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Veterinary surgery : VS2021; 51(2); 311-319; doi: 10.1111/vsu.13751

Ultrasound-guided tenoscopic decompression of digital sheath synoviocoeles in 10 horses.

Abstract: To report the diagnostic features and clinical outcome of horses with digital flexor tendon sheath (DFTS) synoviocoeles treated tenoscopically under ultrasonographic guidance. Methods: Retrospective case series. Methods: Client-owned horses (n = 10). Methods: Medical records were searched for horses with lameness localized to the region of the DFTS and clinical evidence of a fluid-filled mass (synoviocoele) associated with the DFTS. Diagnostic imaging and surgical findings, together with long-term outcome, were reported. Results: Lameness and synoviocoeles were unilateral (5 forelimbs, 5 hindlimbs; 3 lateral and 2 medial in both) and located proximal to the palmar/plantar annular ligament. Synoviocoeles had a firm consistency and focal pain with inability to deflate on non-weight-bearing examination. Intrathecal DFTS anesthesia was positive in 7/8 horses in which it was performed, with the remainder localized to the region of the synoviocoele using perineural and/or intralesional anesthesia. Communication between the DFTS and synoviocoele was suspected ultrasonographically in all cases and confirmed on contrast tenography (6/6). Tenoscopic fenestration of the communication between the DFTS and synoviocoele under ultrasonographic guidance, with treatment of concurrent intrathecal injury (4/10), resolved the lameness in all horses re-evaluated by a veterinarian (9/9) and allowed return to full athletic function in all cases at long-term follow up (median 5 years; range 1.25-9 years). Conclusions: Tenoscopic decompression was an effective treatment for DFTS synoviocoeles, which, along with treatment of concurrent intrathecal injury, carried an excellent prognosis and avoided the need for resection via an extrasynovial approach.
© 2021 The American College of Veterinary Surgeons.
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Publication Date: 2021-12-20 PubMed ID: 34927263DOI: 10.1111/vsu.13751Google 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 investigates the use of ultrasound-guided tenoscopic decompression in treating horses suffering from digital flexor tendon sheath (DFTS) synoviocoeles, revealing the treatment was successful and facilitated the horses’ return to full athletic functionality.

Study Overview

  • The study is a retrospective case series involving ten client-owned horses displaying lameness localized to the DFTS region, and showed signs of a fluid-filled mass, also known as a synoviocoele, associated with the DFTS.
  • The study’s main aim was to report the diagnostic features and the clinical outcomes of horses that were treated with tenoscopic decompression guided by ultrasound.

Study Findings

  • The lameness and synoviocoeles in the horses studied were observed to be unilateral, with equal distribution between the forelimbs and the hindlimbs. Furthermore, the synoviocoeles were located proximal to the palmar/plantar annular ligament.
  • Additionally, the study found that the synoviocoele’s had a firm consistency and caused focal pain, with an inability to deflate upon non-weight-bearing examination.
  • The researchers used intrathecal DFTS anesthesia in 7 out of 8 horses while the remaining horses were localized to the region of the synoviocoele using either perineural or intralesional anesthesia.
  • The communication between the DFTS and synoviocoele was suspected to be revealed through ultrasound in all cases, and confirmed on contrast tenography (6 out of 6 cases).

Treatment Method and Outcome

  • As a treatment method, tenoscopic fenestration of the communication between the DFTS and synoviocoele was performed under ultrasonographic guidance.
  • This treatment, along with treatment of concurrent intrathecal injury (4 out of 10), was found to have resolved the lameness of all horses re-evaluated (9 out of 9), and allowed return to full athletic performance in all cases at long-term follow-up (Median 5 years; Range 1.25-9 years).

Conclusion

  • The study concludes that tenoscopic decompression is a successful treatment for DFTS synoviocoeles. This treatment, in conjunction with treatment of concurrent intrathecal injury, offers an excellent prognosis and eliminates the need for resection via an extrasynovial approach.

Cite This Article

APA
Hawkins A, Chapman L, Meter M, Smith RK. (2021). Ultrasound-guided tenoscopic decompression of digital sheath synoviocoeles in 10 horses. Vet Surg, 51(2), 311-319. https://doi.org/10.1111/vsu.13751

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 51
Issue: 2
Pages: 311-319

Researcher Affiliations

Hawkins, Alex
  • Royal Veterinary College, University of London, Hatfield, UK.
Chapman, Lucy
  • Chine House Veterinary Hospital, Sileby, UK.
Meter, Mark
  • Blaircourt Equine Veterinary Clinic, Essex, UK.
Smith, Roger K
  • Royal Veterinary College, University of London, Hatfield, UK.

MeSH Terms

  • Animals
  • Decompression / veterinary
  • Forelimb
  • Horse Diseases / diagnostic imaging
  • Horse Diseases / surgery
  • Horses
  • Lameness, Animal / diagnostic imaging
  • Lameness, Animal / surgery
  • Retrospective Studies
  • Ultrasonography, Interventional / veterinary

References

This article includes 18 references
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