O'Brien Etienne J O, Smith Roger K W
Clinical Sciences and Services, The Royal Veterinary College, University of London, Hatfield, UK.
Vet Radiol Ultrasound. 2018 Sep;59(5):613-623. doi: 10.1111/vru.12628. Epub 2018 May 18.
Tendon/ligament mineralization is recognized in horses but information regarding its clinical significance is limited. The aims of this observational study were to report the structures most commonly affected by ultrasonographically detectable mineralization and, for these, determine frequency of diagnosis and key clinical features. Cases presented at our hospital in April 1999-April 2013 and September 2014-November 2015 were included: a total of 27 horses (22 retrospective, five prospective). Mineralizations were most common in deep digital flexor tendons (10) and suspensory ligament branches (eight), representing 10% and 7% (estimated), respectively, of horses diagnosed with injuries to these structures during the study. Two deep digital flexor tendon and three suspensory ligament branch cases showed bilateral mineralization. Deep digital flexor tendon mineralization was restricted to the digital flexor tendon sheath, most commonly in the proximal sheath (±sesamoidean canal), and seven of 10 cases involved hindlimbs. Suspensory ligament branch mineralization was visible in the same ultrasound window as the proximal sesamoid bones in 10/11 limbs and six of eight cases involved forelimbs. Previous corticosteroid medication was a feature of one deep digital flexor tendon and one suspensory ligament branch case. Mineralization was associated with lameness in some but not all limbs. Mineralized foci within the deep digital flexor tendon preceded hypoechoic lesion formation in two limbs. Of the cases with deep digital flexor tendon or suspensory ligament branch injury only, one of three and two of three cases, respectively, became sound. Findings indicated that tendon/ligament mineralization can be associated with lameness in some horses, but can also be an incidental finding.
肌腱/韧带矿化在马匹中已得到确认，但关于其临床意义的信息有限。这项观察性研究的目的是报告超声可检测到的矿化最常累及的结构，并针对这些结构确定诊断频率和关键临床特征。纳入了1999年4月至2013年4月以及2014年9月至2015年11月在我院就诊的病例：共计27匹马（22例回顾性病例，5例前瞻性病例）。矿化最常见于指深屈肌腱（10例）和悬韧带分支（8例），分别占研究期间诊断为这些结构损伤马匹的10%和7%（估计值）。2例指深屈肌腱和3例悬韧带分支病例显示双侧矿化。指深屈肌腱矿化局限于指屈肌腱鞘，最常见于近端鞘（±籽骨管），10例中有7例累及后肢。11个肢体中的10个，悬韧带分支矿化在与近端籽骨相同的超声窗可见，8例中有6例累及前肢。1例指深屈肌腱和1例悬韧带分支病例有先前使用皮质类固醇药物的情况。矿化在一些但并非所有肢体中与跛行有关。指深屈肌腱内的矿化灶在2个肢体中先于低回声病变形成。仅在指深屈肌腱或悬韧带分支损伤的病例中，分别有三分之一和三分之二的病例恢复正常。研究结果表明，肌腱/韧带矿化在一些马匹中可能与跛行有关，但也可能是偶然发现。
