Retrospective analysis of oblique and straight distal sesamoidean ligament desmitis in 52 horses.
Authors: Hawkins Alex, O'Leary Lauren, Bolt David, Fiske-Jackson Andrew, Berner Dagmar, Smith Roger
Journal: Equine veterinary journal
Summary
# Editorial Summary: Distal Sesamoidean Ligament Injuries in Horses Injuries to the oblique and straight distal sesamoidean ligaments represent a significant source of distal limb lameness, yet clinical understanding of their presentation and prognosis has remained limited. This retrospective review examined 51 horses with confirmed distal sesamoidean ligament desmitis, comparing ultrasonographic and standing low-field MRI findings whilst tracking return to soundness and performance. The oblique ligament showed no limb predilection (50% fore/hindlimb distribution) and frequently affected the proximal third with associated periligamentary swelling and focal pain, whereas straight ligament injuries predominated in forelimbs (62%); ultrasonography successfully identified lesions in 83% of cases examined, and standing MRI in 72%, supporting their complementary diagnostic value in practice. Only 55% of horses returned to soundness, with merely 31% resuming their intended work, indicating a guarded prognosis regardless of treatment modality or clinical presentation. For practitioners, these findings emphasise the importance of optimised ultrasonographic technique as a practical first-line imaging tool—particularly given the logistical constraints and general anaesthetic risks of high-field MRI—whilst highlighting the need for realistic owner counselling around functional recovery expectations.
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Practical Takeaways
- •Ultrasonography with appropriate views is effective for diagnosing both ODSL and SDSL injuries and should be optimised before pursuing costly high-field MRI
- •Owners should be counselled that prognosis for return to full use is guarded—only 31% of affected horses returned to their intended purpose
- •ODSL and SDSL injuries present differently by location and limb; ODSL commonly shows periligamentar swelling and focal pain, and preferentially affects the proximal ligament
Key Findings
- •SDSL injuries were more common in forelimbs (62%), while ODSL injuries occurred equally in fore- and hindlimbs (50% each)
- •ODSL injuries were 13 times more likely than SDSL injuries to affect the proximal third of the ligament
- •Lesions were readily detected via ultrasonography (83%) and standing low-field MRI (72%)
- •Only 55% of horses returned to soundness and only 31% returned to intended use, with no significant associations between outcome and clinical features or treatment