Desmitis

Erin Malone, DVM, PhD

Equine tendons and ligaments

Desmitis

Desmitis (ligamentous inflammation) is also relatively common in sport horses. It is most commonly seen in dressage horses (hindlimb), event horses (forelimb) and western performance horses

The coffin joint collateral ligaments are often damaged when hoof imbalance develops or with uneven ground. These injuries would be similar to an ankle sprain in a human. Due to the hoof wall, they may be undetected unless an MRI is performed. As with human ankle sprains, reinjury is common for several months.

The suspensory body and/or branches can also become inflamed. This injury is most common in athletic horses. It often affects a single limb but can impact both forelimbs or a forelimb and a hindlimb. Soft ground can make the lameness worse.

Clinical signs

Desmitis is harder to detect on physical examination as the ligament is less likely to swell and the deeper locations make any swelling harder to detect. The suspensory may be painful on palpation but many horses resent palpation of the suspensory body even without any underlying injury. Ultrasound and/or MRI are often needed to make a diagnosis.

Treatment

Treatment is the same as for tendonitis– controlled exercise and monitoring without turnout. However, it often takes 9-12 months.

High energy lasers may also be used to “restart” healing. Shockwave therapy is often used in damaged ligaments that have plateaued and are no longer healing. Shockwave works best if there is a tissue interface (eg insertion of ligament on bone) at the injury.

For suspensory ligament injuries in the hindlimb that won’t heal, neurectomy of the branch to the suspensory may be performed.