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Proximal Suspensory Desmopathy in Hindlimbs: A Correlative Clinical, Ultrasonographic, Gross P ost Mortem and Histological Study
Author(s) -
Dyson S.,
Pinilla M.J.
Publication year - 2015
Publication title -
equine veterinary journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.82
H-Index - 87
eISSN - 2042-3306
pISSN - 0425-1644
DOI - 10.1111/evj.12486_34
Subject(s) - suspensory ligament , medicine , histology , ultrasonography , hindlimb , anatomy , gross examination , magnetic resonance imaging , tendon , achilles tendon , ultrasound , horse , pathology , radiology , biology , paleontology
Reasons for performing study It has been suggested that ultrasonography is unreliable for the detection of hindlimb proximal suspensory desmopathy ( PSD ) based on comparison between ultrasonographic and magnetic resonance images. Objectives To compare ultrasonography with gross and histopathological post mortem examination in horses with PSD diagnosed based on the response to local anaesthesia and ultrasonography. Study design Retrospective study. Methods Nineteen horses with hindlimb PSD were humanely destroyed. The ultrasonographic abnormalities were graded prospectively as mild, moderate or severe based on predefined criteria. Thirty‐seven lame limbs were examined grossly and 36 suspensory ligaments ( SL s) were examined histologically. The histological images were graded blindly based on predefined criteria (0–3 for each tissue type; 0 = normal, 3 = severe abnormality). Descriptive statistics were performed. Results Ultrasonographic lesions were graded moderate in 31/38 (81.6%) and severe in 7/38 (18.4%) limbs; in 4/36 (11.1%) limbs adhesion formation between the proximal aspect of the SL and the accessory ligament of the deep digital flexor tendon was predicted. Gross post mortem examination revealed substantial adhesions between the proximal aspect of the SL and adjacent soft tissues in 10/37 (27.0%) limbs; in 10/37 (27.0%) limbs there were adhesions between the body of the SL and the mid plantar aspect of the third metatarsal bone, extending distally in 6 (16.2%) limbs. Histology revealed abnormalities ( grades 1–3 ) of the collagenous tissue in 25/36 (69.4%) limbs. Muscle was abnormal ( grades 1–3 ) in 35/36 (97.2%) limbs and adipose tissue ( grades 1–3 ) in 16/36 (44.4%) limbs. Neural abnormalities ( grades 1–3 ) were seen in 23/36 (63.9%) limbs and vascular changes ( grade 1 and 2 ) in 2/36 (5.6%) limbs. In 1/36 limbs no abnormality was detected. Conclusions Ultrasonography was reasonably reliable for the detection of SL pathology based on histology as a gold standard, but the ability to detect gross adhesions was limited. Ethical animal research: The study was approved by the Ethical Review Committee of the Animal Health Trust and had informed consent of the owners. Source of funding: None. Competing interests: None declared.