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538


EQUINE VETERINARY EDUCATION / AE / OCTOBER 2014


Original Article


Hindlimb lameness associated with proximal suspensory desmopathy and injury of the accessory ligament of the suspensory ligament in five horses


S. Dyson


Centre for Equine Studies, Animal Health Trust, Newmarket, UK. Corresponding author email: sue.dyson@aht.org.uk Keywords: horse; ultrasonography; hock; metatarsus


Summary The accessory ligament of the hindlimb suspensory ligament arises from the plantar aspect of the calcaneus and fourth tarsal bones and blends with the suspensory ligament in the proximal aspect of the metatarsus. The accessory ligament of the suspensory ligament of both hindlimbs of 12 mature horses, with no history of hindlimb lameness, was assessed ultrasonographically. The ligament comprised linear parallel echoes which were consistently shorter than those of the lateral digital flexor tendon; the dorsal and plantar borders were parallel. Lameness associated with injury of the accessory ligament of the suspensory ligament was identified in 6 of 8 lame hindlimbs of 5 horses, unilaterally in 4 horses and bilaterally in one horse. In all horses there was concurrent proximal suspensory desmopathy. There was localised oedematous swelling on the distal medial aspect of the chestnut extending distally in 2 horses. Lameness was best identified when the horses were ridden. Perineural analgesia of the deep branch of the lateral plantar nerve abolished lameness in 3 horses but perineural analgesia of the tibial nerve was required to abolish lameness in the hindlimb with injury of the accessory ligament of the suspensory ligament in 2 horses. Injury of the accessory ligament of the suspensory ligament was characterised by marked decrease in echogenicity of the ligament and loss of parallel alignment of


the linear echoes, which were shorter than normal in longitudinal images.


Introduction


Proximal suspensory desmopathy is a well documented cause of hindlimb lameness in the horse (Dyson 1994, 1995, 2007; Labens et al. 2010). The anatomical and magnetic resonance features of the accessory ligament of the suspensory ligament in hindlimbs have been previously described (Schulze and Budras 2008); however, the biomechanical function of the ligament is unclear. The accessory ligament of the suspensory ligament arises from the plantar aspect of the calcaneus and fourth tarsal bones and blends with the suspensory ligament in the proximal aspect of the metatarsus (Fig 1). It is a structure which has uniform low signal intensity in magnetic resonance images in all sequences assessed (Schulze and Budras 2008). However, to the author’s knowledge, normal ultrasonographic features and injuries of this ligament have not been described. The purposes of this paper are to describe: 1) the normal ultrasonographic anatomy and 2) clinical features of horses with proximal suspensory desmopathy and concurrent injury of the accessory ligament of the suspensory ligament, response to diagnostic analgesia and ultrasonographic abnormalities.


a)


b)


Fig 1: a) Sagittal high-field T2- weighted gradient echo magnetic resonance image of a tarsus (dorsal is to the left) and b) longitudinal ultrasonographic image (dorsal is to the left and proximal to the top) to show the normal appearance of the accessory ligament of the suspensory ligament. Note the uniform parallel short linear echoes in the ultrasonographic image. These are shorter echoes than those in the lateral digital flexor tendon.


© 2014 EVJ Ltd


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