Page 349 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

324 CHAPTER 1

VetBooks.ir Magnetic resonance imaging/computed within 3–6 weeks. There is obvious swelling in the
area palmar to the metacarpus and dorsal to the ten-
tomography
MRI provides useful information regarding the
the suspensory body becomes obvious on palpation.
bone to ligament interface and helps to determine dons (Fig. 1.625). As oedema recedes, thickening of
the presence of osseous injury that may not be vis- There may be palpable pain. SL body injuries can
ible with other means. This is particularly useful to develop as a chronic or recurrent entity and even-
detect entheseopathy without overt avulsion. CT tually lead to complete breakdown, particularly in
may be more accurate to detect and define the avul- Standardbreds.
sion fragment.
Differential diagnosis
Management Lesions within other parts of the suspensory appa-
Conservative management is often effective, based ratus and the other ligaments and tendons in that
on strict box rest for 3–6 weeks, followed by box rest region; consider other causes of inflammation else-
with walking exercise for a further 6 weeks. A con- where in the metacarpal or metatarsal area.
trolled exercise programme is then initiated for
2–6 months. If concurrent desmopathy is present, Diagnosis
convalescence is expected to take longer. The use of Clinical examination
ancillary treatments (shock-wave, perilesional injec- Palpation often provides a strong suspicion.
tions) has been suggested but not documented. Some Diagnostic analgesia is rarely necessary.
authors recommend the use of biological treatments
when avulsion is associated with severe desmopathy, Radiography
and surgery is probably advisable with desmopathy It is useful to look for fracture or periostitis of the
and avulsion in the hindlimb. The use of surgical second or fourth metacarpal or metatarsal (‘splint’)
microdrilling has been suggested but it is unclear if bones. In rare cases, axial new bone formation is
this provides additional benefits. detected radiographically.

Prognosis
The prognosis is generally good with avulsion alone 1.625
or associated with a very discrete ligamentous lesion.
It is much poorer with significant associated des-
mopathy, especially in the hindlimbs.

DESMOPATHY OF THE
SUSPENSORY LIGAMENT BODY

Overview
SL body injuries are most common in racehorses, the
forelimbs being most often affected in Thoroughbreds
and both fore- and hindlimbs in Standardbreds and
European trotters. In the latter, bilateral injury is fre-
quently encountered. It is rather uncommon in sports
horses, except in association with small metacarpal/ Fig. 1.625 Diffuse
metatarsal bone exostosis (‘splints’). swelling over the
abaxial aspects of the
Clinical presentation metacarpus due to a
The degree of lameness is variable. Lameness is subacute SL ligament
usually severe at the outset and decreases gradually injury.