SummaryBackgroundSuperficial digital flexor tendon (SDFT) injury is an important health and welfare concern in racehorses. It is generally diagnosed with ultrasonography, but predictive ultrasonographic features have not been reported.ObjectivesTo determine ultrasonographic features of forelimb SDFT injury at initial presentation in Thoroughbred racehorses that could predict a successful return to racing (completing ≥5 races).Study designRetrospective cohort study.MethodsDigitised ultrasonographic images of 469 horses with forelimb SDFT injuries from the Hong Kong Jockey Club (2003–2014) were evaluated, using a previously validated ultrasonographic scoring system. Six ultrasonographic parameters were evaluated (type and extent of the injury, location, echogenicity, cross‐sectional area and longitudinal fibre pattern of the maximal injury zone [MIZ]), as well as horse signalment, retirement date and number of races before and after injury. Data were analysed by generalised linear regression with significance at P<0.05.ResultsCases were divided into two groups: 1) For cases of SDFT tendonitis with core lesions, cross‐sectional area at the MIZ was the most significant factor determining a successful return to racing (P = 0.03). If the lesion was <50% of the total cross‐sectional area, horses had 29–35% probability of successfully racing again, but if it was ≥50% this decreased to 11–16%. 2) For cases of SDFT tendonitis without a core lesion, longitudinal fibre pattern at the MIZ best predicted a successful return to racing (P = 0.002); if the affected longitudinal fibre pattern was <75% of the total, horses had 49–99% probability of successfully return to racing, but if it was ≥75% this decreased to 14%.Main limitationsPrognostic information may not be applicable to other breeds/disciplines.ConclusionsThis is the first study to describe ultrasonographic features of forelimb SDFT injuries at initial presentation that were predictive of successful return to racing. The outcomes will assist with early, evidence‐based decisions on prognosis in Thoroughbred racehorses.
<strong>PICO question</strong><br /><p>In horses with superficial digital flexor tendonitis is bandaging and rest compared to rest alone more effective at promoting healing?</p><strong>Clinical bottom line</strong><br /><p>There is currently a lack of scientific evidence to suggest that bandaging promotes effective tendon healing following injury. However, rigid bandages significantly limit lesion propagation in equine superficial digital flexor (SDF) tendinopathies. The result of this PICO question suggests that a short period (ten days) of cast immobilisation during the initial inflammatory phase of the injury improves prognosis by limiting lesion propagation. The level of confidence in the outcomes from the body of evidence in the four studies identified is moderate.</p><br /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" />
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