Incomplete longitudinal fractures and fatigue injury of the proximopalmar medial aspect of the third metacarpal bone in 55 horses

Morgan, R.; Dyson, Sue

doi:10.1111/j.2042-3306.2011.00371.x

Cited by 32 publications

(58 citation statements)

References 16 publications

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“…Unlike hindlimb proximal suspensory desmopathy, there was no association between lesion severity as determined by ultrasonography and the presence of increased radiopharmaceutical uptake, however severely lame horses with mild ultrasonographic abnormalities may have increased radiopharmaceutical uptake reflecting injury at the enthesis. Although stress fractures are infrequently seen in sports horses compared with racehorses, one exception is proximal palmar cortical stress fracture (incomplete longitudinal fracture) of the third metacarpal bone which occurs in mature sports horses . There is invariably increased radiopharmaceutical uptake, which must be distinguished from an avulsion fracture or proximal suspensory desmitis .…”

Section: Discussionmentioning

confidence: 99%

“…Although stress fractures are infrequently seen in sports horses compared with racehorses, one exception is proximal palmar cortical stress fracture (incomplete longitudinal fracture) of the third metacarpal bone which occurs in mature sports horses . There is invariably increased radiopharmaceutical uptake, which must be distinguished from an avulsion fracture or proximal suspensory desmitis . Palmar cortical stress fractures can often be seen radiographically …”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the diagnostic accuracy of skeletal scintigraphy in lame and poorly performing sports horses

Quiney

Ireland

Dyson

2018

Vet Radiology Ultrasound

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Skeletal scintigraphy is an established imaging modality, however, its validity as a diagnostic test in lame or poorly performing sports horses has not been determined. The objective of this retrospective cross-sectional analytical study was to determine the accuracy of skeletal scintigraphy as an indiscriminate screening test in sports horses. All sports horses that underwent scintigraphic examination between March 2008 and December 2014 for which a definitive diagnosis was reached were included. Examinations were evaluated blindly. Characteristics of increased radiopharmaceutical uptake were recorded and subjectively categorized as possibly relevant or non-relevant. Kappa statistics were used to assess agreement between test results and final diagnosis. There were 1222 positive clinical diagnoses in 480 horses, of which 687 regions (56.4%) had no associated increased radiopharmaceutical uptake and 99 regions (8.1%) had non-relevant increased radiopharmaceutical uptake. The sensitivity of increased radiopharmaceutical uptake for identification of final diagnosis was low (43.8%) and specificity was high (94.0%). The agreement was fair (κ = 0.36). Relevance categorization improved the test; the sensitivity for final diagnosis was low (35.7%), specificity was high (98.9%), and the agreement was moderate (κ = 0.45). The agreements of increased radiopharmaceutical uptake and relevance categorization with final diagnosis were only substantial for feet (κ = 0.67 and κ = 0.66, respectively) and proximal aspect of the forelimb (elbow, shoulder, and scapula combined) (κ = 0.69 and 0.78, respectively). Scintigraphic examination is unlikely to lead to a full and correct diagnosis of the cause(s) of lameness or poor performance in sports horses when used as an isolated or indiscriminate screening tool.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of the diagnostic accuracy of skeletal scintigraphy in lame and poorly performing sports horses

Quiney

Ireland

Dyson

2018

Vet Radiology Ultrasound

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“…1992; Powell et al . 2010; Morgan and Dyson 2011). In an MRI study of nonlame horses the proximomedial aspect of the palmar cortex of the McIII was thicker than laterally (Nagy and Dyson 2009).…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging findings in the carpus and proximal metacarpal region of 50 lame horses

Nagy¹,

Dyson²

2011

Equine Veterinary Journal

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“…The focal IRU at the proximal metacarpal region was consistent with a cortical metacarpus fracture. However, similar IRU has been described for longitudinal cortical fractures a condition unrelated to desmitis of the PSL , Morgan et al 2012. Additionally, a low correlation between the presence and intensity of IRU in association with proximal suspensory desmitis in the forelimb is also described without osseous involvement .…”

Section: Discussionmentioning

confidence: 92%

Desmopathy of the front proximal suspensory ligament in conjunction with a metacarpal cortical fracture in a horse: A multi-modality imaging study

Berner¹,

Gerlach²,

Brehm³

et al. 2015

PHK

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Summary: A Warmblood gelding with a grade 3/5 intermitted lameness was presented for nuclear scintigraphic examination, which revealed focal increased uptake at the left proximal metacarpal region ( Figure 1A). Radiographs of this region showed a radiolucent area surrounded by a thin, sclerotic rim. The horse died for reasons unrelated to the lameness. Following, the left forelimb was disarticulated at the elbow joint to further examine the proximal metacarpal region. Ultrasonography showed an enlargement and loss of fibre pattern of the medial lobe of the proximal suspensory ligament (PSL) as well as a focal irregularity of the proximal palmar metacarpal cortex. On transverse T2-weighted magnetic resonance (MR) images the enlargement of the medial lobe could also be detected. Additionally, extensive loss of connective tissue between the PSL and the third metacarpal bone and thickening of the palmar cortex of the metacarpus at this region were seen on MR images. These pathological abnormalities were also detectable with computed tomographic (CT) examination using the soft tissue window. However, CT also demonstrated the presence of a small radiolucent fracture line in the metacarpus. After summarizing all findings the imaging diagnosis of a unilateral, chronic proximal suspensory ligament desmopathy in conjunction with a cortical third metacarpal lesion of the PSL insertion was made. A pathohistological examination confirmed the described imaging findings at the medial lobe of the PSL. Focal areas of granulation tissue and small areas of ossification were detected. The small fracture line at the palmar cortex of the metacarpus was also confirmed by necropsy. Because of its ability to visualize osseous and soft tissue structures, CT-examinations are considered as useful supplementary tool to be included in ambiguous cases of PSL desmopathy.Keywords: horse / suspensory ligament / cortical fracture / computed tomography / magnetic resonance imaging Citation: Berner D., Gerlach K., Brehm W., Mülling C., Schöniger S., Lempe-Troillet A. (2015) Desmopathy of the front proximal suspensory ligament in conjunction with a metacarpal cortical fracture in a horse: A multi-modality imaging study. Pferdeheilkunde 31,[352][353][354][355][356]

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Incomplete longitudinal fractures and fatigue injury of the proximopalmar medial aspect of the third metacarpal bone in 55 horses

Cited by 32 publications

References 16 publications

Evaluation of the diagnostic accuracy of skeletal scintigraphy in lame and poorly performing sports horses

Evaluation of the diagnostic accuracy of skeletal scintigraphy in lame and poorly performing sports horses

Magnetic resonance imaging findings in the carpus and proximal metacarpal region of 50 lame horses

Desmopathy of the front proximal suspensory ligament in conjunction with a metacarpal cortical fracture in a horse: A multi-modality imaging study

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