Olive Julien, Videau Marine
Dr. Julien Olive, Département de Sciences Cliniques, Centre Hospitalier Universitaire Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, J2S 7C6, Canada.
Vet Comp Orthop Traumatol. 2017 Mar 20;30(2):107-110. doi: 10.3415/VCOT-16-08-0120. Epub 2017 Feb 16.
Macroscopic studies have suggested a link between distal border synovial invaginations of the navicular bone and the distal interphalangeal joint. However, many practitioners consider that these invaginations are directly and solely related to navicular disease. The objective was to investigate the communication pattern of these synovial invaginations with the synovial compartments of the distal interphalangeal joint and the navicular bursa, using minimally invasive imaging techniques.
In a prospective observational study, 10 cadaveric limbs with radiographically evident distal border synovial invaginations were randomly assigned to computed tomography arthrography or bursography groups, using iopamidol.
In 5/5 limbs, contrast medium filled the invaginations following distal interphalangeal arthrography. In the other five limbs, no contrast medium filled the invaginations following bursography.
Contrary to existing beliefs, these invaginations are more likely associated with distal interphalangeal joint synovitis and may not be directly linked to primary navicular bone pathology, but might reflect distal interphalangeal arthropathy. Therefore, the rationale for assessment of these invaginations in stallion selection or pre-purchase examinations as a predictive sign for navicular disease is questionable. Nonetheless, comorbidities are frequent in the equine distal limb. Enlarged synovial invaginations may also be seen in limbs with concomitant primary navicular disease. Further studies are needed to elucidate possible inter-related pathological processes.
宏观研究表明舟骨远端边缘滑膜凹陷与远侧指间关节之间存在联系。然而，许多从业者认为这些凹陷直接且仅与舟骨疾病有关。目的是使用微创成像技术研究这些滑膜凹陷与远侧指间关节滑膜腔和舟骨囊的连通模式。
在一项前瞻性观察研究中，将10具影像学上有明显远端边缘滑膜凹陷的尸体肢体随机分为计算机断层扫描关节造影组或囊造影组，使用碘帕醇。
在5/5的肢体中，远侧指间关节造影后造影剂填充了凹陷。在另外五个肢体中，囊造影后没有造影剂填充凹陷。
与现有观点相反，这些凹陷更可能与远侧指间关节滑膜炎有关，可能与原发性舟骨病理无直接关联，但可能反映远侧指间关节病。因此，在种马选择或购前检查中评估这些凹陷作为舟骨疾病预测指标的基本原理值得怀疑。尽管如此，马远端肢体合并症很常见。在伴有原发性舟骨疾病的肢体中也可能出现扩大的滑膜凹陷。需要进一步研究以阐明可能的相互关联的病理过程。
