Treatment of a Cyst-Like Synovial Hernia Associated with the Digital Flexor Tendon Sheath of a 17-Year-Old Pony

This report describes a case of sudden lameness in an 18year-old Percheron cross mare after presumably being kicked by another horse, and the subsequent formation of a ganglion cyst originating from the lateral femorotibial joint. Physical examination, radiographic and ultrasonographic investigation identified a soft round 5 cm diameter mass attached to the left lateral femorotibial joint. After surgical removal, histopathological examination confirmed a ganglion cyst. The horse responded well to the surgical removal of the cyst, and 4 weeks after the surgery, the mare has returned back to her same athletic performance. According to the authors' knowledge, this is the first reported case that describes a peri-articular ganglion cyst originating from the stifle joint.

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acquired peri‐articular ganglion cyst in the lateral femorotibial joint in an 18‐year‐old Percheron cross mare

Alsherif¹,

Myhre²,

Vin³

2020

“…Wilson () described a synovial hernia with synovial membrane herniating through the joint capsule into the subcutaneous space following carpal arthroscopy that required dissection from the surrounding tissues. The terms hernia, ganglion, cyst, synoviocoele and combinations of these terms have been used by authors to describe abnormalities found (Angelides and Wallace ; McIlwraith ; Smith ; Crawford et al . ; Minshall and Wright ; Lacourt et al .…”

Section: Discussionmentioning

confidence: 99%

Synovial herniation as a complication of arthroscopy in a Thoroughbred yearling

Marshall¹,

Adkins²

2013

Summary This paper reports the successful use of a half limb cast to treat prior failures in healing of a synovial hernia in a Thoroughbred yearling. The hernia was due to a nonhealing arthroscopy portal and was confirmed using ultrasonography and positive contrast arthrography to visualise the communication between the metacarpophalangeal joint and subcutaneous space. Surgery was performed 3 times, due to failure of healing of the joint capsule and recurrence of clinical signs. A half limb cast applied following the final surgery effected a repair. At 2 months post surgery there was no recurrence of the subcutaneous swelling and at 3 months post surgery a repeat positive contrast arthrogram confirmed healing of the hernia.

“…Eight of the 10 horses included in the case series were lame and following surgical excision of the cyst, seven of the eight lame horses returned to previous level of work. One case report described successful, conservative management of a similar clinically significant fluid‐filled mass associated with the DFTS in a pony (Smith ). The mass was injected with corticosteroids and atropine and the limb was bandaged for 48 h. According to the human literature, conservative management of dorsal wrist ganglion is associated with increased recurrence rate and reduced success rate compared to surgical excision (Kahn and Hayat ).…”

Section: Introductionmentioning

confidence: 99%

Alternative surgical treatment for synovial ganglion cyst of the digital tendon sheath in one horse

Lipreri

Kelly

2019

Summary A 6‐year‐old Highland pony gelding was presented with severe left fore (LF) limb lameness of acute onset. The lameness occurred concomitantly with mild digital flexor tendon sheath (DFTS) effusion and focal painful swelling on the lateral aspect of the LF fetlock region. Clinical examination and diagnostic analgesia localised the lameness to the fetlock region and on ultrasound, a cyst‐like structure filled with anaechoic fluid was detected just proximal to the lateral sesamoid bone, at the proximo‐lateral aspect of the DFTS and adjacent to the lateral neurovascular bundle. Communication between the cyst‐like structure and the DFTS was suspected ultrasonographically and then confirmed with contrast tenography. Tenoscopic examination of the LF DFTS was performed and the communication between the fluid‐filled structure and the synovial cavity was detected. The defect in the DFTS wall was enlarged tenoscopically and the lining of the cyst‐like structure was debrided. The horse recovered well post‐operatively and was back in work with no evident lameness 8 months after surgery. This alternative minimally invasive surgical treatment had an excellent outcome and has the advantage of reducing the risk associated with en bloc resection.