Page 407 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

382 CHAPTER 1

VetBooks.ir 1.754 1.755

Mt4

T4

Fig. 1.754 Longitudinal sonogram over the Fig. 1.755 Longitudinal sonogram over the
plantarolateral aspect of the distal tarsus.The long branch medial aspect of a tarsus with cunean tendonitis.
of the LPL (arrow) runs distally from the calcaneus, The tendon (arrow) is enlarged, hypoechogenic and
over the plantar aspect of the fourth tarsal bone (T4), to heterogeneous.The underlying bursa is distended with
insert over the proximal aspect of the head of the fourth anechogenic fluid (arrowhead).
metatarsal bone (Mt4). There is mild, hypoechogenic
thickening of the LPL and overlying subcutaneous tissue.
This is a very rare cause of curb-like deformity.

aspects of the tendon may be associated with marked CUNEAN TENDONITIS/BURSITIS
paratendonitis and/or haematoma.
Plantar ligament injuries lead to ligament thick- Overview
ening (Fig. 1.754), although it may be necessary to The cunean tendon is the medial branch of the distal
compare with the opposite limb for confirmation. tendon of the tibialis cranialis muscle. It arises from
Although desmitis with thickening of the ligament, the main tendon on the dorsal aspect of the tarsus and
without changes in echogenicity, has been described runs obliquely and medially to attach to the head of
as a cause of loss of performance in racehorses, the second metatarsal bone. A small, subtendinous
the author has usually observed diffuse or focal bursa is present between the surface of the second and
hypoechogenic lesions within the ligament. There central tarsal bones and the cunean tendon. Cunean
may be associated bone remodelling, particularly at tendonitis and bursitis have been described as a cause
the distal insertion on the fourth metatarsal bone. of lameness and poor performance, especially in rac-
ing Standardbreds. This condition is the subject of
Management controversy, as most authors believe that the pain is
Conservative treatment is preferred in all forms of actually due to DJD of the distal tarsal joints (‘bone
curb. Box rest, in-hand exercise and local hosing and spavin’). Anaesthesia of the bursa or of the tarsometa-
anti-inflammatory treatments are used as for other tarsal and distal intertarsal joints appears to provide
types of tendon/ligament injuries. similar results in many cases of bone spavin.
This author has observed one case of cunean ten-
Prognosis donitis, confirmed on ultrasonography (Fig. 1.755).
The prognosis is good for most cases of curb, This was most likely due to direct trauma and was
although the swelling may persist. SDFT injuries associated with marked focal oedema.
carry a good to poor prognosis, depending on the Treatment, if the condition and associated lame-
severity and extent of the lesion. ness have been confirmed, consists of rest, application