Proximal suspensory desmopathy in hindlimbs: A correlative clinical, ultrasonographic, gross post mortem and histological study.
Authors: Dyson S, Murray R, Pinilla M-J
Journal: Equine veterinary journal
Summary
# Proximal Suspensory Desmopathy in Hindlimbs: Validating Ultrasonographic Diagnosis Dyson, Murray and Pinilla's 2017 investigation directly addressed longstanding concerns about ultrasonography's reliability in detecting hindlimb proximal suspensory ligament (SL) disease by comparing ultrasound findings against post mortem gross pathology and histology across 19 lame horses and 10 controls. Using blinded histological grading as the gold standard, the researchers demonstrated that ultrasonography successfully identified collagenous tissue abnormalities in the SL; histopathology revealed pathological changes in 69.4% of lame limbs, with muscle involvement in 97.2% and adipose tissue abnormalities in 44.4%, validating the ultrasonographic diagnosis in these cases. Notably, gross post mortem examination uncovered substantial adhesions between the proximal SL and adjacent soft tissues in 27% of lame limbs, with further adhesions between the SL body and the third metatarsal bone in a further 27%—pathology not routinely predicted during ultrasonographic assessment. The clinical significance extends to post-operative management: in horses with recurrent lameness following surgical intervention for PSD, adhesion reformation between the SL and surrounding structures was identified, suggesting that adhesion prevention or management may be critical for improved surgical outcomes and returning animals to work.
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Practical Takeaways
- •Ultrasonographic findings of hindlimb suspensory ligament lesions are reliable indicators of pathology and should guide clinical decision-making
- •Post-surgical recurrent lameness in PSD cases may result from adhesion formation rather than incomplete ligament healing, which may require different management strategies
- •Expect significant muscle involvement (97% of cases) and potential adhesion formation when diagnosing proximal suspensory desmopathy
Key Findings
- •Ultrasonography reliably detected suspensory ligament pathology when compared to histology as gold standard
- •Histological abnormalities were present in 69.4% of collagenous tissue, 97.2% of muscle, and 44.4% of adipose tissue in lame limbs
- •Gross post mortem examination revealed adhesions between the proximal suspensory ligament and adjacent soft tissues in 27.0% of lame limbs
- •Adhesions between the suspensory ligament and surrounding tissues may be responsible for recurrent lameness following surgical management