Short-term temporal alterations in magnetic resonance signal occur in primary lesions identified in the deep digital flexor tendon of the equine digit.
Authors: Milner P I, Sidwell S, Talbot A M, Clegg P D
Journal: Equine veterinary journal
Summary
# Editorial Summary Primary deep digital flexor tendon (DDFT) lesions within the equine digit are a significant source of lameness, yet little was known about how these lesions change on magnetic resonance imaging over time or whether different lesion types behave differently during healing. Milner and colleagues followed 23 lame horses with MRI-diagnosed DDFT digit lesions under conservative management, classifying lesions as parasagittal, dorsal border or core types, and quantified lesion volume and signal intensity using T2* sequences at baseline, 3 months and 6 months. Dorsal border lesions demonstrated clinically meaningful improvement, with volume reducing from 0.18 cm³ initially to 0.05 cm³ by 6 months and signal intensity dropping from 4.06 to 2.00 by the 6-month endpoint; parasagittal and core lesions, however, showed no significant changes in either parameter, despite lameness improving across all lesion types. These findings suggest that lesion morphology is an important prognostic indicator on MRI, potentially allowing practitioners to counsel clients on expected healing trajectories and inform decisions about the intensity of rehabilitation protocols—dorsal border lesions appearing favourable for conservative management whilst core and parasagittal lesions may warrant closer monitoring or alternative therapeutic strategies despite apparent clinical improvement.
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Practical Takeaways
- •DDFT lesion type identified on MRI (dorsal border vs. parasagittal vs. core) is an important prognostic indicator—dorsal border lesions are more likely to regress with conservative management
- •Horses with dorsal border DDFT lesions can be managed conservatively with expectation of lesion resolution over 6 months, informing return-to-work timelines
- •Lesion typing should be incorporated into MRI reports and treatment planning, as parasagittal and core lesions behave differently and may require different prognostic counseling
Key Findings
- •Dorsal border DDFT lesions showed statistically significant volume reduction from 0.18 cm³ initially to 0.05 cm³ at 6 months (P<0.01)
- •Dorsal border lesions demonstrated significant intensity reduction at 6 months (4.06 to 2.00 ratiometric intensity, P<0.01)
- •Parasagittal and core lesions showed no significant changes in volume or intensity over the 6-month period despite conservative management
- •Lameness improved in all lesion types following conservative management regardless of lesion morphology