Diagnostic imaging features, cytological examination, and treatment of lymphocytic tenosynovitis of the common digital extensor tendon sheath in an eventing horse.
Abstract: In horses, the structures at the dorsal aspect of the carpus, including the digital extensor tendons, their related tendon sheaths, and bones, are vulnerable to injury because of their superficial location. Injuries to these structures may result in lameness of the affected limb(s) and reduce a horse's athletic performance. A 13-year-old eventing horse that routinely underwent regular exercise exhibited dorsolateral distension of the right carpus. An effusion insensitive to compression was observed in the affected area. No lameness was detected, and the horse exhibited a negative response to the carpal flexion test. Although radiography revealed no abnormal findings in the carpal bones, ultrasonography depicted anechoic fluid and synovial cell proliferation within the common digital extensor tendon sheath. Cytological analysis of the fluid revealed numerous lymphocytes and increased proteinaceous background, suggesting lymphocytic tenosynovitis. The effusion resolved following administration of two intrathecal injections: one injection of corticosteroid combined with hyaluronic acid (HA), and one injection of HA alone. Two weeks after administration of the second injection, daily under-saddle exercise was initiated, consisting of walking and light trotting with a gradual increase in intensity. The horse returned to its habitual intensive training program six weeks following the final injection. In conclusion, the horse was diagnosed with lymphocytic tenosynovitis of the common digital extensor tendon; successful treatment was achieved with administration of corticosteroid and HA. Diagnostic imaging and cytological examination facilitated clinical interpretation and the selection of an appropriate treatment regimen.
© 2021 The Author(s).
Publication Date: 2021-09-26 PubMed ID: 34632158PubMed Central: PMC8488026DOI: 10.1016/j.vas.2021.100209Google Scholar: Lookup
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Summary
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The article looks into a case of a 13-year-old eventing horse diagnosed with lymphocytic tenosynovitis in the common digital extensor tendon. The condition was successfully treated with a regimen involving corticosteroid and hyaluronic acid (HA) injections.
Introduction and Case Overview
- The study revolves around a 13-year-old eventing horse presenting with dorsolateral distension of the right carpus, an issue frequently observed in horses’ athletic performance.
- The horse was not exhibiting signs of lameness, and no abnormal findings were noted through radiographic imaging.
- However, ultrasonography presented anechoic fluid and synovial cell proliferation in the common digital extensor tendon sheath, hinting at a potential issue.
Diagnostic Investigations
- Cytological examination of the fluid revealed numerous lymphocytes and an increased proteinaceous background.
- These findings led to the diagnosis of lymphocytic tenosynovitis, a type of inflammation in the tendon sheath caused by an invasion of lymphocytes.
- Diagnostic imaging played a crucial role in understanding the case, providing evidence for the tenosynovitis despite the horse not showing significant physical symptoms like lameness.
Treatment and Recovery
- The inflammation was treated using two intrathecal injections: a combination of corticosteroid and hyaluronic acid (HA), and HA alone.
- Following the injections, the distension (effusion) resolved. The horse then began a carefully controlled exercise regimen, starting from light exercises with a gradual increase in intensity after two weeks.
- Six weeks after treatment completion, the horse managed to return to its usual, intensive training program, suggesting the success of the treatment.
- This case also highlights the importance of ultrasound-guided therapeutic injections in reducing inflammation and facilitating recovery.
Cite This Article
APA
Chanda M, Klinphayom C, Sungsuwan T, Senarat W, Thongkham E, Kamlangdee A, Senarat N.
(2021).
Diagnostic imaging features, cytological examination, and treatment of lymphocytic tenosynovitis of the common digital extensor tendon sheath in an eventing horse.
Vet Anim Sci, 14, 100209.
https://doi.org/10.1016/j.vas.2021.100209 Publication
Researcher Affiliations
- Department of Large Animal and Wildlife Clinical Science, Faculty of Veterinary Medicine, Kasetsart University Kamphaeng Saen Campus, Nakhon Pathom, Thailand.
- Center of Veterinary Research and Academic Service, Faculty of Veterinary Medicine, Kasetsart University Bang Khen Campus, Bangkok, Thailand.
- Royal Stable Unit, The Royal Thai Army, Bangkok, Thailand.
- Veterinary and Remount Department, The Royal Thai Army, Nakhon Pathom, Thailand.
- Royal Stable Unit, The Royal Thai Army, Bangkok, Thailand.
- Veterinary and Remount Department, The Royal Thai Army, Nakhon Pathom, Thailand.
- Royal Stable Unit, The Royal Thai Army, Bangkok, Thailand.
- Veterinary and Remount Department, The Royal Thai Army, Nakhon Pathom, Thailand.
- Royal Stable Unit, The Royal Thai Army, Bangkok, Thailand.
- Veterinary and Remount Department, The Royal Thai Army, Nakhon Pathom, Thailand.
- Department of Pathology, Faculty of Veterinary Medicine, Kasetsart University, Kamphaeng Saen Campus, Nakhon Pathom, Thailand.
- Orthopedic Surgery and Rehabilitation Center, Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Kasetsart University, Bang Khen Campus, Bangkok, Thailand.
Conflict of Interest Statement
No conflict of interest has been declared.
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Citations
This article has been cited 2 times.- Bungărdean D, Pall E, Daradics Z, Popescu M, Tripon MA, Lupșan AF, Crecan CM, Morar IA, Nicolescu A, Bora FD, Marcus I. In Vitro Effects of PRP, Ozonized PRP, Hyaluronic Acid, Paracetamol, and Polyacrylamide on Equine Synovial Fluid-Derived Mesenchymal Stem Cells. Life (Basel) 2025 Oct 4;15(10).
- Franini A, Entani MG. Common Digital Extensor Tendon Injury in Three Sporting Dogs. Animals (Basel) 2022 Sep 29;12(19).
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