title: Two clinical manifestations of desmopathy of the accessory ligament of the deep digital flexor tendon in the hindlimb of 23 horses.
abstract: BACKGROUND
  Desmopathy of the accessory ligament of the deep digital flexor tendon (ALDDFT) in the hindlimb is an unusual cause of lameness in horses, and reports of the condition are sparse.
  
  
  OBJECTIVE
  To describe the clinical and ultrasonographic findings, therapy and outcome of 23 horses treated for desmopathy of the ALDDFT in the hindlimb.
  
  
  METHODS
  Records of 23 horses with ultrasonographic evidence of desmopathy of the ALDDFT in one or both hindlimbs from 3 referral centres were reviewed retrospectively. Age, breed, sex, duration and nature of clinical signs, results of clinical and lameness examinations, treatment and outcome were recorded.
  
  
  RESULTS
  In 13 horses (Group A), there was an acute onset of unilateral lameness. Ten horses (Group B) had an insidious or sudden onset of postural abnormality. There were 10 cobs, 5 British native-breed ponies and 8 horses of various larger breeds. Twenty horses were used for general purposes, and mean age was 12 years. Enlargement of the ALDDFT in the affected hindlimb(s) was identified in all horses. In 44% of horses, ultrasonographic abnormalities were localised to part of the ALDDFT. Treatment included box-rest and controlled exercise, and 10 horses were subjected to desmotomy or desmectomy of the ALDDFT. Seventy-three percent of horses in Group A returned to full function, while 90% of those in Group B remained lame.
  
  
  CONCLUSIONS
  Two distinct clinical conditions are associated with the ALDDFT of the hindlimb. Traumatically induced injury resulting in acute onset lameness appears to have a favourable prognosis, with most horses returning to previous work. However, postural changes, once present, are irreversible and indicate a poor prognosis.
  
  
  CONCLUSIONS
  Desmopathy of the ALDDFT should be recognised as a potential cause of hindlimb lameness and this study provides clinical and prognostic information. Knuckling and/or semiflexion of the metatarsophalangeal joint may accompany the condition; therefore, if a horse is presented with a flexural deformity of this joint, desmopathy of the ALDDFT should be considered as a primary differential diagnosis.
authors.affiliation: Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK.
authors.forename: E
authors.initials: E
authors.lastname: Eliashar
authors.forename: S J
authors.initials: SJ
authors.lastname: Dysont
authors.forename: R M
authors.initials: RM
authors.lastname: Archer
authors.forename: E R
authors.initials: ER
authors.lastname: Singer
authors.forename: R K W
authors.initials: RK
authors.lastname: Smith
mesh_terms: D000818:Animals; D005260:Female; D006614:Hindlimb / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006734:Horse Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D006736:Horses; D007249:Inflammation / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy / Q000662:veterinary*; D007794:Lameness, Animal / Q000209:etiology; D008297:Male; D011379:Prognosis; D012146:Rest; D012189:Retrospective Studies; D013710:Tendons / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography