29th Cavalry Squadron Royal Horse Guard, Bangkok, Thailand; Veterinary and Remount Department, The Royal Thai Army, Nakhon Pathom, Thailand.
Veterinary and Remount Department, The Royal Thai Army, Nakhon Pathom, Thailand.
J Equine Vet Sci. 2021 Jun;101:103449. doi: 10.1016/j.jevs.2021.103449. Epub 2021 Mar 16.
The fetlock joint is a high mobility structure that accommodates enormous loading during locomotion. An injury of the superficial constituent such as subtendinous bursitis may occur due to repeated trauma. An 8-year old school riding horse was presented with dorsomedial distension in the left hindlimb fetlock region. The lesion was noted following routine exercise. The horse demonstrated no lameness and a negative response to the fetlock flexion test. Radiographic findings revealed a smooth surface cortical thickening on the medial aspect of the distal third metatarsal bone. Furthermore, the ultrasonography showed synovial thickening and proliferation, fibrous thickening with an irregular border in the inner synovial lining, and local protuberance of the fibrous layer within the bursa beneath the long digital extensor tendon. Cytological examination of the fluid from the distended lesion discovered multiple nucleated cells, including synoviocytes, nondegenerate neutrophils, lymphocytes, and macrophages. Eventually, the horse suffered subtendinous bursitis of long digital extensor tendon in the left hindlimb fetlock region. Intrabursa administration of 10 mg triamcinolone acetate alongside 25 mg hyaluronan (HA) and subsequent pressure bandaging were performed in the affected fetlock area. The distension was substantially reduced after the 4-week recovery period post medical administration. In summary, the horse was diagnosed with long digital extensor subtendinous bursitis that can occur accidentally. The diagnostic imaging and cytological analysis of accumulated fluid benefited a critical evaluation and facilitated the selection of the appropriate therapeutic plan for this defect.
球节是一个高活动性的结构，在运动时能承受巨大的负荷。由于反复的创伤，可能会发生浅表结构（如腱鞘囊炎）的损伤。一匹 8 岁的学校骑乘马出现左后肢球节区域的背侧内侧肿胀。在常规运动后发现了病变。这匹马没有跛行，对球节弯曲试验也没有负面反应。放射学检查显示，第三跖骨远端三分之一的内侧有光滑的皮质增厚表面。此外，超声检查显示滑膜增厚和增生，滑膜内层的纤维层增厚，边界不规则，在长趾伸肌腱下的囊内有局部纤维层的突起。对肿胀病变的液体进行细胞学检查发现了多个有核细胞，包括滑膜细胞、非退化性嗜中性粒细胞、淋巴细胞和巨噬细胞。最终，这匹马被诊断为左后肢球节的长趾伸肌腱腱鞘囊炎。在受影响的球节区域，向囊内注射 10 毫克曲安奈德醋酸酯、25 毫克透明质酸（HA），然后进行压力包扎。在药物治疗后的 4 周恢复期后，肿胀明显减少。总之，这匹马被诊断为意外发生的长趾伸肌腱腱鞘囊炎。对积液的影像学诊断和细胞学分析有助于进行关键性评估，并为这种缺陷选择适当的治疗方案。
