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farriery
veterinary
2022
Case Report
Verified

Deep digital flexor tendon lesions in the pastern are associated with the presence of distal tendinopathy.

Authors: Acutt, Contino, Frisbie, Barrett

Journal: Equine veterinary journal

DOI: 10.1111/evj.13470PubMed: 34050982Log in to save

Summary

# Editorial Summary: Deep Digital Flexor Tendon Lesions in the Pastern and Distal Tendinopathy When deep digital flexor tendon (DDFT) pathology presents in the pastern region, clinicians should anticipate concurrent injury further distally within the hoof capsule. Acutt and colleagues analysed 33 horses evaluated with MRI and 58 horses with ultrasonography to characterise DDFT lesions in the pastern and determine their association with tendon damage in the foot. Three-quarters of all pastern DDFT cases showed concurrent distal pathology, with this figure rising to 97% when core lesions were present—and core lesions proved 20.7 times more likely to be associated with foot injury than other lesion types. These findings suggest that pastern DDFT lesions should prompt routine imaging of the tendon through the navicular apparatus, as the presence of proximal damage substantially increases the probability of distal involvement and will materially alter treatment strategy and prognostic counselling. For farriers, veterinarians, and rehabilitation professionals managing horses with DDFT injury, recognising this strong pathological association should shift practice towards comprehensive diagnostic imaging of the entire tendon column rather than assessment of the presenting lesion in isolation.

Read the full abstract on PubMed

Practical Takeaways

  • •When imaging reveals a DDFT lesion in the pastern, always obtain imaging of the distal tendon within the foot to identify concurrent pathology and guide treatment decisions
  • •Core lesions in the pastern carry significantly higher risk of distal tendon involvement; these cases warrant more guarded prognosis and intensive imaging protocols
  • •Assessment of only the pastern-level lesion will underestimate the true extent of DDFT pathology and may compromise treatment planning and outcome prediction

Key Findings

  • •Distal DDFT lesions were present in 75% (95% CI: 66.0-84.0) of all cases with pastern DDFT tendinopathy
  • •Core lesions in the pastern were associated with distal foot lesions in 97% (95% CI: 91.6-100.0) of cases
  • •Core lesions in the pastern were 20.7 times more likely to be associated with foot injury than other pastern lesion types (P = 0.008)
  • •DDFT pathology in the pastern, particularly core lesions, is strongly associated with additional tendinopathy within the hoof capsule

Conditions Studied

deep digital flexor tendon (ddft) lesions in the pasterndistal tendinopathyddft pathology within the hoof capsule

Tags

mrihorseimagingpasterntendonultrasound

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