Magnetic resonance imaging evaluation of 264 horses with foot pain: the podotrochlear apparatus, deep digital flexor tendon and collateral ligaments of the distal interphalangeal joint.
Authors: Dyson, Murray
Journal: Equine veterinary journal
Summary
# Editorial Summary: Magnetic Resonance Imaging Evaluation of Foot Pain in 264 Horses Using MRI to analyse foot pathology in 264 horses with unilateral or bilateral lameness, Dyson and Murray characterised the frequency and distribution of deep digital flexor tendon (DDFT) lesions alongside injuries to the podotrochlear apparatus, navicular bursa and distal interphalangeal joint structures. DDFT pathology proved remarkably prevalent, occurring in 82.6% of affected limbs, with core lesions dominating at the level of the proximal phalanx (90.3%), whilst core lesions, sagittal splits and dorsal abrasions clustered around the collateral sesamoidean ligament (59.4% of limbs) and navicular bone (59.0%). Statistically significant associations emerged between DDFT injury and navicular bone degeneration across all regions, whilst distal sesamoidean impar ligament lesions (38.2% of limbs) and collateral sesamoidean ligament pathology (10.5%) both correlated strongly with navicular bone abnormalities, particularly affecting the proximal and distal borders and medullary region. For practitioners managing chronic foot pain, these findings underscore the futility of treating structures in isolation—successful therapeutic approaches must account for the biomechanical interdependency between the DDFT, collateral ligamentous support, navicular apparatus and joint structures, whilst preventative strategies should focus on identifying and modifying the underlying biomechanical risk factors that drive this cascade of polyarticular pathology.
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Practical Takeaways
- •When treating horses with foot pain, expect DDFT involvement in most cases (>82%) and screen for concurrent navicular bone changes, as these injuries are closely associated
- •Lesion location within the DDFT varies predictably by anatomical site; understanding these patterns helps guide targeted diagnostic imaging and treatment strategies
- •Injuries to the podotrochlear apparatus components are interconnected—addressing one structure in isolation may be insufficient; comprehensive assessment of the entire apparatus is warranted in foot pain cases
Key Findings
- •DDFT lesions occurred in 82.6% of limbs, most commonly at the level of the collateral sesamoidean ligament (59.4%) and navicular bone (59.0%)
- •Core lesions predominated at the proximal phalanx (90.3%), while core lesions, sagittal splits and dorsal abrasions were most common at the CSL and navicular bone levels
- •Lesions of the DSIL (38.2% of limbs) were more common than CSL lesions (10.5%), with both associated with navicular bone abnormalities
- •Strong positive association between DDFT lesions and navicular bone pathology across all aspects of the bone, indicating close biomechanical interactions within the podotrochlear apparatus