Desmitis of the distal digital annular ligament in seven horses: MRI diagnosis and surgical treatment.

Summary

# Desmitis of the distal digital annular ligament: MRI diagnosis and surgical management The distal digital annular ligament (DDAL) is a critical but often overlooked structure in the equine foot, and its pathology has received limited characterisation in the veterinary literature. Cohen and colleagues examined seven horses presenting with clinical signs of DDAL desmitis, establishing baseline MRI parameters for normal DDAL thickness and appearance whilst documenting the characteristic imaging abnormalities associated with inflammatory disease of this ligament. Using MRI as the diagnostic modality, the research team identified ligamentous thickening, signal intensity changes, and structural distortion in affected horses, providing clinicians with specific imaging criteria to differentiate DDAL pathology from other common causes of digital lameness. Beyond diagnosis, the authors developed and described a tenoscopic surgical approach to address DDAL desmitis, offering an alternative to more invasive surgical options. For equine practitioners, this work provides both the imaging knowledge necessary to identify DDAL involvement and a minimally invasive surgical technique to consider when conservative management fails—particularly relevant given the deep location of this structure and its potential involvement in chronic or refractory digital lameness cases.

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Key Findings

• •MRI effectively identified DDAL desmitis with characteristic signal changes and ligament thickening compared to normal MR appearance
• •Normal DDAL thickness was established as baseline reference for comparison in affected horses
• •Tenoscopic surgical technique was successfully applied for treatment of DDAL desmitis in all 7 cases

Conditions Studied