What Is Your Diagnosis?

This research article discusses a case of a 5-year-old Morgan horse stallion exhibiting lameness in its left forelimb, which was initially treated but didn’t show significant improvement, prompting further evaluation involving advanced diagnostic imaging techniques.

Case Presentation

• The article presents a case of a 5-year-old Morgan horse stallion which was referred for evaluation due to a sudden onset of left forelimb lameness while participating in a competition. The initial treatment included athletic rest, painkiller administration (phenylbutazone), and pulsed electromagnetic field therapy.
• Two weeks after these initial interventions, the lameness was evaluated as grade 3/5 on the lameness scale paired with moderate effusion and decreased range of motion. The diagnosis still remained inconclusive after a radiographic evaluation, leading to intra-articular administration of different pharmaceuticals.
• Despite these interventions, the stallion’s condition only slightly improved to grade 2/5 on the lameness scale over the next three weeks.

Further Evaluation and Diagnosis

• Due to the unsatisfactory improvement in the horse’s condition, the animal was referred for more extensive evaluation and definitive diagnosis. During this evaluation, the stallion showed a 3/5 grade lameness and a strong positive response to a flexion test of the distal portion of the left forelimb.
• The use of a palmar digital nerve block, a common diagnostic technique in equine lameness, did not result in any significant improvement. The horse was then put under general anesthesia and underwent magnetic resonance imaging (MRI).
• The MRI included both T1-weighted volumetric interpolated breath-hold examination and Dixon-method proton density–weighted sequences, with and without fat suppression. These techniques are designed to provide detailed images of the tissues, helping in the identification of any abnormalities that may be causing the lameness.