MRI features of multiple phalangeal disorders in a draft horse – a case report
Authors: A. M. Abu-Seida, Yahya M. Elemmawy
Journal: Veterinarski arhiv
Summary
# Editorial Summary This case report documents a 9-year-old draft horse presenting with chronic unilateral forelimb lameness following severe trauma, using MRI to characterise the full extent of concurrent phalangeal pathology. Whilst radiography and ultrasonography provided limited diagnostic information, MRI revealed an extensive cascade of injuries including navicular bursa oedema, distal sesamoidean impar desmitis, deep digital flexor tendon (DDFT) damage at both navicular and post-navicular levels, cartilage erosion in the pastern and coffin joints, and collateral ligament injuries affecting the fetlock, sesamoidean and coffin joints. The severity and multiplicity of these lesions underscores how traumatic insult can simultaneously compromise multiple structures within the distal limb apparatus, creating a complex clinical picture that conventional imaging would substantially underestimate. For equine practitioners managing lameness cases—particularly in draft breeds where load-bearing demands are extreme—this case highlights MRI's superior sensitivity for detecting subtle soft tissue and cartilage involvement that would otherwise remain occult. Given that treatment planning and prognostication depend critically on accurate lesion identification, securing MRI imaging when conventional modalities prove inconclusive may prove essential for optimising outcomes in complicated polyarticular or polytissue lameness presentations.
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Practical Takeaways
- •When trauma cases present with unexplained chronic lameness unresponsive to conventional imaging, MRI should be pursued early as it reveals multiple concurrent injuries that radiography and ultrasound may miss
- •Multiple phalangeal structures are frequently affected simultaneously in severe trauma cases; treatment planning must account for the full injury pattern to optimize outcomes
- •Understanding the MRI appearance of these concurrent injuries helps practitioners recognize when complex multi-structure damage is present and when referral for advanced imaging is warranted
Key Findings
- •A single case of severe forelimb trauma resulted in multiple concurrent phalangeal disorders including navicular bursa edema, DDFT injury, and cartilage erosions across multiple joints
- •MRI demonstrated superior diagnostic capability compared to radiography and ultrasonography for identifying the full extent of soft tissue and cartilage damage
- •The draft horse presented with multiple simultaneous ligamentous injuries (distal sesamoidean impar desmitis, collateral desmitis at multiple sites) following severe trauma