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Home / Equine Research Bank / Equine Vet J / Magnetic resonance Imaging for diagnosing and managing deep ...
Equine veterinary journal2025; doi: 10.1111/evj.14508

Magnetic resonance Imaging for diagnosing and managing deep digital flexor tendinopathy in equine athletes: Insights, advances and future directions.

Abstract: Deep digital flexor (DDF) tendinopathy is a significant cause of lameness and poor performance in equine athletes with substantial implications for their return to athletic performance. Magnetic resonance imaging (MRI) is increasingly integrated into the diagnostic workup of horses with foot pain and has revolutionised the diagnosis and management of these injuries. This review discusses the principles of MRI in the context of deep digital flexor tendon (DDFT) injury, comparing high-field and low-field systems and highlighting the clinical relevance of technical parameters, including field strength and sequence selection, in achieving an accurate diagnosis. This review also critically evaluates how different configurations and/or imaging features of tendon lesions may impact patient prognosis, considers the complementary role of computed tomography and ultrasonography in cases where MRI may not be feasible, and discusses emerging imaging techniques including positron emission tomography (PET)-MRI and quantitative MRI. Lastly, this review underscores the importance of serial imaging to monitor lesion progression and guide rehabilitation, while identifying knowledge gaps and proposing future research directions. Ultimately, a multidisciplinary approach incorporating advanced imaging and tailored rehabilitation is essential to improving clinical outcomes in horses with DDFT injuries.
© 2025 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2025-05-02 PubMed ID: 40314097DOI: 10.1111/evj.14508Google 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.

The research article reviews the use of Magnetic Resonance Imaging (MRI) in diagnosing and managing deep digital flexor tendinopathy in horses and discusses the future of imaging techniques in this context.

Use of MRI in Diagnosing DDFT injury

  • The research highlights how MRI has revolutionised the diagnosis and management of deep digital flexor tendon (DDFT) injuries in horses. The MRI is integrated into the diagnostic procedure in case of foot pain in horses.
  • The expectations from MRI scan ranges from detecting injuries to guiding lesion progression and rehabilitation.

High-field and low-field MRI Systems

  • The study critically compares the high-field and low-field MRI systems for diagnosing and managing DDFT injuries.
  • It outlines the relevance of various technical parameters in an MRI, such as field strength and sequence selection, to achieve an accurate diagnosis.

Tendon Lesion Configurations and Imaging features

  • The research also reviews how different configurations and imaging features of tendon lesions may impact the prognosis of the patient.
  • The review also hints towards a complementary role of computed tomography and ultrasonography especially in situations where MRI may not be feasible.

Emerging Imaging Techniques

  • The research focuses on new and emerging imaging techniques like positron emission tomography (PET)-MRI and quantitative MRI. These advancements could potentially improve the efficiency of diagnosis and treatment.
  • The article acknowledges the need for a multidisciplinary approach, which would include advanced imaging and a tailored rehabilitation process, to improve clinical outcomes in horses with DDFT injuries.

Serial Imaging and Rehabilitation

  • The importance of serial imaging, which is imaging at regular intervals for tracking changes, is underscored in the review.
  • This strategy helps in monitoring the progression of the lesion and steers the rehabilitation of the horse, thereby improving the treatment outcomes.

Future Directions

  • In the end, the authors identify knowledge gaps in existing research and propose future trajectories for investigations.
  • There is a strong emphasis on understanding the limitations and potentials of advanced imaging techniques to better manage tendinopathy in equine athletes.

Cite This Article

APA
Scharf A, Acutt E, Bills K, Werpy N. (2025). Magnetic resonance Imaging for diagnosing and managing deep digital flexor tendinopathy in equine athletes: Insights, advances and future directions. Equine Vet J. https://doi.org/10.1111/evj.14508

Publication

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

Researcher Affiliations

Scharf, Alexandra
  • Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Acutt, Elizabeth
  • Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Bills, Kathryn
  • Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Werpy, Natasha
  • Equine Diagnostic Imaging, Inc., Archer, Florida, USA.

References

This article includes 158 references
  1. Ely ER, Avella CS, Price JS, Smith RKW, Wood JLN, Verheyen KLP. Descriptive epidemiology of fracture, tendon and suspensory ligament injuries in National Hunt racehorses in training.. Equine Vet J 2009;41:372–378.
  2. Parkin TDH, Rogers K, Stirk A. Risk factors for tendon strain injury during racing in Great Britain.. Proceedings of the 16th International Conference of Racing Analysts and Veterinarians Newmarket, UK: R and W Publications; 2006. p. 104.
  3. Williams RB, Harkins LS, Hammond CJ, Wood JL. Racehorse injuries, clinical problems and fatalities recorded on British racecourses from flat racing and National Hunt racing during 1996, 1997 and 1998.. Equine Vet J 2001;33:478–486.
  4. Gutierrez‐Nibeyro SD, Werpy NM, Gold SJ, Olguin S, Schaeffer DJ. Standing MRI lesions of the distal interphalangeal joint and podotrochlear apparatus occur with a high frequency in warmblood horses.. Vet Radiol Ultrasound 2020;61:336–345.
  5. Eliashar E, McGuigan MP, Wilson AM. Relationship of foot conformation and force applied to the navicular bone of sound horses at the trot.. Equine Vet J 2004;36:431–435.
  6. Viitanen M, Bird J, Smith R, Tulamo R‐M, May SA. Biochemical characterisation of navicular hyaline cartilage, navicular fibrocartilage and the deep digital flexor tendon in horses with navicular disease.. Res Vet Sci 2003;75:113–120.
  7. Crişan MI, Damian A, Ştefănuţ LC, Dezdrobitu CC, Neagu DM, Denoix J‐M. Global epidemiological analysis of prevalence and risk factors associated with the deep digital flexor tendinopathy in the equine distal limb: 100 cases.. J Equine Vet Sci 2018;67:55–60.
  8. Cillan‐Garcia E, Milner PI, Talbot A, Tucker R, Hendey F, Boswell J. Deep digital flexor tendon injury within the hoof capsule; does lesion type or location predict prognosis?. Vet Rec 2013;173:70.
  9. Lutter JD, Schneider RK, Sampson SN, Cary JA, Roberts GD. 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;247:1309–1318.
  10. Patterson‐Kane JC, Becker DL, Rich T. The pathogenesis of tendon microdamage in athletes: the horse as a natural model for basic cellular research.. J Comp Pathol 2012;147:227–247.
  11. Marsh CA, Schneider RK, Sampson SN, Roberts GD. 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;241:1353–1364.
  12. Sampson SN, Schneider RK, Gavin PR, Ho CP, Tucker RL, Charles EM. Magnetic resonance imaging findings in horses with recent onset navicular syndrome but without radiographic abnormalities.. Vet Radiol Ultrasound 2009;50:339–346.
  13. Murray RC, Dyson SJ, Tranquille C, Adams V. Association of type of sport and performance level with anatomical site of orthopaedic injury diagnosis.. Equine Vet J 2006;38(S36):411–416.
  14. Acutt EV, Contino EK, Frisbie DD, Barrett MF. Deep digital flexor tendon lesions in the pastern are associated with the presence of distal tendinopathy.. Equine Vet J 2022;54:502–512.
  15. Dyson S, Murray R, Schramme M, Branch M. Lameness in 46 horses associated with deep digital flexor tendonitis in the digit: diagnosis confirmed with magnetic resonance imaging.. Equine Vet J 2003;35:681–690.
  16. Dyson S, Murray R, Schramme M, Branch M. Magnetic resonance imaging of the equine foot: 15 horses.. Equine Vet J 2003;35:18–26.
  17. Evrard L, Joostens Z, Vandersmissen M, Audigié F, Busoni V. Comparison between Ultrasonographic and standing magnetic resonance Imaging findings in the Podotrochlear apparatus of horses with foot pain.. Front Vet Sci 2021;8:675180.
  18. 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 2023;13(14):2328.
    doi: 10.3390/ani13142328google scholar: lookup
  19. Vallance S, Bell R, Spriet M, Kass PH, Puchalski SM. Comparisons of computed tomography, contrast‐enhanced computed tomography and standing low‐field magnetic resonance imaging in horses with lameness localised to the foot. Part 2: lesion identification.. Equine Vet J 2012;44:149–156.
  20. Vallance SA, Bell RJW, Spriet M, Kass PH, Puchalski SM. Comparisons of computed tomography, contrast enhanced computed tomography and standing low‐field magnetic resonance imaging in horses with lameness localised to the foot. Part 1: anatomic visualisation scores.. Equine Vet J 2012;44:51–56.
  21. Van Thielen B, Murray R, De Ridder F, Vandenberghe F, Van den Broeck R, Busoni V. Comparison of ultrasonography and MRI in the evaluation of palmar foot pain.. 14th ESVOT Congress Germany: Munich; 2008. p. 230.
  22. . About Us.. Hallmarq Veterinary Imaging 2025. Available from: https://hallmarq.net/us/about/.
  23. Arnold TC, Freeman CW, Litt B, Stein JM. Low‐field MRI: clinical promise and challenges.. J Magn Reson Imaging 2023;57:25–44.
  24. Byrne CA, Marshall JF, Voute LC. Clinical magnetic resonance image quality of the equine foot is significantly influenced by acquisition system.. Equine Vet J 2021;53:469–480.
  25. Murray RC, Werpy N. Image interpretation and artefacts.. Equine MRI Chichester, UK: John Wiley & Sons Ltd; 2010. p. 101–145.
  26. Rutt BK, Lee DH. The impact of field strength on image quality in MRI.. J Magn Reson Imaging 1996;6:57–62.
  27. Magee T, Shapiro M, Williams D. Comparison of high‐field‐strength versus low‐field‐strength MRI of the shoulder.. Am J Roentgenol 2003;181:1211–1215.
  28. Tung GA, Entzian D, Green A, Brody JM. High‐field and low‐field MR imaging of superior glenoid labral tears and associated tendon injuries.. Am J Roentgenol 2000;174:1107–1114.
  29. Doll CU, von Pueckler K, Offhaus J, Berner D, Burk J. Characterization of equine chronic tendon lesions in low‐ and high‐field magnetic resonance Imaging.. Vet Sci 2022;9(6):297.
  30. 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;165:281–288.
  31. Werpy NM, Ho CP, Pease AP, Kawcak CE. The effect of sequence selection and field strength on detection of osteochondral defects in the metacarpophalangeal joint.. Vet Radiol Ultrasound 2011;52:154–160.
  32. Werpy NM, Ho CP, Kawcak CE. Magic angle effect in normal collateral ligaments of the distal interphalangeal joint in horses imaged with a high‐field magnetic resonance imaging system.. Vet Radiol Ultrasound 2010;51:2–10.
  33. Busoni V, Snaps F. Effect of deep digital flexor tendon orientation on magnetic resonance imaging signal intensity in isolated equine limbs‐the magic angle effect.. Vet Radiol Ultrasound 2002;43:428–430.
  34. Spriet M, Zwingenberger A. Influence of the position of the foot on MRI signal in the deep digital flexor tendon and collateral ligaments of the distal interphalangeal joint in the standing horse.. Equine Vet J 2009;41:498–503.
  35. Omoumi P, Mourad C, Ledoux JB, Hilbert T. Morphological assessment of cartilage and osteoarthritis in clinical practice and research: intermediate‐weighted fat‐suppressed sequences and beyond.. Skeletal Radiol 2023;52:2185–2198.
  36. Werpy NM, Ho CP, Garcia EB, Kawcak CE. The effect of varying echo time using T2‐weighted FSE sequences on the magic angle effect in the collateral ligaments of the distal interphalangeal joint in horses.. Vet Radiol Ultrasound 2013;54:31–35.
  37. Werpy NM. Magnetic resonance Imaging of the equine patient: a comparison of high‐ and low‐field systems.. Clin Tech Equine Pract 2007;6:37–45.
  38. Labens R, Schramme MC, Murray RC, Bolas N. Standing low‐field MRI of the equine proximal metacarpal/metatarsal region is considered useful for diagnosing primary bone pathology and makes a positive contribution to case management: a prospective survey study.. Vet Radiol Ultrasound 2020;61:197–205.
  39. Recht MP, White LM, Fritz J, Resnick DL. Advances in musculoskeletal Imaging: recent developments and predictions for the future.. Radiology 2023;308:e230615.
  40. Bolen G, Audigié F, Spriet M, Vandenberghe F, Busoni V. Qualitative comparison of 0.27 T, 1.5 T, and 3 T magnetic resonance images of the normal equine foot.. J Equine Vet Sci 2010;30:9–20.
  41. Sherlock CE, Mair TS, Ireland J, Blunden T. Do low field magnetic resonance imaging abnormalities correlate with macroscopical and histological changes within the equine deep digital flexor tendon?. Res Vet Sci 2015;98:92–97.
  42. Mair TS, 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;46:458–466.
  43. Gutierrez‐Nibeyro S, Werpy N, White N II. Standing low‐field magnetic resonance imaging in horses with chronic foot pain.. Aust Vet J 2012;90(3):75–83.
    doi: 10.1111/j.1751-0813.2011.00875.xgoogle scholar: lookup
  44. Holowinski M, Judy C, Saveraid T, Maranda L. Resolution of lesions on STIR images is associated with improved lameness status in horses.. Vet Radiol Ultrasound 2010;51:479–484.
  45. Vanel M, Olive J, Gold S, Mitchell RD, Walker L. Clinical significance and prognosis of deep digital flexor tendinopathy assessed over time using MRI.. Vet Radiol Ultrasound 2012;53:621–627.
  46. Parkes R, Newton R, Dyson S. Is there an association between clinical features, response to diagnostic analgesia and radiological findings in horses with a magnetic resonance imaging diagnosis of navicular disease or other injuries of the podotrochlear apparatus?. Vet J 2015;204:40–46.
  47. Barr AR, Dyson SJ, Barr FJ, O'Brien JK. Tendonitis of the deep digital flexor tendon in the distal metacarpal/metatarsal region associated with tenosynovitis of the digital sheath in the horse.. Equine Vet J 1995;27:348–355.
  48. de Zani D, Polidori C, di Giancamillo M, Zani DD. Correlation of radiographic measurements of structures of the equine foot with lesions detected on magnetic resonance imaging.. Equine Vet J 2016;48:165–171.
  49. Holroyd K, Dixon JJ, Mair T, Bolas N, Bolt DM, David F. Variation in foot conformation in lame horses with different foot lesions.. Vet J 2013;195:361–365.
  50. Busoni V, Heimann M, Trenteseaux J, Snaps F, Dondelinger RF. 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;46:279–286.
  51. Hewitt‐Dedman CL, Biggi M, Van Zadelhoff C, Schwarz T, Reardon RJM, Taylor SE. Imaging findings and clinical outcome of foot pain attributable to insertional deep digital flexor tendon injury and/or fluid signal within the flexor surface of the distal phalanx.. Equine Vet Educ 2021;34(10):e422–e430.
  52. Arensburg L, Wilderjans H, Simon O, Dewulf J, Boussauw B. Nonseptic tenosynovitis of the digital flexor tendon sheath caused by longitudinal tears in the digital flexor tendons: a retrospective study of 135 tenoscopic procedures.. Equine Vet J 2011;43:660–668.
  53. Wilderjans H, Boussauw B, Madder K, Simon O. Tenosynovitis of the digital flexor tendon sheath and annular ligament constriction syndrome caused by longitudinal tears in the deep digital flexor tendon: a clinical and surgical report of 17 cases in warmblood horses.. Equine Vet J 2003;35:270–275.
  54. Smith MR, Wright IM. Noninfected tenosynovitis of the digital flexor tendon sheath: a retrospective analysis of 76 cases.. Equine Vet J 2006;38:134–141.
  55. Cender AN, Mahlmann K, Ehrle A, Merle R, Pieper L, Lischer CJ. Diagnosis and outcome following tenoscopic surgery of the digital flexor tendon sheath in German sports and pleasure horses.. Equine Vet J 2023;55:48–58.
  56. Birch HL, Bailey JV, Bailey AJ, Goodship AE. Age‐related changes to the molecular and cellular components of equine flexor tendons.. Equine Vet J 1999;31(5):391–396.
  57. Harrison SM, Whitton RC, Kawcak CE, Stover SM, Pandy MG. Relationship between muscle forces, joint loading and utilization of elastic strain energy in equine locomotion.. J Exp Biol 2010;213:3998–4009.
  58. O'Brien C, Marr N, Thorpe C. Microdamage in the equine superficial digital flexor tendon.. Equine Vet J 2021;53:417–430.
  59. Dahlgren LA, Brower‐Toland BD, Nixon AJ. Cloning and expression of type III collagen in normal and injured tendons of horses.. Am J Vet Res 2005;66:266–270.
  60. Jacobson E, Dart AJ, Mondori T, Horadogoda N, Jeffcott LB, Little CB. Focal experimental injury leads to widespread gene expression and histologic changes in equine flexor tendons.. PLoS One 2015;10:e0122220.
  61. Smith RKW, Birch HL, Goodman S, Heingård D, Goodship AE. The influence of ageing and exercise on tendon growth and degeneration—hypotheses for the initiation and prevention of strain‐induced tendinopathies.. Comp Biochem Physiol A Mol Integr Physiol 2002;133:1039–1050.
  62. Zeugolis DI, Chan JCY, Pandit A. Tendons: engineering of functional tissues.. Tissue Engineering Berlin: Springer; 2011. p. 537–572.
    doi: 10.1007/978-3-642-02824-3_25google scholar: lookup
  63. Birch HL, Smith TJ, Poulton C, Peiffer D, Goodship AE. Do regional variations in flexor tendons predispose to site‐specific injuries?. Equine Vet J 2002;34(S34):288–292.
  64. Birch HL, Bailey AJ, Goodship AE. Macroscopic ‘degeneration’ of equine superficial digital flexor tendon is accompanied by a change in extracellular matrix composition.. Equine Vet J 1998;30:534–539.
  65. 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.
  66. Johnson SA, Valdes‐Martinez A, Turk PJ, McIlwraith CW, Barrett MF, McGilvray KC. Longitudinal tendon healing assessed with multi‐modality advanced imaging and tissue analysis.. Equine Vet J 2021;54(4):766–781.
  67. Murray RC, Blunden TS, Schramme MC, Dyson SJ. How does magnetic resonance imaging represent histologic findings in the equine digit?. Vet Radiol Ultrasound 2006;47:17–31.
  68. Karjalainen PT, Soila K, Aronen HJ, Pihlajamäki HK, Tynninen O, Paavonen T. MR imaging of overuse injuries of the Achilles tendon.. Am J Roentgenol 2000;175:251–260.
  69. Haims AH, Schweitzer ME, Patel RS, Hecht P, Wapner KL. MR imaging of the Achilles tendon: overlap of findings in symptomatic and asymptomatic individuals.. Skeletal Radiol 2000;29:640–645.
  70. Berner D, Brehm W, Gerlach K, Offhaus J, Scharner D, Burk J. Variation in the MRI signal intensity of naturally occurring equine superficial digital flexor tendinopathies over a 12‐month period.. Vet Rec 2020;187:e53.
  71. Schick F, Dammann F, Lutz O, Claussen CD. Adapted techniques for clinical MR imaging of tendons.. Magn Reson Mater Phys Biol Med 1995;3:103–107.
  72. Doll CU, Bohner M, Berner D, Buettner K, Horstmeier C, Winter K. Approaches to standardising the magnetic resonance image analysis of equine tendon lesions.. Vet Rec Open 2023;10:e257.
  73. Schramme M, Kerekes Z, Hunter S, Labens R. MR imaging features of surgically induced core lesions in the equine superficial digital flexor tendon.. Vet Radiol Ultrasound 2010;51:280–287.
  74. Dakin SG, Dudhia J, Smith RK. Resolving an inflammatory concept: the importance of inflammation and resolution in tendinopathy.. Vet Immunol Immunopathol 2014;158:121–127.
  75. Crass JR, Genovese RL, Render JA, Bellon EM. Magnetic resonance, ultrasound and histopathologic correlation of acute and healing equine tendon injuries.. Vet Radiol Ultrasound 2005;33:206–216.
  76. Smith RKW. Treatment of tendinopathies.. Equine Vet Educ 2024;36(12):659–672.
    doi: 10.1111/eve.13987google scholar: lookup
  77. Williams IF, McCullagh KG, Goodship AE, Silver IA. Studies on the pathogenesis of equine tendonitis following collagenase injury.. Res Vet Sci 1984;36:326–338.
  78. Schramme M, Hunter S, Campbell N, Blikslager A, Smith R. A surgical tendonitis model in horses: technique, clinical, ultrasonographic and histological characterisation.. Vet Comp Orthop Traumatol 2010;23:231–239.
  79. Watts AE, Nixon AJ, Yeager AE, Mohammed HO. A collagenase gel/physical defect model for controlled induction of superficial digital flexor tendonitis.. Equine Vet J 2012;44:576–586.
  80. Fu SC, Rolf C, Cheuk YC, Lui PP, Chan K‐M. Deciphering the pathogenesis of tendinopathy: a three‐stages process.. Sports Med Arthrosc Rehabil Ther Technol 2010;2:30.
  81. Meeremans M, Van de Walle GR, Van Vlierberghe S, De Schauwer C. The lack of a representative tendinopathy model hampers fundamental mesenchymal stem cell research.. Front Cell Dev Biol 2021;9:651164.
    doi: 10.3389/fcell.2021.651164google scholar: lookup
  82. Luo J, Wang Z, Tang C, Yin Z, Huang J, Ruan D. Animal model for tendinopathy.. J Orthop Translat 2023;42:43–56.
  83. Karlin WM, Stewart AA, Durgam SS, Naughton JF, O'Dell‐Anderson KJ, Stewart MC. Evaluation of experimentally induced injury to the superficial digital flexor tendon in horses by use of low‐field magnetic resonance imaging and ultrasonography.. Am J Vet Res 2011;72:791–798.
  84. Smith R, McIlwraith W, Schweitzer R, Kadler K, Cook J, Caterson B. Advances in the understanding of tendinopathies: a report on the Second Havemeyer Workshop on equine tendon disease.. Equine Vet J 2014;46(1):4–9.
  85. Khan MR, Dudhia J, David FH, De Godoy R, Mehra V, Hughes G. Bone marrow mesenchymal stem cells do not enhance intra‐synovial tendon healing despite engraftment and homing to niches within the synovium.. Stem Cell Res Ther 2018;9:169.
  86. Khan MR, Smith RK, David F, Lam R, Hughes G, De Godoy R. Evaluation of the effects of synovial multipotent cells on deep digital flexor tendon repair in a large animal model of intra‐synovial tendinopathy.. J Orthop Res 2020;38:128–138.
  87. Milner PI, Sidwell S, Talbot AM, Clegg PD. Short‐term temporal alterations in magnetic resonance signal occur in primary lesions identified in the deep digital flexor tendon of the equine digit.. Equine Vet J 2012;44:157–162.
  88. Sampson SN, Schneider RK, Gavin PR. Magnetic resonance imaging findings in horses with recent and chronic bilateral forelimb lameness diagnosed as navicular syndrome.. Proc Am Assoc Equine Practnrs 2008;54:419–434.
  89. Biggi M, Dyson S. Hind foot lameness: results of magnetic resonance imaging in 38 horses (2001–2011).. Equine Vet J 2013;45:427–434.
  90. Schramme MC. Deep digital flexor tendonopathy in the foot.. Equine Vet Educ 2011;23:403–415.
  91. Murray RC, Schramme MC, Dyson SJ, Branch MV, Blunden TS. Magnetic resonance imaging characteristics of the foot in horses with palmar foot pain and control horses.. Vet Radiol Ultrasound 2006;47:1–16.
  92. 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;39:340–343.
  93. Witte S, Dedman C, Harriss F, Kelly G, Chang Y‐M, Witte TH. Comparison of treatment outcomes for superficial digital flexor tendonitis in National Hunt racehorses.. Vet J 2016;216:157–163.
  94. Tamura N, Kodaira K, Yoshihara E, Mae N, Yamazaki Y, Mita H. A retrospective cohort study investigating risk factors for the failure of thoroughbred racehorses to return to racing after superficial digital flexor tendon injury.. Vet J 2018;235:42–46.
  95. Nicholson CW, Berlet GC, Lee TH. Prediction of the success of nonoperative treatment of insertional Achilles tendinosis based on MRI.. Foot Ankle Int 2007;28:472–477.
  96. Byrne CA, Voute LC, Marshall JF. Interobserver agreement during clinical magnetic resonance imaging of the equine foot.. Equine Vet J 2024;57(2):406–418.
    doi: 10.1111/evj.14126google scholar: lookup
  97. ELKhamary AN, Keenihan EK, Schnabel LV, Redding WR, Schumacher J. Leveraging MRI characterization of longitudinal tears of the deep digital flexor tendon in horses using machine learning.. Vet Radiol Ultrasound 2022;63:580–592.
  98. Kent AV, Chesworth MJ, Wells G, Gerdes C, Bladon BM, Smith RKW. Improved diagnostic criteria for digital flexor tendon sheath pathology using contrast tenography.. Equine Vet J 2020;52:205–212.
  99. Smith MRW, Wright IM. Endoscopic evaluation of the navicular bursa: observations, treatment and outcome in 92 cases with identified pathology.. Equine Vet J 2012;44:339–345.
  100. Giorio ME, Graham RJ, Berner D, O'Neill HD, Bladon BM. Presence and size of synovial masses within the navicular bursa correlate well between magnetic resonance imaging and bursoscopy and have a guarded prognosis.. Equine Vet J 2024;56:982–988.
  101. Murray RC, Roberts BL, Schramme MC, Dyson SJ, Branch M. Quantitative evaluation of equine deep digital flexor tendon morphology using magnetic resonance imaging.. Vet Radiol Ultrasound 2004;45:103–111.
  102. Hoaglund EL, Barrett MF. Magnetic resonance imaging changes of the navicular bursa following navicular bursoscopy in seven horses.. Equine Vet Educ 2020;33:531–538.
  103. 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.
  104. Janvier V, Olive J, Rossier Y. Magnetic resonance assessment of the equine distal phalanx facies flexoria.. J Equine Vet Sci 2017;53:116–122.
  105. Spriet M, Murphy B, Vallance SA, Vidal MA, Whitcomb MB, Wisner ER. Magic angle magnetic resonance imaging of diode laser induced and naturally occurring lesions in equine tendons.. Vet Radiol Ultrasound 2012;53:394–401.
  106. Berner D, Mader D, Gross C, Gerlach K. Effect of scan plane and arthrography on visibility and Interobserver agreement of the equine distal sesamoidean impar ligament on magnetic resonance images.. J Equine Vet Sci 2020;94:103227.
  107. Holowinski ME, Solano M, Maranda L, García‐López JM. Magnetic resonance imaging of navicular bursa adhesions.. Vet Radiol Ultrasound 2012;53:566–572.
  108. Bell CD, Howard RD, Taylor DS, Voss ED, Werpy NM. 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;234:920–925.
  109. Schramme M, Kerekes Z, Hunter S, Nagy K, Pease A. Improved identification of the palmar fibrocartilage of the navicular bone with saline magnetic resonance bursography.. Vet Radiol Ultrasound 2009;50:606–614.
  110. Maher MC, Werpy NM, Goodrich LR, McIlwraith CW. Positive contrast magnetic resonance bursography for assessment of the navicular bursa and surrounding soft tissues.. Vet Radiol Ultrasound 2011;52:385–393.
  111. Assmann A, Ohlerth S, Hartmann S, Torgerson P, Bischofberger A. Does direct MRI tenography improve the diagnostic performance of low‐field MRI to identify artificially created soft‐tissue lesions within the equine cadaveric digital flexor tendon sheath?. Animals (Basel) 2023;13(24):3772.
  112. Aßmann AD, Ohlerth S, Torgerson PR, Bischoberger AS. Sensitivity and specificity of 3 tesla magnetic resonance imaging and multidetector computed tomographic tenography to identify artificially induced soft tissue lesions in the equine cadaveric digital flexor tendon sheath.. Equine Vet Educ 2022;35(7):e507–e516.
  113. van Veggel ECS, Selberg KT, van der Velde‐Hoogelander B, Vanderperren K, Cokelaere SM, Bergman H‐J. Deep digital flexor tendon injury at the level of the proximal phalanx in frontlimbs with tendon sheath distension characterized by standing low‐field magnetic resonance imaging in horses: 13 cases (2015–2021).. Front Vet Sci 2021;8:734729.
  114. Fortier LA, Nixon AJ, Ducharme NG, Mohammed HO, Yeager A. Tenoscopic examination and proximal annular ligament desmotomy for treatment of equine “complex” digital sheath tenosynovitis.. Vet Surg 1999;28:429–435.
  115. Caspers MK, Gier CJ, Reesink HL. Equine non‐septic tenosynovitis: a systematic literature review of site‐specific pathological lesions, outcomes and surgical complications.. Equine Vet J 2024;56:842–857.
  116. Thünker F, Oosterlinck M, Vanderperren K, Martens A. Long‐term results of tenoscopic treatment of lesions in the digital flexor tendon sheath: a retrospective study of fifty horses.. Vlaams Diergeneeskd Tijdschr 2019;88:9–18.
  117. Werpy NM. Recheck magnetic resonance imaging examinations for evaluation of musculoskeletal injury.. Vet Clin North Am Equine Pract 2012;28:659–680.
  118. Barrett MF, Frisbie DD, King MR, Werpy NM, Kawcak CE. A review of how magnetic resonance imaging can aid in case management of common pathological conditions of the equine foot.. Equine Vet Educ 2016;29:683–693.
  119. Whitcomb MB. How to perform a complete ultrasonographic evaluation of the pastern.. Proceedings Am Assoc Equine Pract, Lexington, KY, USA 2005. p. 465–472.
  120. Bolen G, Busoni V, Jacqmot O, Snaps F. Sonographic anatomy of the palmarodistal aspect of the equine digit.. Vet Radiol Ultrasound 2007;48:270–275.
  121. Sage AM, Turner TA. Ultrasonography of the soft tissue structures of the equine foot.. Equine Vet Educ 2010;14:221–224.
  122. Busoni V, Denoix JM. Ultrasonography of the podotrochlear apparatus in the horse using a transcuneal approach: technique and reference images.. Vet Radiol Ultrasound 2001;42:534–540.
  123. Porter EG, Werpy NM. New concepts in standing advanced diagnostic equine Imaging.. Vet Clin North Am Equine Pract 2014;30(1):239–268.
    doi: 10.1016/j.cveq.2013.11.001google scholar: lookup
  124. Jones AR, Ragle CA, Mattoon JS, Sanz MG. Use of non‐contrast‐enhanced computed tomography to identify deep digital flexor tendinopathy in horses with lameness: 28 cases (2014–2016).. J Am Vet Med Assoc 2019;254(7):852–858.
    doi: 10.2460/javma.254.7.852google scholar: lookup
  125. Lin S‐T, Peter VG, Schiavo S, Pokora R, Patrick H, Bolas N. Identification of heterotopic mineralization and adjacent pathology in the equine fetlock region by low‐field magnetic resonance imaging, cone‐beam and fan‐beam computed tomography.. J Equine Vet Sci 2023;126:104252.
  126. O'Brien EJ, Smith RK. Mineralization can be an incidental ultrasonographic finding in equine tendons and ligaments.. Vet Radiol Ultrasound 2018;59:613–623.
  127. Van Hamel S, Bergman H, Puchalski S, 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;46(3):300–305.
    doi: 10.1111/evj.12129google scholar: lookup
  128. Puchalski SM, Galuppo LD, Drew CP, Wisner ER. Use of contrast‐enhanced computed tomography to assess angiogenesis in deep digital flexor tendonopathy in a horse.. Vet Radiol Ultrasound 2009;50:292–297.
  129. Curtiss AL, Ortved KF, Dallap‐Schaer B, Gouzeev S, Stefanovski D, Richardson DW. Validation of standing cone beam computed tomography for diagnosing subchondral fetlock pathology in the thoroughbred racehorse.. Equine Vet J 2021;53:510–523.
  130. Stewart HL, Siewerdsen JH, Selberg KT, Bills KW, Kawcak CE. Cone‐beam computed tomography produces images of numerically comparable diagnostic quality for bone and inferior quality for soft tissues compared with fan‐beam computed tomography in cadaveric equine metacarpophalangeal joints.. Vet Radiol Ultrasound 2023;64:1033–1036.
  131. Pauwels F, Hartmann A, Alawneh J, Wightman P, Saunders J. Contrast enhanced computed tomography findings in 105 horse distal extremities.. J Equine Vet Sci 2021;104:103704.
  132. Pauwels FE, Van der Vekens E, Christan Y, Koch C, Schweizer D. Feasibility, indications, and radiographically confirmed diagnoses of standing extremity cone beam computed tomography in the horse.. Vet Surg 2021;50:365–374.
  133. Nelson BB, Goodrich LR, Barrett MF, Grinstaff MW, Kawcak CE. Use of contrast media in computed tomography and magnetic resonance imaging in horses: techniques, adverse events and opportunities.. Equine Vet J 2017;49(4):410–424.
  134. Pauwels FAB, Lumsden J. Diagnostic utility of 123 distal extremity intravenous contrast enhanced computed tomography examinations in the horse.. European Veterinary Diagnostic Imaging (ECVDI) Congress Athens, Greece; 2024. p. 20.
  135. Shanklin AJ, Baldwin CM, Ellesmere L, Stack JD. Computed tomographic contrast tenography aids pre‐operative diagnosis in clinical conditions of the digital flexor tendon sheath.. Equine Vet Educ 2023;36:197–205.
  136. Wilson S, Spriet M, Mur PE, Anishchenko S, Beylin D, Katzman S. (18) Fluorine‐fluorodeoxyglucose positron emission tomography for assessment of deep digital flexor tendinopathy: an exploratory study in eight horses with comparison to CT and MRI.. Vet Radiol Ultrasound 2021;62:610–620.
  137. Mann K, Hart J, Duerr F. 18F‐FDG positron emission tomography—an innovative technique for the diagnosis of a canine lameness.. Front Vet Sci 2016;3:45.
    doi: 10.3389/fvets.2016.00045google scholar: lookup
  138. Kleinrensink NJ, Foppen W, Ten Katen I, van der Veen PH, de Klerk B, Diepstraten SCE. Comparison of the heel enthesitis MRI scoring system (HEMRIS) with clinical enthesitis and local metabolic activity on PET‐CT.. RMD Open 2020;6:1–9.
  139. Frank I, Mann K, Duerr F. Fluorine‐18‐fluoro‐2‐deoxy‐d‐glucose PET‐CT aids in detection of soft‐tissue injuries for dogs with thoracic or pelvic limb lameness.. Vet Radiol Ultrasound 2019;60:575–585.
  140. Pige C, Spriet M, Perez‐Nogues M, Katzman S, Le Jeune S, Galuppo L. Comparison of (18)F‐sodium fluoride positron emission tomography and computed tomography for imaging of the fetlock in 25 nonracehorses.. Equine Vet J 2024;56:1008–1018.
  141. Spriet M, Arndt S, Pige C, Pye J, O'Brion J, Carpenter R. Comparison of skeletal scintigraphy and standing (18) F‐NaF positron emission tomography for imaging of the fetlock in 33 thoroughbred racehorses.. Vet Radiol Ultrasound 2023;64:123–130.
  142. Spriet M, Espinosa‐Mur P, Kyme AZ, Stepanov P, Zavarzin V, Schaeffer S. (18) F‐sodium fluoride positron emission tomography of the racing thoroughbred fetlock: validation and comparison with other imaging modalities in nine horses.. Equine Vet J 2019;51:375–383.
  143. Spriet M, Espinosa P, Kyme AZ, Stepanov P, Zavarzin V, Schaeffer S. Positron emission tomography of the equine distal limb: exploratory study.. Vet Radiol Ultrasound 2016;57:630–638.
  144. Spriet M. Positron emission tomography: a horse in the musculoskeletal imaging race.. Am J Vet Res 2022;83(7).
    doi: 10.2460/ajvr.22.03.0051google scholar: lookup
  145. Kim du H, Sung DH, Ga HY, Choi JY. Metabolic patterns of the shoulder joint on (18)F‐fluorodeoxyglucose positron emission tomography/computed tomography in adhesive capsulitis.. Ann Nucl Med 2014;28:136–144.
  146. Eliasson P, Couppe C, Lonsdale M, Svensson RB, Neergaard C, Kjaer M. Ruptured human Achilles tendon has elevated metabolic activity up to 1 year after repair.. Eur J Nucl Med Mol Imaging 2016;43:1868–1877.
  147. Rauscher I, Beer AJ, Schaeffeler C, Souvatzoglou M, Crönlein M, Kirchhoff C. Evaluation of 18F‐fluoride PET/MR and PET/CT in patients with foot pain of unclear cause.. J Nucl Med 2015;56:430–435.
  148. Pye J, Spriet M, O'Brion J, Carpenter R, Blea JA, Dowd JP. Longitudinal monitoring of fetlock lesions in thoroughbred racehorses using standing 18F‐sodium fluoride positron emission tomography.. Am J Vet Res 2022;83(10):ajvr.22.03.0062.
  149. Moller M, Kalebo P, Tidebrant G, Movin T, Karlsson J. The ultrasonographic appearance of the ruptured Achilles tendon during healing: a longitudinal evaluation of surgical and nonsurgical treatment, with comparisons to MRI appearance.. Knee Surg Sports Traumatol Arthrosc 2002;10:49–56.
  150. Pownder SL, Hayashi K, Lin BQ, Meyers KN, Caserto BG, Breighner RE. Differences in the magnetic resonance imaging parameter T2* may be identified during the course of canine patellar tendon healing: a pilot study.. Quant Imaging Med Surg 2021;11:1234–1246.
  151. Xie Y, Liu S, Qu J, Wu P, Tao H, Chen S. Quantitative magnetic resonance imaging UTE‐T2* mapping of tendon healing after arthroscopic rotator cuff repair: a longitudinal study.. Am J Sports Med 2020;48:2677–2685.
  152. Bachmann E, Rosskopf AB, Gotschi T, Klarhöfer M, Deligianni X, Hilbe M. T1‐ and T2*‐mapping for assessment of tendon tissue biophysical properties: a phantom MRI study.. Invest Radiol 2019;54:212–220.
  153. Grosse U, Springer F, Hein T, Grözinger G, Schabel C, Martirosian P. Influence of physical activity on T1 and T2* relaxation times of healthy Achilles tendons at 3T.. J Magn Reson Imaging 2015;41:193–201.
  154. Breda SJ, de Vos RJ, Poot DHJ, Krestin GP, Hernandez‐Tamames JA, Oei EHG. Association between T(2)(*) relaxation times derived from ultrashort echo time MRI and symptoms during exercise therapy for patellar tendinopathy: a large prospective study.. J Magn Reson Imaging 2021;54:1596–1605.
  155. Brinkhof S, Te Moller N, Froeling M, Brommer H, van Weeren R, Ito K. T2* mapping in an equine articular groove model: visualizing changes in collagen orientation.. J Orthop Res 2020;38:2383–2389.
  156. Hayashi D, Roemer FW, Tol JL, Heiss R, Crema MD, Jarraya M. Emerging quantitative Imaging techniques in sports medicine.. Radiology 2023;308:e221531.
  157. Zellers JA, Edalati M, Eekhoff JD, McNish R, Tang SY, Lake SP. Quantative MRI predicts tendon mechanical behavior, collagen composition, and organization.. J Orthop Res 2023;41:2329–2338.
  158. Dyson SJ, Murray R, Schramme MC. Lameness associated with foot pain: results of magnetic resonance imaging in 199 horses (January 2001–December 2003) and response to treatment.. Equine Vet J 2005;37:113–121.

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