44
46TH
ANNUAL
CONGRESS
OF
THE
SAEVA
SKUKUZA
16-‐20
FEBRUARY
2014
joint, and the medial oblique distal sesamoidean ligament [23]. Desmitis of the
collateral ligaments of the distal interphalangeal joint has been described as a cause
of lameness, diagnosed in “high field” scanners. However, the presence of this
artefact can make the diagnosis challenging in standing MRI, and ideally the diagnosis
is confirmed by the presence of osseous abnormalities of the insertion or origin of
the ligament [24]. Similarly, desmitis of the sesamoidean ligaments has been
described. However, the presence of this artefact in these ligaments can make the
diagnosis particularly challenging using a horizontal magnetic field in the standing
horse.
It is fair to say that therapy has not kept pace with diagnosis, though there have been
developments in this field. Direct medication of the navicular bursa is a logical step
when imaging suggests that this is the location of the pathology. Two studies have
now documented the effect of bursal medication [25,26]. Combined, these papers
have shown that between 70 and 80% of horses will respond to medication of the
navicular bursa, and the mean duration of soundness was 7.3 and 9.3 months. Both
studies identified that abnormalities of the navicular bone, such as flexor surface
erosions or adhesions, were associated with a worse outlook. One study concluded
that horses with increased fibrous scar formation in the navicular bursa were
associated with a worse outlook. This finding is interesting, as this condition is
potentially responsive to minimally invasive surgery, to examine the navicular bursa.
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