The use of intrathecal analgesia and contrast radiography as preoperative diagnostic methods for digital flexor tendon sheath pathology.

This research paper explores the use of intrathecal analgesia and contrast radiography as diagnostic methods in horses for two types of tears in the digital flexor tendon sheath. The study finds that these methods provide valuable insights into the presence of these tears and can guide decisions on whether to pursue conservative or surgical treatment for lameness in horses.

Objective and Methodology

• The primary objective of the study was to assess the effectiveness of intrathecal analgesia and contrast radiography in diagnosing manica flexoria (MF) and deep digital flexor tendon (DDFT) tears in horses. Ultrasonography has been found to be less sensitive in diagnosing MF tears compared to marginal tears of the DDFT. This prompted the need for alternative or additional diagnostic tools.
• The study involved an analysis of case records for horses presented to a referral clinic over a seven year period. These horses underwent either intrathecal diagnostic analgesia alone or in combination with contrast radiography of the Digital Flexor Tendon Sheath (DFTS), followed by tenoscopy.

Results and Conclusions

• The study found that horses with DDFT tears were significantly more likely to respond positively to intrathecal analgesia compared to those with MF tears. This suggests that intrathecal analgesia can be an effective diagnostic technique for DDFT tears.
• Contrast radiography was found to be highly effective in predicting MF tears, with a sensitivity of 96% and specificity of 80%. This technique was less sensitive in predicting DDFT tears, albeit with a high specificity of 84%.
• The study therefore concludes that the use of intrathecal analgesia in combination with contrast radiography presents a highly effective diagnostic method for detecting MF tears within the DFTS. Despite lower sensitivity, contrast radiography also accurately predicts DDFT tears.
• The researchers conclude that performing contrast radiography at the same time as intrathecal analgesia provides useful information that can guide the decision-making process in whether to manage lameness conservatively or with tenoscopic evaluation.