Centre for Equine Studies, Animal Health Trust, Newmarket, Suffolk, UK.
Equine Vet J. 2010 Oct;42(7):591-9. doi: 10.1111/j.2042-3306.2010.00097.x.
Osseous spurs on the dorsoproximal aspect of the third metatarsal bone (MtIII) are common, but their clinical significance is unknown.
To verify the sites of insertion of the dorsal metatarsal ligament and the tendons of tibialis cranialis and fibularis tertius in order to determine if periarticular osteophytes and entheseophytes could be differentiated radiologically; and to determine the frequency of occurrence of osseous spurs on the dorsoproximal aspect of MtIII.
The frequency of osseous spurs on the dorsoproximal aspect of MtIII would be higher in lame than in clinically normal horses and higher in horses with distal hock joint pain or proximal suspensory desmitis than in horses with other causes of hindlimb lameness.
A retrospective study of data from the clinical work up and tarsal radiographs of 455 horses was performed. Horses were divided into: Group 1, clinically normal horses; Groups 2-5, according to the diagnosis of hindlimb lameness. Radiographs were examined for the presence of an osseous spur on the dorsoproximal aspect of MtIII; pathology of the distal tarsal joints was graded. The associations between the presence of a spur and lameness, diagnosis group and the grade of distal tarsal joint abnormalities were analysed statistically using Chi-squared tests.
An osseous spur was present in 25% of horses; 13% of horses with bilateral radiographs had bilateral spurs. There was no significant difference in frequency of the presence of a spur between lame and nonlame horses, or between horses with other causes of hindlimb lameness and horses with proximal suspensory desmitis and/or distal tarsal joint pain. The presence of an osseous spur was significantly associated with the grade of radiological abnormality in the distal tarsal joints (tarsometatarsal joint P = 0.018: centrodistal joint P = 0.027). In many horses it was not possible to differentiate accurately between osteophytes and entheseophytes.
The presence of an osseous spur on the dorsoproximal aspect of MtIII in the absence of other radiological abnormalities may be an incidental finding. Osseous spurs occur more frequently in hocks with radiological abnormalities in the distal tarsal joints and may be an indicator of distal tarsal joint osteoarthritis. The clinical significance must be established by intra-articular analgesia.
第三跖骨背侧近侧骨突（MtIII）很常见，但它们的临床意义尚不清楚。
验证背侧跖骨韧带和胫骨前肌和腓骨第三肌的附着点，以确定是否可以通过关节周围骨赘和腱骨赘进行放射学区分；并确定 MtIII 背侧近侧骨突的发生率。
与临床正常马相比，跛行马 MtIII 背侧近侧骨突的发生率更高，与跗关节疼痛或近端悬韧带炎的马相比，与其他后肢跛行原因的马相比，跗关节疼痛或近端悬韧带炎的马更高。
对 455 匹马的临床检查和跗关节 X 线片进行回顾性研究。根据后肢跛行的诊断，将马匹分为：第 1 组，临床正常马匹；第 2-5 组。检查 MtIII 背侧近侧是否存在骨突；对跗关节远端进行病理分级。使用卡方检验统计分析存在骨突与跛行、诊断组和跗关节远端异常程度之间的关系。
25%的马存在骨突；双侧 X 线片的 13%的马存在双侧骨突。跛行马和非跛行马之间、其他后肢跛行原因的马和患有近端悬韧带炎和/或跗关节疼痛的马之间，骨突的存在频率没有显着差异。骨突的存在与跗关节远端的放射学异常程度显着相关（跗跖关节 P=0.018：中距关节 P=0.027）。在许多马中，无法准确区分骨赘和腱骨赘。
在没有其他放射学异常的情况下，MtIII 背侧近侧存在骨突可能是偶然发现。跗关节远端关节有放射学异常的跗关节中，骨突的发生率更高，可能是跗关节骨关节炎的指标。必须通过关节内镇痛来确定其临床意义。
