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  Discussion on Research Summary: Prognosticating Sesmoiditis
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DrO

Posted on Friday, Aug 21, 2015 - 9:41 am:

If I understand the term "odds ratio" correctly, yearling TB race horses with changes in the appearance of the suspensory ligament branch on ultrasound were 5 times more likely to go and develop sesmoiditis during training.
DrO

Equine Vet J. 2015 Aug 17.
Association between sesamoiditis, subclinical ultrasonographic suspensory ligament branch change and subsequent clinical injury in yearling Thoroughbreds.
Plevin S1, McLellan J1, O'Keeffe T2.

Author information:
1Florida Equine Veterinary Associates, 10195 N Hwy 27, Ocala, Florida, 34482, USA.
2Rossdales Equine Hospital, Cotton End Road, Exning, Newmarket, CB8 7NN, UK.

Abstract
REASONS FOR PERFORMING THE STUDY:
Sesamoiditis is a common radiologic finding in yearling Thoroughbreds. The condition is believed to be associated with suspensory ligament branch insertional injury (SLBI), which is known to affect racing performance. The presence of subclinical suspensory ligament branch change (SSLBC) in untrained yearlings has not been investigated. Associations between sesamoiditis, SSLBC and subsequent suspensory ligament branch injury would allow more accurate prognoses to be made regarding the development of SLBI. They could also provide opportunity for intervention and prevention of SLBI.

OBJECTIVES:
To test our hypotheses that untrained yearling Thoroughbreds with sesamoiditis would be more likely to have ultrasonographic findings of subclinical suspensory ligament branch change (SSLBC) and those horses with concurrent sesamoiditis and SSLBC would be more likely to develop clinical suspensory ligament branch injury with training.

STUDY DESIGN:
Prospective, cohort, observational study.

METHODS:
Yearling Thoroughbreds located at a single training centre were evaluated at the onset of their training careers and for the next 9 months. Radiographic and ultrasonographic examination of bilateral forelimb proximal sesamoid bones and suspensory ligament branches was performed.

RESULTS:
Fifty horses were eligible, resulting in 200 forelimb sesamoid/suspensory ligament branch pairs. A significant relationship existed between possibly significant sesamoiditis (PS sesamoiditis) and possibly significant suspensory change (PS SSLBC) (P<0.001). The odds ratio of sesamoids with 'PS-Sesamoiditis' also demonstrating concurrent PS SSLBC was 5.1 (95% CI 2.68-9.70, p<0.001). A significant relationship also existed between the concurrent presence of PS Sesamoiditis and PS SSLBC and the subsequent development of clinical signs of SLBI (p<0.001, OR 11.7, 95% CI 4.1-33.4).

CONCLUSIONS:
The associations identified in this study highlight the importance of ultrasonographic examination of suspensory ligament branches in horses with PS sesamoiditis. This information should allow more accurate prognostic advice regarding potential SLBI development and also provide opportunities for intervention and prevention of clinical SLBI.
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