Magnetic Resonance Imaging-Guided Treatment of Equine Distal Interphalangeal Joint Collateral Ligaments: 2009-2014.
Authors: White Nathaniel A, Barrett Jennifer G
Journal: Frontiers in veterinary science
Summary
# Editorial Summary: MRI-Guided Treatment of Equine DIP Collateral Ligament Disease Collateral ligament desmopathy at the distal interphalangeal joint remains a challenging diagnosis, yet targeted injection therapy under imaging guidance offers a promising alternative to conventional management. White and Barrett reviewed 13 cases of horses with MRI-confirmed DIJCL inflammation treated via low-field MRI-guided injection of mesenchymal stem cells, platelet-rich plasma, or both, combined with appropriate farriery and rest periods. All 13 horses resolved their lameness attributable to collateral ligament disease, with 10 returning to their previous level of performance and three achieving slightly reduced workload. The technical feasibility of conducting these injections safely with the horse standing in the MRI scanner—previously validated in cadaverous work—was successfully translated to clinical application. For farriers, vets, and rehabilitation specialists managing cases of persistent DIP joint-related lameness with MRI evidence of collateral ligament pathology, this work provides evidence that biological injection therapy combined with judicious shoeing modifications and rest may resolve both clinical and imaging findings in the majority of cases.
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Practical Takeaways
- •MRI-guided injection of stem cells or PRP combined with rest and appropriate shoeing appears effective for resolving lameness from collateral ligament injuries at the DIP joint
- •This technique enables precise targeting of the injured ligament without surgery, potentially reducing recovery time compared to conventional treatments
- •Most horses (77%) return to their expected performance level, making this a viable option for competitive and working horses with DIJCL desmopathy
Key Findings
- •All 13 horses with MRI-diagnosed DIJCL desmopathy showed complete lameness resolution following MRI-guided injection of mesenchymal stem cells and/or PRP
- •10 of 13 treated horses returned to expected performance levels, while 3 returned to less than expected performance
- •MRI-guided DIJCL injection can be safely performed in standing horses within a low-field MRI magnet