Follow-Up Magnetic Resonance Imaging of Sagittal Groove Disease of the Equine Proximal Phalanx Using a Classification System in 29 Non-Racing Sports Horses.
Authors: Faulkner Josephine E, Joostens Zoë, Broeckx Bart J G, Hauspie Stijn, Mariën Tom, Vanderperren Katrien
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary: Sagittal Groove Disease Progression in Sports Horses Sagittal groove disease (SGD) of the proximal phalanx represents a significant cause of forelimb lameness in performance horses, yet the natural progression of MRI changes during rehabilitation remains poorly characterised in the literature. This retrospective study tracked sequential MRI findings in 29 warmblood sports horses (predominantly show jumpers) with SGD using a standardised classification system, examining how lesions evolved during the initial rehabilitation period and beyond return to work. Whilst 18 limbs showed stable MRI classifications and seven improved, concerning patterns emerged in three cases where mid-stage lesions (classifications 4b and 4c, involving bone oedema and subchondral microfissures or demineralisation) progressed to incomplete fracture, suggesting these represent critical thresholds warranting closer clinical surveillance. Conservative management proved effective for 86% of horses, achieving return to full training and competition within an average of 9.4 months, though 20% subsequently developed recurrent lameness, with repeat imaging revealing variable progression patterns—some lesions worsened, others stabilised or improved. These findings highlight considerable individual variability in SGD behaviour and underscore the need for larger prospective studies to identify reliable prognostic indicators, which would enable practitioners to better counsel clients on expected recovery timelines and inform decisions about training intensity during rehabilitation phases.
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Practical Takeaways
- •SGD lesions showing bone oedema with microfissures or demineralisation (classes 4b/4c) warrant careful monitoring as they may progress to incomplete fractures—consider extended rest or more conservative management
- •Most horses (86%) successfully return to competition after SGD treatment, but expect 9–10 months recovery time and monitor 1 in 5 for recurrent issues after resuming work
- •Sequential MRI findings are highly variable in SGD; lack of radiographic improvement doesn't always predict poor outcomes, so clinical assessment should guide management decisions alongside imaging
Key Findings
- •MRI classification remained constant in 62% of limbs (18/29) during initial rehabilitation, while 24% improved and 14% worsened or fluctuated
- •Classifications 4b and 4c (bone oedema with microfissure or demineralisation) progressed to incomplete macrofissure (class 5) in 3 limbs, suggesting these are prodromal lesions
- •86% of horses (25/29) returned to full training and competition after conservative or surgical treatment with mean recovery of 9.4±4.4 months
- •20% of horses (6/30 re-scanned limbs) presented with recurrent lameness after return to work, with variable MRI progression patterns