An overview of proximal suspensory ligament desmitis
Authors: Anderson Jonathan
Journal: UK-Vet Equine
Summary
# Editorial Summary: Proximal Suspensory Ligament Desmitis Proximal suspensory ligament (PSL) desmitis represents a significant clinical challenge across equine practice, affecting performance and soundness in both forelimbs and hindlimbs through degenerative changes in this critical supporting structure. Anderson's comprehensive overview synthesises current understanding of how PSL desmitis presents clinically, highlighting that presentations can vary considerably depending on anatomical location, chronicity, and the degree of ligamentous involvement. Diagnostic approaches encompassing lameness examination, ultrasonography, and advanced imaging modalities enable practitioners to differentiate PSL desmitis from other common causes of distal limb lameness, though ultrasonographic assessment remains the most practical tool for identifying ligamentous pathology in field settings. The review consolidates established treatment strategies ranging from conservative management (controlled exercise, therapeutic farriery, and injection therapies) through to surgical intervention when indicated, though it emphasises that outcomes depend heavily on early diagnosis and individualised rehabilitation protocols tailored to the severity and location of injury. For practitioners managing performance horses, recognition of the variable clinical presentation of PSL desmitis—particularly subtle gait abnormalities preceding obvious lameness—becomes essential for intervention before extensive degenerative changes compromise long-term prognosis.
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Practical Takeaways
- •Proximal suspensory desmitis should be included in your differential diagnosis list for any lame horse, particularly those with obscure forelimb or hindlimb lameness
- •Diagnostic imaging including ultrasound and nuclear scintigraphy can help confirm the condition and guide treatment planning
- •Treatment approaches range from conservative management to advanced therapies, allowing tailoring to individual cases and performance goals
Key Findings
- •Proximal suspensory disease is a common cause of both forelimb and hindlimb lameness in horses
- •The condition presents with variable clinical signs depending on limb location
- •Multiple diagnostic techniques are available for identifying proximal suspensory ligament lesions
- •Treatment options vary and include both conservative and interventional approaches