CLINICAL SIGNIFICANCE AND PROGNOSIS OF DEEP DIGITAL FLEXOR TENDINOPATHY ASSESSED OVER TIME USING MRI.
Summary of "CLINICAL SIGNIFICANCE AND PROGNOSIS OF DEEP DIGITAL FLEXOR TENDINOPATHY ASSESSED OVER TIME USING MRI."
Deep digital flexor (DDF) tendinopathy is one of the most frequent causes of foot lameness and the prognosis is guarded. The progress of lesion healing may be followed by magnetic resonance (MR) imaging to formulate a prognosis and to adapt the rehabilitation program. We assessed the correlation of outcome with total tendon damage and temporal resolution of MR abnormalities. Images from 34 horses with DDF tendinopathy that had undergone at least two low-field standing MR examinations of the foot (mean 2.5 ± 1.3 times) were reviewed. No horse having a T1-GRE hyperintense lesion over 30 mm in length or over 10% tendon cross-sectional area returned to its previous activity level. Horses with concomitant lesions had worse outcome than horses with DDF tendinopathy only (P = 0.005). In all horses including those with excellent outcome, the lesion persisted, even mildly, in T1-GRE and PD images. Horses with tendon lesion resolution on STIR-FSE and T2-FSE images on recheck examination had a better outcome (P = 0.0004 and P = 0.002, respectively), and all horses that returned to their previous level of performance had complete resolution of signal hyperintensity on the STIR-FSE sequence. Although rehabilitation remains multifactorial, characteristics of DDF tendinopathy and concomitant lesions on first and recheck MR examinations allow refining the prognosis.
Affiliation
From the Diagnostic Imaging Department, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada; Diagnostic Imaging Department, National Veterinary School of Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, Franc
Journal Details
This article was published in the following journal.
Name: Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International V
ISSN: 1058-8183
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22741926
- DOI: http://dx.doi.org/10.1111/j.1740-8261.2012.01961.x
Medical and Biotech [MESH] Definitions
Tendinopathy
Clinical syndrome describing overuse tendon injuries characterized by a combination of PAIN, diffuse or localized swelling, and impaired performance. Distinguishing tendinosis from tendinitis is clinically difficult and can be made only after histopathological examination.
Trigger Finger Disorder
A painful disability in the hand affecting the finger or thumb. It is caused by mechanical impingement of the digital flexor tendons as they pass through a narrowed retinacular pulley at the level of the metacarpal head. Thickening of the sheath and fibrocartilaginous metaplasia can occur, and nodules can form. (From Green's Operative Hand Surgery, 5th ed, p2137-58).
Analog-digital Conversion
The process of converting analog data such as continually measured voltage to discrete, digital form.
Osteoarthropathy, Primary Hypertrophic
A conditioned chiefly characterized by thickening of the skin of the head and distal extremities, deep folds and furrows of the skin of the forehead, cheeks, and scalp, seborrhea, hyperhidrosis, periostosis of the long bones, digital clubbing, and spadelike enlargement of the hands and feet. It is more prevalent in the male, and is usually first evident during adolescence. It is believed to be inherited as an autosomal dominant trait. (From Dorland, 27th ed)
Psoas Muscles
A powerful flexor of the thigh at the hip joint (psoas major) and a weak flexor of the trunk and lumbar spinal column (psoas minor). Psoas is derived from the Greek "psoa", the plural meaning "muscles of the loin". It is a common site of infection manifesting as abscess (PSOAS ABSCESS). The psoas muscles and their fibers are also used frequently in experiments in muscle physiology.
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