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Home / Equine Research Bank / Equine Vet J / Presence and size of synovial masses within the navicular bu...
Equine veterinary journal2023; doi: 10.1111/evj.14040

Presence and size of synovial masses within the navicular bursa correlate well between magnetic resonance imaging and bursoscopy and have a guarded prognosis.

Abstract: Focal hyperintense lesions within the navicular bursa emanating from the dorsal border of the deep digital flexor tendon (DDFT) can be recognised on T1-weighted magnetic resonance images (MRI) and have been attributed to lameness in horses. Removal of these lesions, also referred to as synovial masses, by navicular bursoscopy is currently recommended. Objective: To investigate the correlation between MRI and navicular bursoscopic findings. It is hypothesised that the prognosis following surgery is proportional to the size of the DDFT lesion. Methods: Retrospective analysis of clinical records. Methods: Horses undergoing standing low-field MRI and navicular bursoscopy with >1 year follow-up were included. A grading system was developed to classify the size of synovial mass(es) and lesion(s) of the DDFT on MRI and at surgery. Generalised estimating equations were used to evaluate the association between MRI findings and surgery and between outcome and severity of the tendon injury. Results: Fifty-nine horses presenting over a 15-year period (2006-2021) fulfilled inclusion criteria. Ninety navicular bursae were examined both on MRI and endoscopically. There was strong correlation between the size of synovial masses and tendon lesions on MRI and bursoscopy (p < 0.001, OR: 25.61, 95% CI 8.71-75.29 and p < 0.001, OR: 7.34, 95% CI 2.70-19.92, respectively). Size of tendon lesion and synovial mass had no impact on prognosis (p = 0.3, OR: 1, 95% CI 1-1 and p = 0.1, OR: 1, 95% CI 1-1, respectively), which was guarded (30.5% return to previous level of exercise). Conclusions: Performance data for conservatively treated horses with MRI-detected synovial masses was not considered, nor was the effect of navicular bursal effusion. Horses were not randomly assigned to treatment protocols. Conclusions: There is good correlation between MRI and bursoscopic findings of DDFT lesions and synovial masses within the navicular bursa, with no false positives. Size of the synovial masses and DDFT lesions does not influence prognosis following navicular bursoscopy. Unassigned: Fokale hyperintense Läsionen in der Bursa podotrochlearis, die vom dorsalen Rand der tiefen Beugesehne (TBS) ausgehen, können auf T1-gewichteten Magnetresonanztomographiebildern (MRT) erkannt werden und wurden mit Lahmheit bei Pferden in Verbindung gebracht. Die Entfernung dieser Läsionen, auch als Synovialmassen bezeichnet, durch Bursoskopie der Bursa podotrochlearis wird derzeit empfohlen. Unassigned: Untersuchung der Korrelation zwischen Befunden in der MRT Untersuchung und der Bursoskopie der Bursa podotrochlearis. Es wird vermutet, dass die Prognose nach der Operation proportional zur Größe der TBS-Läsion ist. Methods: Retrospektive Analyse. Methods: Pferde, die eine stehende Niederfeld-MRT Untersuchung und Bursoskopie der Bursa podotrochlearis mit mehr als einem Jahr Follow-up durchliefen, wurden eingeschlossen. Ein Graduierungssystem wurde entwickelt, um die Größe der Synovialmasse(n) und Läsion(en) der TBS auf den MRT Bildern und bei der Operation zu klassifizieren. Generalisierte Schätzgleichungen wurden verwendet, um die Assoziation zwischen MRT- und Operationsbefunden sowie zwischen Prognose und Schwere der Sehnenverletzung zu bewerten. Results: Neunundfünfzig Pferde, die über einen Zeitraum von 15 Jahren (2006-2021) vorgestellt wurden, erfüllten die Kriterien. Neunzig Bursae podotrochlearis wurden sowohl im MRT als auch endoskopisch untersucht. Es gab eine starke Korrelation zwischen der Größe der Synovialmassen und Sehnenläsionen im MRT und der Bursoskopie (P < 0,001, Odds-Ratio = 25,61 mit 95% Konfidenzintervallen (KI) bzw. P < 0,001, Odds-Ratio = 7,34 mit 95% KI). Die Größe der Sehnenläsion und Synovialmasse hatte keinen Einfluss auf die Prognose (P = 0,3, Odds-Ratio: 1, 95% KI und P = 0,1, Odds-Ratio: 1, 95% KI), die vorsichtig war (30,5% Rückkehr zum vorherigen Leistungsniveau). WICHTIGSTE EINSCHRÄNKUNGEN: Leistungsdaten für konservativ behandelte Pferde mit MRT-detektierten Synovialmassen wurden nicht berücksichtigt, ebenso wenig wie der Effekt von einer vermehrten Füllung der Bursa podotrochlearis. Pferde wurden nicht zufällig den Behandlungsprotokollen zugewiesen. Unassigned: Es besteht eine gute Korrelation zwischen MRT- und bursoskopischen Befunden von TBS-Läsionen und Synovialmassen in der Bursa podotrochlearis, ohne falsch positive Ergebnisse. Die Größe der Synovialmassen und TBS-Läsionen beeinflusst die Prognose nach der Bursoskopie der Bursa podotrochlearis nicht.
© 2023 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2023-12-22 PubMed ID: 38131123DOI: 10.1111/evj.14040Google Scholar: Lookup
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Summary

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The research investigates the relationship between MRI and bursoscopy findings in identifying synovial masses and DDFT lesions within the navicular bursa in horses. Although there is a strong correlation between the two diagnostic methods, the size of the synovial masses and DDFT lesions does not affect the prognosis after navicular bursoscopy.

Methodology and Sample

  • The study is a retrospective analysis of clinical records of 59 horses over a 15-year period between 2006 and 2021.
  • All the horses had undergone standing low-field MRI and navicular bursoscopy with a follow-up of more than a year.
  • A grading system was formulated to classify the size of the synovial mass and lesions on MRI and at surgery.
  • Generalised estimating equations were used to assess the association between the diagnosis from MRI scans, surgical findings and the outcome severity of the tendon injury.

Findings

  • Ninety navicular bursae were analyzed both on MRI and endoscopically.
  • The investigators discovered a strong correlation between MRI findings and bursoscopy when determining the size of synovial masses and tendon lesions.
  • The predictor variables for this strong correlation were p < 0.001, OR: 25.61, 95% CI 8.71-75.29 and p < 0.001, OR: 7.34, 95% CI 2.70-19.92 respectively.
  • However, the size of the synovial masses or DDFT lesions didn’t have an impact on the prognosis. This was indicated by a probability of 0.3 and odds ratio of 1.
  • Post-surgical prognosis was guarded with only 30.5% of horses returning to their previous level of exercise.

Research Limitations

  • Data for conservatively-treated horses with MRI-detected synovial masses was not considered.
  • The effect of navicular bursal effusion was also not included in the study.
  • The horses were not randomly assigned to different treatment protocols. This might impact the accuracy and integrity of the results.

Conclusions

  • There is a strong correlation between the MRI and bursoscopy findings of DDFT lesions and synovial masses within the navicular bursa.
  • However, the size of the synovial masses and DDFT lesions does not influence the prognosis after the navicular bursoscopy.
  • Further research may involve a larger sample size and consider other variables for a more comprehensive study.

Cite This Article

APA
Giorio ME, Graham RJ, Berner D, O'Neill HD, Bladon BM. (2023). 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. https://doi.org/10.1111/evj.14040

Publication

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

Researcher Affiliations

Giorio, Maria Elisabetta
  • Equine Referral Hospital, Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK.
Graham, Robyn J
  • Equine Hospital, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK.
Berner, Dagmar
  • Equine Referral Hospital, Department of Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK.
O'Neill, Henry D
  • Donnington Grove Veterinary Group, Berkshire, UK.
Bladon, Bruce M
  • Donnington Grove Veterinary Group, Berkshire, UK.

References

This article includes 23 references
  1. Schramme MC. Deep digital flexor tendinopathy in the foot. Equine Vet Educ 2011;23(8):403-415.
  2. 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.
  3. Dyson S, Murray R, Schramme M. 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.
  4. Widmer WR, Buckwalter KA, Fessler JF, Hill MA, VanSickle DC, Ivancevich S. Use of radiography, computed tomography and magnetic resonance imaging for evaluation of navicular syndrome in the horse. Vet Radiol Ultrasound 2000;41:108-116.
  5. Mair TS, Kinns JEN. 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.
  6. 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.
  7. 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.
  8. 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.
  9. Whitton R, Buckley C, Donovan T, Wales AD, Dennis R. The diagnosis of lameness associated with distal limbpathology in a horse: a comparison of radiography, computed tomography and magnetic resonance imaging. Vet J 1998;155:223-229.
  10. 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.
  11. Smith MRW, Wright IM, Smith RKW. 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.
  12. Cillán-García E, Milner PI, Talbot A, Ticker 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(3):70.
  13. 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.
  14. Van Veggel ECS, Selberg KT, van Der Velde-Hoogelander B, Vanderperren K, Cokelaere S, Bergman HJ. Deep digital flexor tendon injury at the level of the proximal phalanx in front limbs with tendon sheath distension characterized by standing low-field magnetic resonance imaging in horses: 13 cases (2015-2021). Front Vet Sci 2021;8:734739.
  15. 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.
  16. Holowinski ME, Solano M, Maranda L, Garcia-Lopez JM. Magnetic resonance imaging of the navicular bursa adhesions. Vet Radiol Ultrasound 2012;53:566-572.
  17. Mair TS, Kinns J, Jones RD, Bolas NM. Magnetic resonance imaging of the distal limb of the standing horse. Equine Vet Educ 2005;17:74-78.
  18. Denoix J-M, Busoni V. Ultrasonography of joints and synovia. In: White NA, Moore JN, editors. Current techniques in equine surgery and lameness. 2nd ed. Philadelphia: WB Saunders; 1998. p. 643-654.
  19. McIlwraith CW, Nixon AJ, Wright IM. Bursoscopy. In: McIlwraith CW, Nixon AJ, Wright IM, editors. Diagnostic and surgical arthroscopy in the horse. 4th ed. Amsterdam: Elsevier; 2015. p. 387-406.
  20. Marsh CA, Schneider RK, Sampson SN, Roberts GD. Response to injection of the navicular bursa with corticosteroids and hyaluronan following high-field magnetic resonance imaging in horses with signs of navicular syndrom:101 cases (2000-2008). J Am Vet Med Assoc 2012;241(10):1353-1364.
  21. Hoaglund EL, Barrett MF. Magnetic resonance imaging changes of the navicular bursa following navicular bursoscopy in seven horses. Equine Vet Educ 2021;33(10):531-538.
  22. 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.
  23. 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.

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