Quadrilateral suspensory and straight sesamoidean ligament calcifying desmopathy in an Arabian mare
Authors: Hui S. K. Y., Turner S. J., Leaman T. R., de Brot S., Barakzai S. Z.
Journal: Equine Veterinary Education
Summary
# Editorial Summary A 5-year-old Arabian mare presented with behavioural changes, generalised stiffness, and concurrent polyuria and polydipsia, alongside bilateral forelimb suspensory ligament (SL) and palmar soft tissue pain. Radiographic examination revealed distinctive radiopaque striations within the straight sesamoidean ligaments (SSLs) and milder changes in the SL branches bilaterally, whilst ultrasonography demonstrated multifocal hyperechoic lesions in the SSLs with enlargement and mixed echogenicity throughout the SL structures. Post-mortem and histological examination confirmed severe dystrophic mineralisation with cartilaginous and osseous metaplasia affecting all four limbs' SLs and SSLs, establishing a diagnosis of primary calcifying desmopathy rather than degenerative suspensory ligament desmitis. This case is clinically significant because the radiographic and histopathological findings diverge substantially from typical degenerative suspensory ligament disease, and the bilateral, four-limb involvement with concurrent systemic signs (polyuria, polydipsia) suggests an underlying metabolic or systemic calcification disorder warrants investigation. For equine practitioners, this case highlights the diagnostic value of combining radiography and ultrasonography to differentiate calcifying desmopathy from more common degenerative conditions, and underscores the importance of considering systemic disease when encountering atypical presentations of what may appear superficially to be conventional ligamentous injury.
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Practical Takeaways
- •Calcifying desmopathy should be considered in differential diagnosis for horses presenting with bilateral forelimb pain and stiffness; radiographs showing mineralization patterns can help distinguish this condition from common degenerative suspensory ligament disease
- •This condition may present with systemic signs (polyuria, polydipsia) alongside musculoskeletal findings, warranting investigation of underlying metabolic or systemic disorders
- •Definitive diagnosis requires histopathological examination; imaging alone may not differentiate calcifying desmopathy from degenerative changes, affecting treatment decisions and prognosis
Key Findings
- •5-year-old Arabian mare presented with bilateral forelimb pain, stiffness, and behavioral changes associated with multifocal ligament mineralization
- •Radiography revealed marked radiopaque striations in straight sesamoidean ligaments and suspensory ligament branches bilaterally
- •Histopathology demonstrated severe dystrophic mineralization with cartilaginous and osseous metaplasia in all four limbs' suspensory and sesamoidean ligaments
- •Clinical presentation mimicked degenerative suspensory ligament desmitis but imaging and pathological findings indicated primary calcifying desmopathy rather than degenerative disease