Desmitis of the Accessory Ligament of the Deep Digital Flexor Tendon in the Horse: Clinical and Ultrasonographic Features A Report of 24 Cases

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Abstract
The clinical and ultrasonographic features of desmitis of the accessory ligament of the deep digital flexor tendon (carpal check ligament) are reported in a series of 24 horses. Lameness associated with the carpal check ligament especially was found in Warmblood riding horses ranging in age from 6 to 18 years with a mean age of 11.3 years. The most striking clinical feature was a firm, painful swelling medially and laterally in the proximal and/or mid metacarpal region, corresponding with the dorsoproximal-palmarodistal oblique direction of the carpal check ligament. Sonographically swelling of the carpal check ligament was common, the enlarged ligament mostly showing a type 1-2 texture. Occasionally a more localized lesion with a type 3-4 texture was present. About 40% of the horses also showed additional lesions in (one of three other flexor tendons or ligaments in the metacarpal region. Most horses were treated conservatively, i.e. boxstallrest and/or a controlled exercise regime were applied. From the 19 horses available for follow up (1-36 months), only 3 horses resumed full work. Obviously the prognosis of this injury is guarded.