Proximal suspensory desmopathy in hindlimbs: A correlative clinical, ultrasonographic, grosspost mortemand histological study

Abstract

Ultrasonography was reliable for the detection of SL pathology based on histology as the gold standard. Adhesions may be a reason for recurrent lameness after surgery.

Magnetic Resonance Imaging, Gross Postmortem, and Histological Findings for Soft Tissues of the Plantar Aspect of the Tarsus and Proximal Metatarsal Region in Non‐lame Horses

“…The greatest variation was seen in the shape, distribution, and signal intensity of the central and peripheral muscle and adipose tissue. Decrease in signal intensity of the muscle and adipose tissue has been related to injury and a recent study has highlighted the frequency of occurrence of muscle pathology in association with proximal suspensory desmopathy . It has previously been demonstrated that intermediate signal intensity within the suspensory ligament is related to the presence of muscle tissue, the distribution, and amount of which showed considerable variation .…”

“…The size of the suspensory ligament, its proximity to the metatarsal bones and comparison with the contralateral limb (if lameness is unilateral) may aid interpretation. Adhesions between the suspensory ligament and either the adjacent soft tissue structures or the metatarsal bones may occur in association with proximal suspensory desmopathy and knowledge of normal MR anatomy may facilitate their identification …”

“…Historically, ultrasonography has been the diagnostic technique of choice for assessment of the soft tissue structures of the plantar aspect of the tarsus and the proximal metatarsal region. The accuracy of diagnosis of proximal suspensory desmopathy achieved by conventional diagnostic imaging techniques based on magnetic resonance imaging (MRI) as the gold standard has been questioned, although a more recent study showed good correlation between ultrasonography and histology . However, assessment of the abaxial aspects of the suspensory ligament can be challenging depending on the ultrasound beam width and shape and the conformation of the horse's limb, although this can be overcome to some extent by assessing the suspensory ligament in a nonweightbearing limb with the ultrasound beam on and off incidence …”

“…However, the relationships of the suspensory ligament with adjacent tissues were not described. A recent study highlighted the presence of adhesions between the suspensory ligament and adjacent tissues in lame horses and the limited ability to detect adhesions ultrasonographically …”

Comparison of Metzenbaum scissors and Y‐shaped fasciotome for deep metatarsal fasciotomy for the treatment of proximal suspensory ligament desmopathy in horses

“…All limbs selected for the study had no history of preexisting pathology of the hind limb PSL. In horses with PSLD, adhesions may form between PSL and proximoplantar aspect of the metatarsal bone or the surrounding tissue . In addition, chronic inflammation of the metatarsal fascia results in thickening of this structure, which can impede the cutting capacity of the instrument used to incise it.…”