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Primary desmitis of the palmar and plantar annular ligaments in horses: 25 cases (1990–2003)

Julie D. McGhee DVM1,2, Nathaniel A. White DVM, MS, DACVS3, and Laurie R. Goodrich DVM4
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  • 1 Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech, Leesburg, VA 20177.
  • | 2 Present address is 6675 Glenville Rd, Glen Rock, PA 17327.
  • | 3 Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech, Leesburg, VA 20177.
  • | 4 Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.

Abstract

Objective—To determine clinical and ultrasonographic abnormalities in horses with primary desmitis of the palmar or plantar annular ligament (PAL) and the response to treatment.

Design—Retrospective study.

Animals—25 horses.

Procedure—Data collected from medical records included signalment, horse use, affected limb, severity and duration of lameness, results of diagnostic tests performed, ultrasonographic findings, treatment, and outcome.

Results—All horses had a prominent swelling in the region of the affected PAL, and signs of pain were evident during palpation of the swelling. In all horses, the affected PAL was thicker than normal as determined ultrasonographically. Twenty horses had hypoechoic regions in the PAL. Four horses, including 1 horse with 3 affected limbs, were treated by means of PAL desmoplasty, 9 were treated by means of PAL desmotomy, and 12 were treated with rest. Follow-up information was available for 21 horses. All 4 horses that underwent PAL desmoplasty, 4 of 7 horses that underwent PAL desmotomy, and 7 of 10 horses treated with rest alone became sound.

Conclusions and Clinical Relevance—Results suggest that primary desmitis of the PAL may be a cause of lameness in horses. Although significant differences in outcome between horses treated with rest alone versus PAL desmoplasty versus PAL desmotomy were not identified, because it is less invasive, PAL desmoplasty should be considered for treatment of horses with PAL desmitis that do not respond to conservative treatment and do not have any evidence of constriction of the digital flexor tendons. (J Am Vet Med Assoc 2005;226:83–86)

Abstract

Objective—To determine clinical and ultrasonographic abnormalities in horses with primary desmitis of the palmar or plantar annular ligament (PAL) and the response to treatment.

Design—Retrospective study.

Animals—25 horses.

Procedure—Data collected from medical records included signalment, horse use, affected limb, severity and duration of lameness, results of diagnostic tests performed, ultrasonographic findings, treatment, and outcome.

Results—All horses had a prominent swelling in the region of the affected PAL, and signs of pain were evident during palpation of the swelling. In all horses, the affected PAL was thicker than normal as determined ultrasonographically. Twenty horses had hypoechoic regions in the PAL. Four horses, including 1 horse with 3 affected limbs, were treated by means of PAL desmoplasty, 9 were treated by means of PAL desmotomy, and 12 were treated with rest. Follow-up information was available for 21 horses. All 4 horses that underwent PAL desmoplasty, 4 of 7 horses that underwent PAL desmotomy, and 7 of 10 horses treated with rest alone became sound.

Conclusions and Clinical Relevance—Results suggest that primary desmitis of the PAL may be a cause of lameness in horses. Although significant differences in outcome between horses treated with rest alone versus PAL desmoplasty versus PAL desmotomy were not identified, because it is less invasive, PAL desmoplasty should be considered for treatment of horses with PAL desmitis that do not respond to conservative treatment and do not have any evidence of constriction of the digital flexor tendons. (J Am Vet Med Assoc 2005;226:83–86)