title: Treatment of chronic or recurrent proximal suspensory desmitis using radial pressure wave therapy in the horse.
abstract: BACKGROUND
  Proximal suspensory desmitis (PSD) is diagnosed with increasing frequency in horses and radial pressure wave therapy (RPWT) is a widely used therapy for painful orthopaedic conditions in man and dogs. There are, however, few published data as to the outcome of its use in PSD.
  
  
  OBJECTIVE
  To evaluate the use of RPWT in the treatment of chronic or recurrent PSD in the horse, an injury which carries a poor prognosis for return to athletic function with conservative management alone.
  
  
  OBJECTIVE
  RPWT and controlled exercise improves the prognosis of chronic or recurrent PSD in the horse when compared to previously published results of controlled exercise alone.
  
  
  METHODS
  The use of RPWT in the management of chronic or recurrent proximal suspensory desmitis (PSD) was evaluated in 65 horses. Diagnosis was based on response to local analgesia, ultrasonography and radiography. Horses were classified according to severity of ultrasonographic lesions, whether fore- or hindlimbs were affected, and duration of lameness prior to diagnosis. Horses were treated 3 times at 2-week intervals and followed a controlled exercise programme; they were reassessed clinically and ultrasonographically 10-12 weeks after diagnosis, when further exercise recommendations were made dependent upon the animal's progress.
  
  
  RESULTS
  Forty-one percent of horses with hindlimb lameness and 53% with forelimb lameness were nonlame and returned to full work 6 months after diagnosis. The prognosis was significantly affected by the ultrasonographic grade at the time of diagnosis and by ultrasonographic evidence of resolution of the lesion in hindlimb cases.
  
  
  CONCLUSIONS
  These findings, when compared to previously published results of treatment using controlled exercise alone, suggest that RPWT improves the prognosis for PSD in the hindlimb.
  
  
  CONCLUSIONS
  RPWT is a useful treatment modality for chronic or recurrent PSD when combined with controlled exercise. Further studies are required on the effect of RPWT employing histology and biomechanics in order to fully evaluate its use on equine tissues.
authors.affiliation: Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK.
authors.forename: O M
authors.initials: OM
authors.lastname: Crowe
authors.forename: S J
authors.initials: SJ
authors.lastname: Dyson
authors.forename: I M
authors.initials: IM
authors.lastname: Wright
authors.forename: M C
authors.initials: MC
authors.lastname: Schramme
authors.forename: R K W
authors.initials: RK
authors.lastname: Smith
mesh_terms: D017677:Age Distribution; D000818:Animals; D002908:Chronic Disease; D005260:Female; D005552:Forelimb / Q000000981:diagnostic imaging / Q000473:pathology; D019220:High-Energy Shock Waves; D006614:Hindlimb / Q000000981:diagnostic imaging / Q000473:pathology; D006734:Horse Diseases / Q000175:diagnosis / Q000628:therapy*; D006736:Horses; D007249:Inflammation / Q000628:therapy / Q000662:veterinary*; D007794:Lameness, Animal / Q000175:diagnosis / Q000628:therapy*; D008022:Ligaments / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D010805:Physical Conditioning, Animal / Q000502:physiology; D011379:Prognosis; D011859:Radiography; D012008:Recurrence; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014463:Ultrasonography