Tenosynovitis of the carpal sheath of the digital flexor tendons associated with tears of the radial head of the deep digital flexor: Observations in 11 horses

Abstract

Clinicians evaluating lame horses should include tearing of the radial head of the DDF as a differential diagnosis in animals with distended carpal sheaths. Tenoscopic surgery is a recommended treatment.

Musculoskeletal Lesions and Lameness in 121 Horses With Carpal Sheath Effusion (1999–2010)

“…This study detected few carpal sheath effusion cases associated with bony abnormalities. Previous reports have documented impingement and disruption of the deep digital flexor in association with osteochondroma and exostosis in some, but not all cases . In the present study, lesions were more commonly detected in the superficial digital flexor muscle and tendon with only three limbs exhibiting deep digital flexor muscle abnormalities.…”

“…Anatomical landmarks describing the extent of the carpal sheath include the proximal border at 8–10 cm proximal to the accessory carpal bone and the distal border at approximately 10 cm distal to the carpus where the deep digital flexor tendon and accessory ligament of the deep digital flexor tendon intersect. It is difficult to appreciate the carpal sheath by palpation or ultrasound unless there is synovial effusion . While the existing literature documents multiple etiologies that can cause carpal sheath effusion, the relative incidence of these lesions is currently unknown.…”

Contrast radiography in the equine orthopaedic case

“…When evaluating equine tendon sheaths it is well documented that ultrasonography is the diagnostic method of choice (Smith and Wright ; Arensburg et al . ; Minshall and Wright ,b). A limitation of ultrasonography is the penetration of ultrasound waves in thick‐skinned breeds (draught and cob breeds) when evaluating the digital flexor tendon sheath (Smith and Wright ; Arensburg et al .…”

Clinical, radiological and ultrasonographic features, treatment and outcome in 22 horses with caudal distal radial osteochondromata

“…2004), fractures of the accessory carpal bone (Dyson and Dik 1995; Nixon et al . 2004), superficial digital flexor tendonitis (Dyson and Dik 1995), incomplete rupture of the deep digital flexor tendon (DDFT) (Dik 1990) and tearing of its radial head (Minshall and Wright 2012). Although osteochondromata of the caudal distal radius is a well recognised clinical entity, a total of only 16 cases reported by 7 author groups have been found in the literature (Stahre and Tufvesson 1967; Lundvall and Jackson 1976; Lee et al .…”

“…Tenosynovitis of the carpal sheath of the digital flexor tendons (vagina synovialis communis mm flexorum) has been ascribed to osteochondromata of the caudal distal radius (Stahre and Tufvesson 1967;Lee et al 1979;Held et al 1988;Squire et al 1992;Southwood et al 1997;Nixon 2002;McIlwraith et al 2005), exostosis of the caudal margin of the distal radial metaphyseal growth plate (Nixon et al 2004;McIlwraith et al 2005), tearing of the accessory ligament of the superficial digital flexor tendon (Nixon et al 2004), fractures of the accessory carpal bone (Dyson and Dik 1995;Nixon et al 2004), superficial digital flexor tendonitis (Dyson and Dik 1995), incomplete rupture of the deep digital flexor tendon (DDFT) (Dik 1990) and tearing of its radial head (Minshall and Wright 2012). Although osteochondromata of the caudal distal radius is a well recognised clinical entity, a total of only 16 cases reported by 7 author groups have been found in the literature (Stahre and Tufvesson 1967;Lundvall and Jackson 1976;Lee et al 1979;Held et al 1988;Squire et al 1992;Southwood et al 1997;Jansson 1998), and in these, details of size, location and morphology are lacking.…”