Hind foot lameness: results of magnetic resonance imaging in 38 horses (2001-2011).
Authors: Biggi M, Dyson S
Journal: Equine veterinary journal
Summary
# Editorial Summary: Hind Foot Lameness—MRI Findings in 38 Horses Whilst MRI of the equine front foot is well-documented, considerably less is known about the distribution and nature of lesions in hind foot lameness cases. Biggi and Dyson retrospectively evaluated MRI scans from 38 horses with hindlimb lameness confirmed by plantar nerve blocks at the proximal sesamoid level, comparing lesion types and locations with previously published front foot data and tracking clinical outcomes. Collateral sesamoidean ligament (CSL) injury emerged as the most common primary diagnosis (24%), followed by multiple concurrent injuries (24%) and primary bone pathology (21%), with the remainder distributed amongst distal interphalangeal joint collateral desmopathy, deep digital flexor tendonitis and navicular disease. Of the 24 horses with adequate follow-up information, 46% returned to their previous level of performance, 8% managed lighter work, and 38% were retired due to recurrent lameness; notably, 63% of horses with primary CSL injury successfully returned to athletic function. These findings indicate that whilst primary bone lesions carry a more guarded prognosis, CSL injuries in the hind foot present a more optimistic outlook than might be anticipated, suggesting that farriers and rehabilitation specialists should consider targeted therapeutic approaches for this commonly diagnosed condition.
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Practical Takeaways
- •MRI is useful for identifying structural causes of hind foot lameness after confirming plantar nerve block response; collateral sesamoidean ligament injury and bone pathology are common findings
- •Collateral sesamoidean ligament injuries have relatively favorable prognosis with over 60% returning to work, but primary bone lesions carry poorer prognosis and warrant careful prognostication
- •Multiple concurrent injuries are present in some lame horses and should be documented to inform treatment planning and owner expectations
Key Findings
- •Collateral sesamoidean ligament injury was the primary diagnosis in 9 of 38 horses (24%) with hind foot lameness
- •Primary bone pathology accounted for 8 cases (21%), with 4 of 7 euthanized horses having primary bone lesions
- •Of 24 horses with follow-up data, 11 returned to previous performance (46%) and 9 were retired due to recurrent lameness (38%)
- •Five of 8 horses with collateral sesamoidean ligament injury returned to previous performance, indicating reasonable prognosis for this condition