Lameness associated with foot pain: results of magnetic resonance imaging in 199 horses (January 2001--December 2003) and response to treatment.
Authors: Dyson S J, Murray R, Schramme M C
Journal: Equine veterinary journal
Summary
# Editorial Summary: MRI findings in equine foot lameness Between 2001 and 2003, Dyson and colleagues used magnetic resonance imaging to identify the underlying pathology in 199 horses with foot pain that had proved diagnostically elusive despite conventional imaging and localised analgesia. Deep digital flexor (DDF) tendonitis emerged as the predominant finding (59% of cases), whilst collateral ligament desmitis of the distal interphalangeal joint was the second most common injury (31%), with a substantial proportion of horses presenting with concurrent involvement of multiple structures. Long-term follow-up revealed markedly different prognoses depending on lesion type: traumatic injuries to the phalanges achieved excellent outcomes in 71% of cases, whereas primary DDF tendon or collateral ligament injuries returned to full athletic function in only 28–29% of horses, and combined DDF tendonitis with navicular bone pathology carried the poorest prognosis. These findings provide practitioners with a rational anatomical basis for treatment decisions and prognostic counselling, though the fundamental mechanisms driving soft tissue injury in the equine foot remain incompletely understood and warrant further investigation to optimise management strategies.
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Practical Takeaways
- •MRI diagnosis of foot lameness enables rational treatment planning rather than empirical approaches, but soft tissue injuries (DDF, CL) carry guarded prognoses for return to full work
- •Traumatic injuries to the middle or distal phalanges are most likely to resolve completely; plan conservative management strategies accordingly
- •Horses with combined DDF and navicular lesions have poor outlooks—discuss realistic expectations with owners and consider early decisions about future athletic use
Key Findings
- •Deep digital flexor tendonitis was the most common MRI-identified foot injury (59% of cases), with primary DDF tendonitis in 33% and combined DDF/navicular lesions in 14%
- •Collateral ligament desmitis of the DIP joint was the second most common injury (31% of cases), present as primary injury in 15% and in combination with other injuries in 16%
- •Return to full athletic function occurred in only 28% of horses with primary DDF lesions and 29% with primary CL desmitis, but 71% of horses with traumatic phalanx injuries achieved excellent outcomes
- •Combined DDF tendon and navicular bone injuries had poor prognosis with majority of horses developing persistent lameness