Magnetic resonance imaging‐guided injection of platelet‐rich plasma for treatment of an insertional core lesion of the deep digital flexor tendon within the foot of a horse
Authors: Marcatili M., Marshall J., Voute L.
Journal: Equine Veterinary Education
Summary
# Editorial Summary Deep digital flexor tendon insertional lesions within the foot present a diagnostic and therapeutic challenge, as these are difficult to visualise and treat accurately. Marcatili and colleagues used magnetic resonance imaging to both definitively diagnose an insertional core lesion in the right forefoot of a horse and to guide real-time needle positioning for platelet-rich plasma injection under general anaesthesia, with the injected volume correlating closely to the calculated lesion dimensions. This MRI-guided injection technique proved practicable and offers significant advantages over alternative approaches: it provides superior soft tissue visualisation compared to ultrasonography, eliminates radiation exposure inherent to computed tomography, and delivers superior needle positioning accuracy compared to both methods. For equine practitioners managing Deep Digital Flexor (DDF) tendon injuries, this approach represents a valuable refinement in treating insertional lesions that might otherwise respond poorly to conventional therapy, though the requirement for general anaesthesia and access to MRI facilities will necessarily limit its application to referral centres. The technique's capacity to achieve precise drug delivery to a clearly defined lesion has potential to improve clinical outcomes in cases where conservative management or external therapy has failed.
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Practical Takeaways
- •MRI-guided platelet-rich plasma injection is a viable treatment option for deep digital flexor tendon insertional lesions within the foot, offering superior precision compared to other imaging modalities
- •This technique requires general anaesthesia and access to MRI facilities, making it a specialized referral procedure rather than field treatment
- •For working horses with suspected insertional DDFT lesions unresponsive to conventional therapies, MRI-guided intervention should be considered as it allows accurate lesion targeting and measurement
Key Findings
- •MRI-guided injection of platelet-rich plasma successfully treated a deep digital flexor tendon insertional lesion within the foot
- •MRI guidance allowed accurate needle positioning with injected volume approximating the calculated lesion volume
- •MRI-guided injection is practicable under general anaesthesia and offers superior accuracy compared to computed tomography and ultrasonography without radiation exposure