Osseous abnormalities associated with collateral desmopathy of the distal interphalangeal joint: part 1.
Authors: Dakin S G, Dyson S J, Murray R C, Tranquille C
Journal: Equine veterinary journal
Summary
# Editorial Summary: Osseous Abnormalities in Collateral Ligament Injury at the DIP Joint Collateral ligament (CL) injuries of the distal interphalangeal joint represent a significant cause of chronic foot lameness in performance horses, yet the extent of associated bone pathology has remained poorly characterised. Dakin and colleagues retrospectively analysed MRI images from 313 feet (289 horses) with confirmed DIP joint collateral desmopathy, documenting the frequency, distribution and character of concurrent osseous lesions and correlating findings with scintigraphic uptake patterns. Osseous abnormalities were identified in 45.7% of affected feet, predominantly comprising entheseous new bone formation and endosteal irregularity of the middle and distal phalanges; notably, lesions occurred more frequently at the ligament insertion than origin, and medially more than laterally. A significant association existed between radiopharmaceutical uptake and osseous injury, though the converse—normal scintigraphic appearance alongside substantial bone pathology—was also documented. These findings have important implications for diagnostic interpretation and prognostication: reliance on nuclear scintigraphy alone risks overlooking clinically relevant osseous changes, making MRI invaluable for comprehensive assessment of DIP joint collateral ligament pathology. Understanding the biomechanical sequelae of entheseous new bone and endosteal changes will help farriers and veterinarians contextualise the chronicity of cases and tailor interventions accordingly, though further research is needed to establish how osseous severity influences return-to-performance outcomes.
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Practical Takeaways
- •Nearly half of horses with collateral ligament injuries of the DIP joint have associated bone changes; MRI is valuable for identifying these lesions which may influence prognosis
- •Normal bone scintigraphy does not rule out significant bone pathology related to collateral ligament injury—MRI is needed for definitive assessment
- •Medial collateral ligament injuries are more likely to produce osseous changes than lateral injuries, and insertion site injuries are more commonly associated with bone lesions
Key Findings
- •Osseous abnormalities were detected in 45.7% (143/313) of feet with collateral ligament injury of the DIP joint
- •Entheseous new bone and endosteal irregularity of the middle and distal phalanges were the most frequent osseous lesions
- •Osseous abnormalities occurred more frequently at ligament insertion sites than origin sites, and medially more than laterally
- •Significant association exists between increased radiopharmaceutical uptake and osseous injury, but normal scintigraphic uptake does not exclude significant osseous pathology