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Retrospective analysis of oblique and straight distal sesamoidean ligament desmitis in 52 horses

Hawkins, Alex; O’Leary, Lauren; Bolt, David; Fiske?Jackson, Andrew; Berner, Dagmar; Smith, Roger


Alex Hawkins

Lauren O’Leary

David Bolt

Andrew Fiske?Jackson

Dagmar Berner

Roger Smith


Injuries to the oblique (ODSL) or straight (SDSL) distal sesamoidean ligaments are a recognised cause of distal limb lameness in the horse. However, there are only limited publications addressing common diagnostic features and prognosis.

(a) Report findings on ultrasonography and standing low‐field magnetic resonance imaging (sMRI) in horses with ODSL or SDSL injury; (b) Identify clinical variables associated with lesion type and (c) Identify factors associated with return to soundness in horses with ODSL or SDSL injury.

Study design
Retrospective case series.

Horses with a primary diagnosis of ODSL or SDSL injury confirmed with a combination of diagnostic analgesia and detection of a lesion on imaging (ultrasonographic ± advanced imaging) were included. Return to soundness and performance follow‐up data were obtained.

Fifty‐one horses were included. SDSL injuries were more common in the forelimb (13/21, 62%), while ODSL injuries had equal frequency in fore‐ (15/30, 50%) and hindlimbs (15/30, 50%). ODSL injuries were more likely than SDSL injuries to affect the proximal third of the ligament (OR =13; 95% CI 2.3‐74.3; p = 0.004) and often presented with periligamentar swelling (20/30;67%) and focal pain (22/28;79%). Lesions were frequently detected using ultrasonography (35/42;83%) and sMRI examination (18/25;72%). Only 27/49 cases (55%) returned to soundness, with only 15/49 (31%) returning to intended use. There were no significant associations between outcome and clinical features or treatment.

Main limitations
There was no comparative “gold standard” to validate lesions such as high‐field MRI or histopathology.

In contrast to previous studies, ODSL and SDSL injuries were readily identified ultrasonographically using appropriate views, and with sMRI. Given the limited availability, cost and general anaesthetic risks associated with high‐field MRI, more focus should be placed on optimising the ultrasonographic examination. Owners of affected horses should be informed of the guarded prognosis for return to full use.


Hawkins, A., O’Leary, L., Bolt, D., Fiske‐Jackson, A., Berner, D., & Smith, R. (2021). Retrospective analysis of oblique and straight distal sesamoidean ligament desmitis in 52 horses. Equine Veterinary Journal,

Journal Article Type Article
Acceptance Date Feb 10, 2021
Online Publication Date Mar 11, 2021
Publication Date Mar 11, 2021
Deposit Date Mar 25, 2021
Publicly Available Date Mar 25, 2021
Journal Equine Veterinary Journal
Print ISSN 0425-1644
Electronic ISSN 2042-3306
Publisher Wiley
Peer Reviewed Peer Reviewed
Keywords Equine; General Medicine
Public URL


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