|
|
Discussion on LDE tenosynovitis
|
| Author |
Message |
New Member:
clauee
|
Posted on Friday, Dec 26, 2014 - 10:22 am:
Hello! I have a young mare who had an accident a couple of years ago... we don't know what happened as it was during the night in the pasture, she could barely walk for 3 days and then remained lame for a few weeks... there were no signs of swelling or wound intially, but after a few days some swelling appeared in her belly, which led to a diagnosis of "muscle tear or elongation" somewhere in her hip. About one month after this accident, a little swelling appeared at the junction of the Long and Lateral digital extensors on her right hind limb... It has always been soft with no heat, and was diagnosed as a vein swelling, aparrently it had nothing to do with her accident. The mare is now 5 1/2 years old, and lately we started her training (gently). The swelling on her hind limb has become worse, although she is not lame, and a little cyst developped at this location on the tendons. Furthermore, some swelling + heat appeared on the dorsal aspect of the hock (along the long digital extensor tendon). I had the vet come over again and we proceeded to a full lameness exam, leading to the diagnosis of LDE tenosynovitis. I have ultrasonds showing the tendon, it looks like two tendons instead of one (seems like it is ruptured in the sense of the fibers, on a length of about 5 cm, below the retinaculum). The vet injected a mix of corticosteroids + hyaluronan, gave her 2 days of stall rest and three months off training (this mare lives outside 24/7). Is this a common condition? There is no lameness, and it doesn't seem painful, but the swelling increases with movment...How long after the injection should I see a difference in the swelling (it's been 4 days since and it still looks the same). Is the long-term prognosis good? Thank you
|
Moderator:
DrO
|
Posted on Saturday, Dec 27, 2014 - 9:33 am:
Welcome Claudelle,
Bursal swelling and a mild extensor tenosynovitis of the extensor bursas just over and just below the hock is a common injury caused by catching of the toe during the early forward phase of movement. This can be as simple as a trip or stepping in a hole. This usually has a good prognosis though the bursal swelling is often persistent. However your history suggests that you have a long standing problem that has not healed well and gotten worse with exercise. The many factors do not allow us to make accurate statements about your horse in particular and the best person to answer your questions is the examining veterinarian who has seen the lesions and ultrasounds.
Sometimes it takes a week or more for swelling caused by inflammation to respond to steroid treatment and may continue to improve over weeks and months. Swelling caused by loss of tissue elasticity from chronic distension, poor venous/lymphatic drainage, or inflammation not responsive to the steroids will not improve. Sometimes drainage, steroid injection, then well applied pressure bandaging for an extended time will help such problems when injection alone does not help. Lastly there may be some surgical alternatives so if the problem persists consider contacting a equine surgeon for his opinion.
DrO
|
New Member:
clauee
|
Posted on Sunday, Dec 28, 2014 - 4:46 pm:
Dr.O,
Thank you very much for the information. It was the first time my vet seen this condition, so referred to the local equine surgeon for diagnosis + treatment... Hopefully the injection will help, reevaluation is scheduled in three months.
|
New Member:
clauee
|
Posted on Tuesday, Feb 17, 2015 - 4:45 pm:
Here are the images from the ultrasound in december:
|
Member:
clauee
|
Posted on Tuesday, Feb 17, 2015 - 4:48 pm:
ultrasound 2:
|
Member:
clauee
|
Posted on Tuesday, Feb 17, 2015 - 4:49 pm:
|
Moderator:
DrO
|
Posted on Saturday, Feb 21, 2015 - 10:34 am:
Thanks for the update claudelle, how is the swelling doing?
DrO
|
Member:
clauee
|
Posted on Saturday, Feb 21, 2015 - 11:28 am:
the swelling at the junction of Long and Lateral digital extensors remained the same, but the swelling higher on the LDE has diminished about 75%. I will take a picture today of what it looks like... It seems to respond to bandages, so I do when possible with the weather... the images posted above are from diagnosis in december, I will get a follow-up end of march. Is there a way to know (from these images) if this is an old trauma? is the damage to the tendon reversible?
|
Moderator:
DrO
|
Posted on Sunday, Feb 22, 2015 - 5:17 pm:
No claudelle it is not possible to say much from static ultrasound images as I can tell you from hundreds of experiences a static image cannot provide the same information as actually doing the ultrasound. The biggest problem is that artifacts in a static image can mislead you. However the prognosis I give above is not based on the amount of damage but the particular tendons injured and there is nothing in these images to change my judgment.
DrO
|
Member:
clauee
|
Posted on Tuesday, Feb 24, 2015 - 10:30 am:
thank you 
I will give an update when we have the follow-up exam end of march!
|
|
|
