Page 295 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

270 CHAPTER 1

VetBooks.ir 1.512 1

Fig. 1.512 Supra- and interspinous
2
desmitis in a horse without dorsal
spinous process impingement. Increased
osteoclastic activity weakens the
ligament attachment, predisposing to
injury. Sclerosis, lysis and entheseophyte
formation can be seen in the three spaces
to the right of the image.

1.513

Fig. 1.513 Small avulsion bone injuries
sustained after supraspinous ligament
trauma (arrows).

1.514
1
2

Fig. 1.514 Chronic supraspinous
desmitis manifest in this horse with
thickening of the soft tissues and rounded
entheseophytes on the dorsal tips of the
dorsal spinous processes (arrows).

Diagnosis and fibrosis present in the supraspinous ligament
Avulsion fracture fragments may be observed on (Fig. 1.515). Injection of local anaesthetic around
laterolateral radiographs (Fig. 1.513) at the inser- the injured ligament may reduce pain dramatically.
tion point of the ligament onto the DSP. Thickening Interspinous ligament desmitis is not well defined.
of the soft tissues overlying the DSPs and rounded The changes seen may resemble those seen with
entheseophytes on the dorsal tips of the DSPs is a impingement of DSPs, namely sclerosis and occa-
progressive finding with chronicity (Fig. 1.514). sional lysis in the adjacent DSP, but unlike that con-
Ultrasound assessment of the supraspinous liga- dition, the interspinous space tends to be normal
ment can show entheseophytes more clearly and may sized. Increased osteoclast activity in the enthesis is
also illustrate acute hypoechoic zones or thickening readily visible on gamma scintigraphy.