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Dancot M, Joostens Z, Audigié F, Busoni V. The plantar proximal cortex of the third metatarsal bone shows raised longitudinal ridges at the suspensory ligament enthesis in normal equine isolated limbs - a radiographic, computed tomography, and MRI study. Front Vet Sci 2023; 10:1265116. [PMID: 38033644 PMCID: PMC10687415 DOI: 10.3389/fvets.2023.1265116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/12/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction Knowledge of normal radiographic appearance is essential to avoid misinterpretation of radiographs. This study aimed to assess the computed tomographic (CT) appearance of the plantar surface of the proximal metatarsus and evaluate the influence of the radiographic angle on the trabecular/cortical interface of the proximal plantar metatarsal cortex on lateromedial and slightly oblique radiographs. Methods Eight hindlimbs were collected from six horses with no known history of lameness and euthanized for reasons unrelated to the study. Limbs underwent computed tomographic (CT) and radiographic examination (dorsoplantar, lateromedial, and slightly oblique radiographic views obtained by angling the beam dorsally and plantarly from the plane used for the lateromedial projection). Standing magnetic resonance (MR) imaging and computed tomography (CT) were used to confirm normalcy. Images were compared side-by-side by two experienced readers. Results Limbs were normal at MR imaging. Longitudinal linear ridges were present on the proximal plantar metatarsal surface in all limbs (1-2 sagittal ridges and 1 ridge located at the medial or lateral margin of the suspensory ligament). Longitudinal ridges were positioned facing an adipose-muscular bundle of the suspensory ligament on CT images and were visible as linearly increased opacities on dorsoplantar radiographs. The delineation of the trabecular/cortical interface of the proximal metatarsus changed with radiographic projection and was the sharpest on the plantaro 85° lateral to the dorsomedial oblique view. Conclusion The proximal third metatarsal bone shows individual morphological variations, with longitudinal linear ridges that alter the bone homogeneity on dorsoplantar radiographs. An oblique plantaro 85° lateral to the dorsomedial view is suggested to better assess the presence of subcortical sclerosis when proximal suspensory enthesopathy is suspected.
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Affiliation(s)
- Michaël Dancot
- Department of Medical Imaging, Faculty of Veterinary Medicine, Université de Liège, Liège, Belgium
| | | | - Fabrice Audigié
- CIRALE, Ecole Nationale Vétérinaire d’Alfort, Goustranville, France
| | - Valeria Busoni
- Department of Medical Imaging, Faculty of Veterinary Medicine, Université de Liège, Liège, Belgium
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Scharf A, de Solis CN, Sampson SN, Glass K, Watts AE. Suspensory ligament size does not change after plantar fasciotomy and neurectomy of the deep branch of the lateral plantar nerve by ultrasonographic assessment. Vet Surg 2021; 51:259-269. [PMID: 34970755 PMCID: PMC9306907 DOI: 10.1111/vsu.13757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 10/18/2021] [Accepted: 12/10/2021] [Indexed: 12/02/2022]
Abstract
Objective To determine the short‐term effect of plantar fasciotomy and neurectomy (PFN) of the deep branch of the lateral plantar nerve on the proximal suspensory ligament (PSL) cross‐sectional area (CSA) in horses with hindlimb proximal suspensory desmopathy (PSD). Study design Analytical, observational, cohort study. Sample population Twenty‐one horses. Methods Records of horses with chronic PSD treated by PFN were included if a preoperative ultrasonographic examination was available and at least one postoperative ultrasonographic examination. One masked observer measured the ultrasonographic cross‐sectional area (CSA) of the PSL. Intraobserver reliability was determined by repeatedly measuring a subset of ultrasonographic images (n = 127). Two masked observers measured the cross‐sectional area of the proximal suspensory ligament (PSL‐CSA) on preoperative proton density (PD)‐weighted transverse high field magnetic resonance images (n = 19 horses) . Agreements for PSL‐CSA between preoperative ultrasonographic and MRI measures and between the two magnetic resonance imaging (MRI) observers were assessed. Follow up considered the horses’ ability to return to exercise and their owners’ satisfaction. Results The reliability of the ultrasonographic measurement of the PSL‐CSA was excellent. Agreement between ultrasonographic assessment and MRI assessment of PSL‐CSA was good. No difference was detected between preoperative (median, interquartile range; oblique‐incidence, 2.07, 1.72‐2.55; on‐incidence, 2.23, 1.98‐2.65) and postoperative (oblique‐incidence, 2.08, 1.80‐2.74; on‐incidence, 2.28, 2.01‐2.74) PSL‐CSAs. At a median of 12 months (4‐33 months), 16/20 (80%) owners reported the horse was “better” and 15/20 (75%) functioned at or above preoperative levels. Conclusion Ultrasonographic measurement of the PSL‐CSA was reproducible and in good agreement with MRI measurement. The PSL‐CSA was not influenced by PFN. Clinical significance The PSL‐CSA cannot be used to guide return to function.
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Affiliation(s)
- Alexandra Scharf
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | | | - Sarah N Sampson
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Kati Glass
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Ashlee E Watts
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
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Schraml S, Barrios Santos WA, Bässler C, Mülling C. Suspensory ligament or interosseous muscle? Histology of the interosseous muscle of South American Camelids. Anat Histol Embryol 2021; 51:69-78. [PMID: 34751976 DOI: 10.1111/ahe.12751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/30/2021] [Accepted: 10/19/2021] [Indexed: 11/25/2022]
Abstract
The interosseous muscles (IOM) have evolved to largely collagenized structures in many large grazers, including South American Camelids (SACs). SACs include lama (Lama glama), alpaca (Vicugna pacos), guanaco (Lama guanicoe) and vicuna (Vicugna vicugna). This study reports on a comparative histomorphological evaluation of the IOM in these four species. First, a descriptive qualitative analysis of the tissue composition within the physiological IOM clearly demonstrates that the IOM of all SAC species is predominantly tendinous. However, we can always find a small amount of striated muscle fibres supporting the claim that the term "interosseous muscle" should be preferred over the denomination "suspensory ligament". Second, we quantify the ratio of muscle tissue (MTr) occupying the cross-sectional area (CSA) of 80 limbs at three levels and examine it in relation to limb, sample localization and species. Values for MTr are highest at the middle level, ranging from 0.4% to 15.2% with a mean of 3.4% ± 3.2%. We also detect notable amounts of muscle tissue at the distal sample level in the area of the branches of the IOM. Of all SACs, alpacas present the highest MTr. Lamas have a significantly larger MTr than guanacos. These results suggest the influence of domestication and/or physical activity on the muscle tissue content of the IOM of SACs. Amounts and distribution of muscle, adipose and lose connective tissue vary greatly for each sample localization and within individuals of one species. This may complicate the interpretation of MRI images of SACs' IOM for diagnostic purposes.
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Affiliation(s)
- Susanne Schraml
- Institute of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary medicine, Leipzig University, Leipzig, Germany
| | - William Arthur Barrios Santos
- Laboratorio de Histología, Embriología y Patología, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Claus Bässler
- Department Biodiversity Conservation, Institute for Ecology, Evolution and Diversity, Goethe-Universität Frankfurt, Biologicum, Germany
| | - Christoph Mülling
- Institute of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary medicine, Leipzig University, Leipzig, Germany
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Maleas G, Mageed M. Effectiveness of Platelet-Rich Plasma and Bone Marrow Aspirate Concentrate as Treatments for Chronic Hindlimb Proximal Suspensory Desmopathy. Front Vet Sci 2021; 8:678453. [PMID: 34222402 PMCID: PMC8253571 DOI: 10.3389/fvets.2021.678453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
This retrospective study aimed to evaluate the clinical effect of bone marrow aspirate concentrate (BMAC) and leukocyte rich PRP (LR-PRP) compared to horses undergoing controlled exercise alone in horses with >3 months proximal suspensory desmopathy in hindlimbs (HPSD). Nighty-three horses were divided into three groups according to the treatment: a control (n = 22), LR-PRP (n = 46), and BMAC (n = 25) group. Lameness and ultrasound scores were recorded before treatment (T0) and at 6 months (T1) post-treatment. Records horses considered sound at evaluation and level of performance were additionally registered at 12 months (T2) and 18 months (T3) after treatment. The BMAC cytology profiles from 22 horses were also analysed and compared to clinical outcomes. The results at T1 showed that 9% (2/22) of the horses in the control group were sound compared to 59% (25/46) and 84% (21/25) in the LR-PRP and BMAC groups, respectively. Additionally, ultrasound scores at T1 in the BMAC and LR-PRP groups were improved in comparison with the control group (p = 0.02). At T2, 68% of the horses in the BMAC group and 39% of the horses in the LR-PRP group had returned to the previous performance level. At T3, a significantly higher percentage of horses in the LR-PRP (43%) and BMAC (72%) group were sound when compared to the control (4.6%) group (p = 0.02). Similarly, at T3, significantly more horses of the BMAC (16/25) and of the LR-PRP (15/46) group had returned to the previous or a higher performance level compared to the control (1/22) group (p = 0.01). No correlation was found between long-term clinical outcome and cytology profiles in the BMAC group. In conclusion, long-term outcomes of treatment with LR-PRP or BMAC are significantly better than conventional treatment of the hindlimb chronic PSD in horses. Additionally, BMAC yielded better lameness scores than LR-PRP at short- and long-term follow-up.
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Labens R, Schramme MC, Murray RC, Bolas N. Standing low-field MRI of the equine proximal metacarpal/metatarsal region is considered useful for diagnosing primary bone pathology and makes a positive contribution to case management: A prospective survey study. Vet Radiol Ultrasound 2019; 61:197-205. [PMID: 31800146 DOI: 10.1111/vru.12824] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 08/05/2019] [Accepted: 09/04/2019] [Indexed: 11/28/2022] Open
Abstract
High-field MRI of the proximal metacarpal/metatarsal region has been associated with great diagnostic potential and clinical reports of standing low-field MRI of the forelimb suggest the same. To better understand diagnostic outcomes with standing low-field MRI of the proximal suspensory region, a prospective survey study was conducted and users of a widely available system questioned on their experience, operating procedures, and interpretation of standing low-field MRI findings. Response data included scores on a modified Likert scale from which weighted ratings were calculated for statistical analyses. Depending on the question, responses were obtained from 17 to 29 of the 38 invited facilities. Users indicated that standing low-field MRI was most frequently performed in the face of equivocal diagnostic findings; compared to Sports horses, general purpose riding horses were thought less likely to have detectable abnormalities and standing low-field MRI was rated most useful for the detection of primary bone pathology in the proximal metacarpal region. Standing low-field MRI signal change involving both the suspensory ligament and adjacent bone concurrently was rated most relevant and abnormalities solely affecting the muscle/adipose tissue bundles least relevant for diagnosing suspensory ligament injury. Transverse scans and in decreasing order T1-weighted gradient echo, short-tau inversion recovery FSE, T2*-weighted gradient echo, and T2-weighted FSE sequences were most frequently acquired and judged most useful by the majority of users experienced in imaging of the target area. This survey supports the relevant impact of standing low-field MRI on clinical case management, particularly in the context of imaging the proximal metacarpal region.
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Affiliation(s)
- Raphael Labens
- Faculty of Science, School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Michael C Schramme
- VetAgro Sup, Campus Veterinaire de Lyon, University of Lyon, Lyon, France
| | - Rachel C Murray
- Rossdales Equine Hospital and Veterinary Diagnostic Centre, Newmarket, Suffolk, UK
| | - Nick Bolas
- Hallmarq Veterinary Imaging Ltd, Guildford, UK
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Mizobe F, Nomura M, Kato T, Nambo Y, Yamada K. Signal changes in standing magnetic resonance imaging of osseous injury at the origin of the suspensory ligament in four Thoroughbred racehorses under tiludronic acid treatment. J Equine Sci 2017; 28:87-97. [PMID: 28955160 PMCID: PMC5608961 DOI: 10.1294/jes.28.87] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 06/15/2017] [Indexed: 11/22/2022] Open
Abstract
Problems associated with the proximal metacarpal region, such as an osseous injury associated with tearing of Sharpey’s fibers or an avulsion fracture of the origin of the suspensory ligament (OISL), are important causes of
lameness in racehorses. In the present study, four Thoroughbred racehorses (age range, 2–4 years) were diagnosed as having forelimb OISL and assessed over time by using standing magnetic resonance imaging (sMRI). At the first sMRI
examination, all horses had 3 characteristic findings, including low signal intensity within the trabecular bone of the third metacarpus on T1-weighted images, intermediate-to-high signal intensity surrounded by a hypointense rim
on T2*-weighted images, and high signal intensity on fat-suppressed images. Following the sMRI examination, all horses received 50 mg of tiludronic acid by intravenous regional limb perfusion once weekly for 3 weeks. Attenuation
of the high signal intensity on T2*-weighted and fat-suppressed images was observed on follow-up sMRI in 3 horses. Following rest and rehabilitation, these 3 horses successfully returned to racing. In contrast, the other horse
that did not show attenuation of the high signal intensity failed to return to racing. To our knowledge, this is the first report of OISL in Thoroughbred racehorses assessed over time by sMRI under tiludronic acid treatment. Our
findings support the use of sMRI for examining lameness originating from the proximal metacarpal region to refine the timing of returning to exercise based on follow-up examinations during the recuperation period.
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Affiliation(s)
- Fumiaki Mizobe
- Racehorse Hospital, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
| | - Motoi Nomura
- Racehorse Hospital, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
| | - Tomohiro Kato
- Racehorse Hospital, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
| | - Yasuo Nambo
- Department of Clinical Veterinary Science, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan
| | - Kazutaka Yamada
- Laboratory of Veterinary Radiology, School of Veterinary Medicine, Azabu University, Kanagawa 252-5201, Japan
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Dyson S, Pinilla MJ, Bolas N, Murray R. Proximal suspensory desmopathy in hindlimbs: Magnetic resonance imaging, gross post‐mortem and histological study. Equine Vet J 2017; 50:159-165. [DOI: 10.1111/evj.12756] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 08/16/2017] [Indexed: 11/30/2022]
Affiliation(s)
- S. Dyson
- Centre for Equine Studies Animal Health Trust Newmarket, Suffolk UK
| | - M. J. Pinilla
- Centre for Preventative Medicine Animal Health Trust Newmarket, Suffolk UK
| | - N. Bolas
- Hallmarq Veterinary Imaging Guildford, Surrey UK
| | - R. Murray
- Centre for Equine Studies Animal Health Trust Newmarket, Suffolk UK
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