tendon and associated structures in the equine foot (suprasesamoidean area). Equine Vet Educ 2011;23:369-76.
  37. Webbon P. A post mortem study of equine digital flexor tendons. Equine Vet J 1977;9:61-7.
  38. Beck S, Blunden T, Dyson S, Murray R. Are matrix and vascular changes involved in the pathogenesis of deep digital flexor tendon injury in the horse?. Vet J 2011;189:289-95.
  39. Blunden T, Dyson S, Murray R. Histopathological findings in horses with chronic palmar foot pain and age-matched control horses. Part 2: the deep digital flexor tendon. Equine Vet J 2006;38:23-7.
  40. 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;41:25-33.
  41. Shields GE, Barrett MF, Frisbie DD. Comparison of ultrasound and MRI for detection of soft tissue injuries in the palmar aspect of the equine foot. Proc Am Ass Equine Practnrs 2017;63:227.

Citations

This article has been cited 4 times.
  1. Barrett MF, Goorchenko GE, Frisbie DD. Comparison of Ultrasound and Magnetic Resonance Imaging for Identifying Soft Tissue Abnormalities in the Palmar Aspect of the Equine Digit. Animals (Basel) 2023 Jul 17;13(14).
    doi: 10.3390/ani13142328pubmed: 37508105google scholar: lookup
  2. Kim T, Lee S, Seo JP. Evaluation of computed tomographic anatomy of the foot in Jeju horses. J Vet Sci 2026 Jan;27(1):e7.
    doi: 10.4142/jvs.25250pubmed: 41663115google scholar: lookup
  3. Scharf A, Acutt E, Bills K, Werpy N. Magnetic resonance imaging for diagnosing and managing deep digital flexor tendinopathy in equine athletes: Insights, advances and future directions. Equine Vet J 2025 Sep;57(5):1183-1203.
    doi: 10.1111/evj.14508pubmed: 40314097google scholar: lookup
  4. 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.
    doi: 10.5455/OVJ.2023.v13.i12.24pubmed: 38292704google scholar: lookup
Subscribe to our newsletter
Join 99,344 horse owners like you who receive our email updates on horse health and nutrition.