Radiographic changes of the proximal third metatarsal bone do not predict presence or severity of proximal suspensory desmopathy in a predominately Quarter Horse population.
Authors: Hinkle Frances E, Selberg Kurt T, Frisbie David D, Barrett Myra F
Journal: Equine veterinary journal
Summary
# Editorial Summary: Radiographic Assessment of Proximal Suspensory Ligament Disease Proximal suspensory desmopathy (PSD) is a significant cause of hindlimb lameness in performance horses, yet the reliability of radiographic diagnosis remains unclear. This 2023 study compared radiographic findings of the proximal third metatarsal bone with MRI findings in a predominantly Quarter Horse population to determine whether bone changes visible on radiographs could predict the presence or severity of suspensory ligament damage. Despite identifying radiographic abnormalities in the proximal metatarsus—including lucencies, sclerosis, and enthesiopathy—the researchers found no meaningful correlation between these bone changes and either the presence of PSD on MRI or the degree of soft-tissue damage detected. The implications are substantial: radiographic changes at this site should not be interpreted as reliable indicators of proximal suspensory disease, and their absence certainly does not exclude it. For practitioners managing hindlimb lameness cases, this reinforces that radiographs alone are inadequate for definitive assessment of suspensory ligament pathology; MRI or ultrasound remain essential for accurate diagnosis and prognosis when PSD is suspected, even when radiographs appear relatively normal.
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Practical Takeaways
- •Normal radiographs of the proximal metatarsus do not exclude proximal suspensory ligament disease—use MRI for definitive diagnosis when this condition is suspected
- •Radiographic changes alone are insufficient for assessing severity of suspensory ligament pathology; MRI is necessary for treatment planning and prognosis
- •In Quarter Horses with suspected proximal suspensory origin problems, advance imaging should be strongly considered rather than relying solely on radiographic findings
Key Findings
- •Radiographic changes of the proximal third metatarsal bone do not reliably predict the presence of proximal suspensory desmopathy
- •Radiographic findings do not correlate with severity of proximal suspensory desmopathy on MRI
- •MRI reveals ligamentous pathology not visible on radiographs in horses with suspensory disease
- •Comparison of radiography to MRI demonstrates significant limitations of radiographic interpretation in proximal suspensory origin assessment