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  Discussion on Check ligament injury?
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Posted on Wednesday, May 9, 2001 - 2:09 pm:

Dr O,
I posted a few messages last year about a 10yr old with arthritis in a fetlock joint. Now, having retired her I am already having problems with my new horse (fully vetted on purchase) - a 6yr old warmblood. He has suffered (since first being turned out in the field) from recurring (3 times in the last 2 months) and fairly significant swelling on the right hind cannon bone (mainly inside only) from just below the hock to above the fetlock. The swelling appears to start and end (the last bit to go down) at the top. He is not lame (even with flexion test) but the swelling is not 'filled legs' and sometimes has heat at the top. It last appeared last week and took 7 days of box rest to go down (with bute) - he was grazed sensibly in the field yesterday but it was enough for it to reappear. My vet said she is 80% sure it is a strain to the check ligament but she did an ultrasound scan and can see nothing. He is now back on box rest.
Any suggestions would be appreciated.
Alice

Posted on Thursday, May 10, 2001 - 9:19 am:

Well Alice,
There is not much I can add from here and you must follow your vets instructions. I think it is possible your problem derives from direct trauma or less serious problems (for a list see Equine Diseases: Skin Diseases: Diagnosing and Assessing Swellings in Horses and see also Equine Diseases: Lameness: Swollen, Painful, Legs). If there is no lameness and no changes on the ultrasound, perhaps you could continue to work at lower levels of exercise.
DrO

Posted on Thursday, May 10, 2001 - 2:40 pm:

Dr O,
thanks for your reply. I am confused by my vet's diagnosis (though i have to admit it is what is suspected anyway) due to the lack of anything concrete on the scan. Is it possible for there to be some kind of minor strain that could cause such swelling and heat (the swelling has gone down a little overnight but there is still heat at the inside top of the canon bone) without it showing on the scan?
If it is some other kind of direct trauma i.e he hit himself (this is possible as he brushes behind (though it is much higher up), why would the swelling reoccur with little work so long after the initial injury? Is there anything else i should do or should i just do the box rest and cross fingers it doesn't come back this time?

thanks
alice

Posted on Friday, May 11, 2001 - 7:47 am:

Alice,
1) Is it possible for there to be some kind of minor strain that could cause such swelling and heat (the swelling has gone down a little overnight but there is still heat at the inside top of the canon bone) without it showing on the scan?
Yes it is possible.
2) If it is some other kind of direct trauma i.e he hit himself (this is possible as he brushes behind (though it is much higher up), why would the swelling reoccur with little work so long after the initial injury?
How do you know when the initial injury was or that the injury in not recurrent?

3) Is there anything else i should do or should i just do the box rest and cross fingers it doesn't come back this time?
I answered this one above.
DrO

Posted on Wednesday, May 16, 2001 - 7:45 am:

Dr O,
sorry i have a couple more questions and a lengthy update! Since my last post the vet has changed her mind (having consulted a couple of other vets) about the check ligament theory and said that as there was no real lameness nor anything on the scan that it can't be the ligament. She said it must be repeated interference and that i should start lunging + limited turnout to see what sparked it off. The swelling is down since she saw it but i don't think has benefited from the lunging as there is some swelling and heat. I am pretty sure that he is not repeatedly knocking himself so high up (top of inside of cannon bone) but would be interested in your thoughts about some kind of bone trauma (like a splint)from him hitting himself (through boots) the first time he went out, that is flaring up intermittently (over the last 2 months)? When compared to the other leg, the top of the cannon bone feels as if there is something harder (bone/fibrous? )underneath the swelling.
Sorry for the essay but i don't feel i am getting anywhere with this as i still have no diagnosis!
thanks

Posted on Wednesday, May 16, 2001 - 11:19 am:

Yes your supposition is possible and a radiograph designed to show up uncalcified swellings of the perisoteum should be fairly diagnostic for a splint from traumatic origin. See Equine Diseases: Lameness: Problems of Muscles, Tendons, Ligaments, and Bones: Splints for more.
DrO
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