Contrast Enhanced Computed Tomography Findings in 105 Horse Distal Extremities.
Authors: Pauwels Frederik, Hartmann Angela, Alawneh John, Wightman Paul, Saunders Jimmy
Journal: Journal of equine veterinary science
Summary
# Editorial Summary: Contrast Enhanced CT for Equine Distal Limb Pathology A retrospective analysis of 105 CT examinations across 56 horses with foot lameness employed a multi-modality contrast protocol—combining intra-arterial CT angiography with intra-articular and intra-bursal contrast enhancement—to characterise soft tissue and osseous pathology with improved diagnostic clarity. Navicular bone disease was the most prevalent finding (64%), followed by deep digital flexor tendinopathy (43%), distal interphalangeal osteoarthritis (35%), navicular bursitis (31%), and collateral ligament desmopathy (26%), yet only a quarter of navicular bone lesions were deemed clinically significant, compared to 77% of DDF tendon abnormalities and 51% of DIP joint osteoarthritis. Notably, navicular bursa pathology correlated with concurrent navicular bone disease and flexor tendon lesions, suggesting these conditions frequently coexist rather than presenting in isolation. For practitioners managing chronic foot lameness, these findings underscore that imaging prevalence differs markedly from clinical relevance—incidental navicular changes are common but may not explain lameness, whereas flexor tendon and DIP joint changes warrant closer consideration as contributors to clinical signs. This contrast-enhanced protocol offers improved soft tissue visualisation and may assist in distinguishing clinically significant lesions from inconsequential findings when investigating persistent foot lameness.
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Practical Takeaways
- •Not all imaging findings warrant clinical concern—radiographic navicular changes are common but often subclinical; focus diagnostic efforts on DDFT and DIP joint changes which show higher clinical significance
- •This imaging protocol allows comprehensive assessment of foot lameness cases; consider using when foot pain persists after farriery and basic diagnostics
- •Navicular bursa involvement often coexists with other pathology; treatment plans should address the full diagnostic picture rather than isolated findings
Key Findings
- •Navicular bone disease was the most common finding (64%) but only 25% were clinically significant
- •Deep digital flexor tendon lesions (43%) and DIP osteoarthritis (35%) were predominantly clinically significant at 77% and 51% respectively
- •Navicular bursa abnormalities (31%) were associated with both navicular bone disease and DDFT lesions
- •Combined CT/CTA/CTAR protocol successfully characterized six main diagnostic categories in distal limb pathology