SAEVA Congress 2018 Proceedings | 12-15 February 2018 | ATKV Goudini Spa
scutum medium . The medial - to - lateral thickness of the SDSL ranges from 17 - 30 mm in the proximal pastern region and decreases to 10 - 15 mm over distal P1 and then widens over the scutum medium to 45 - 65 mm . The SDSL is very echogenic with normal parallel fiber alignment throughout , except at the insertion where a central hypoechoic area is imaged normally .
Small splits or core lesions may be imaged in the SDSL . Injuries to the SDSL proximal to its insertion should be considered in horses with lameness localized to the distal fore or hind limb that had no radiographic lesions . Swelling here is difficult to detect due to the overlying deep digital flexor tendon but pain can be detected in acute cases on deep palpation .
Acute core lesion in the proximal lateral portion of the SDSL
Areas of periosteal proliferative change or avulsion fractures at the insertion of the SDSL on proximal P2 may be seen in horses with SDSL desmitis . Avulsion fractures of the origin of the SDSL are less common than with MDSL desmitis but once again , the base of the sesamoids should be carefully imaged to see if avulsion fractures are present . Repair of the SDSL is detected when there is improved echogenicity and fiber pattern in the injured area .
Abaxial or axial desmitis of the PIP joint
Injury to the abaxial ligament of the PIP joint is less common than injury to the SDFT , DDFT or distal sesamoidean ligaments in the pastern and injury to the axial ligaments is rare . The injuries to the abaxial ligaments may be associated with severe lameness , heat , sensitivity and swelling when there is severe disruption of the ligament or there may be minimal ligamentous damage with new bone formation at the origin of the ligament . The abaxial ligament originates medially at laterally in the mid pastern region and inserts superficial to the SDFT on proximal P2 . The axial ligament originates distal to the abaxial ligament and inserts between the SDFT and the SDSL onto proximal P2 . Moderate to severe injuries may lead to osteoarthritis of the PIP joint .
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