{"id":1186,"date":"2020-08-03T16:11:57","date_gmt":"2020-08-03T15:11:57","guid":{"rendered":"https:\/\/hallmarq.net\/?post_type=studies&#038;p=1186"},"modified":"2024-12-19T13:28:47","modified_gmt":"2024-12-19T13:28:47","slug":"18-year-old-warmblood-gelding","status":"publish","type":"studies","link":"https:\/\/hallmarq.net\/us\/case-studies\/18-year-old-warmblood-gelding\/","title":{"rendered":"Bilateral Chondral Lesions of Distal Interphalangeal Joint"},"content":{"rendered":"\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"has-black-color has-text-color wp-block-heading\">Bilateral chondral lesions of the distal interphalangeal joint in a warmblood<\/h2>\n\n\n\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h4 class=\"has-black-color has-text-color wp-block-heading\">History<\/h4>\n\n\n\n<p>An 18-year-old Warmblood gelding was presented with a right forelimb lameness of chronic duration. The horse had already received intra-articular medication of steroids and hyaluronic acid to both forelimb distal interphalangeal (DIP) joints on multiple occasions in the few years prior to presentation.<\/p>\n\n\n\n<h4 class=\"has-black-color has-text-color wp-block-heading\">Clinical examination<\/h4>\n\n\n\n<p>There was mild distension of the dorsoproximal recess of the DIP join on both left and right forelimbs. Initially a 2\/5 (AAEP lameness grade) right forelimb lameness was observed which resolved after a RF abaxial sesamoid nerve block. Lameness then switched and a 1\/5 (AAEP lameness grade) was observed in the left forelimb which resolved after a LF abaxial sesamoid nerve block. The horse then remained sound.<\/p>\n\n\n\n<h4 class=\"has-black-color has-text-color wp-block-heading\">Radiographic findings<\/h4>\n\n\n\n<p>Mild osteophyte formation at the dorsoproximal articular margin of the distal phalanx was evident bilaterally. No other abnormalities were noted (Fig. 1).<\/p>\n\n\n\n<h4 class=\"has-black-color has-text-color wp-block-heading\">MRI findings<\/h4>\n\n\n\n<p>On the right forelimb, there was focal low signal in T1 and T2*-weighted high-resolution sequences at the lateral aspect of the cartilage layers of the distal interphalangeal joint indicative of full thickness erosion (Fig. 2). There was no associated subchondral bone remodelling or inflammatory changes. There was moderate narrowing of the interarticular space at the lateral aspect of the DIP joint. Hyperintense signal in the STIR images indicated moderate distension of the dorsoproximal and palmaroproximal recesses of the DIP joint consistent with the clinical examination (Fig. 3). Mild chronic remodelling of the navicular bone was also noted with similar findings evident in the left forelimb DIP joint.<\/p>\n\n\n<div class=\"image-gallery js-stagger-animation\"><div class=\"image-gallery__images js-stagger-animation__child\"><div class=\"image-gallery__image\"><a class=\"image-gallery__imageLink image-popup\" href=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-1a.jpg\" title=\"Fig 1a\"><img loading=\"lazy\" decoding=\"async\" width=\"515\" height=\"526\" src=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-1a.jpg\" class=\"attachment-3-by-2-cropped-1000 size-3-by-2-cropped-1000\" alt=\"\" srcset=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-1a.jpg 515w, https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-1a-294x300.jpg 294w, https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-1a-500x511.jpg 500w\" sizes=\"auto, (max-width: 515px) 100vw, 515px\" \/><\/a><\/div><div class=\"image-gallery__image\"><a class=\"image-gallery__imageLink image-popup\" href=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-1b.jpg\" title=\"Fig 1b\"><img loading=\"lazy\" decoding=\"async\" width=\"626\" height=\"502\" src=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-1b.jpg\" class=\"attachment-3-by-2-cropped-1000 size-3-by-2-cropped-1000\" alt=\"\" srcset=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-1b.jpg 626w, https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-1b-300x241.jpg 300w, https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-1b-500x401.jpg 500w, https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-1b-540x433.jpg 540w\" sizes=\"auto, (max-width: 626px) 100vw, 626px\" \/><\/a><\/div><div class=\"image-gallery__image\"><a class=\"image-gallery__imageLink image-popup\" href=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-2ae.jpg\" title=\"Fig 2ae\"><img loading=\"lazy\" decoding=\"async\" width=\"131\" height=\"171\" src=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-2ae.jpg\" class=\"attachment-3-by-2-cropped-1000 size-3-by-2-cropped-1000\" alt=\"\" \/><\/a><\/div><div class=\"image-gallery__image\"><a class=\"image-gallery__imageLink image-popup\" href=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-2be.jpg\" title=\"Fig 2be\"><img loading=\"lazy\" decoding=\"async\" width=\"299\" height=\"352\" src=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-2be.jpg\" class=\"attachment-3-by-2-cropped-1000 size-3-by-2-cropped-1000\" alt=\"\" srcset=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-2be.jpg 299w, https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-2be-255x300.jpg 255w\" sizes=\"auto, (max-width: 299px) 100vw, 299px\" \/><\/a><\/div><div class=\"image-gallery__image\"><a class=\"image-gallery__imageLink image-popup\" href=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-3e-1.jpg\" title=\"Fig 3e\"><img loading=\"lazy\" decoding=\"async\" width=\"134\" height=\"116\" src=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-3e-1.jpg\" class=\"attachment-3-by-2-cropped-1000 size-3-by-2-cropped-1000\" alt=\"\" \/><\/a><\/div><\/div><div class=\"image-gallery__thumbs\"><div class=\"image-gallery__thumb js-stagger-animation__child\"><div class=\"image-gallery__thumb-inner\"><img loading=\"lazy\" decoding=\"async\" width=\"500\" height=\"375\" src=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-1a-500x375.jpg\" class=\"attachment-4-by-3-cropped-500 size-4-by-3-cropped-500\" alt=\"\" \/><\/div><\/div><div class=\"image-gallery__thumb js-stagger-animation__child\"><div class=\"image-gallery__thumb-inner\"><img loading=\"lazy\" decoding=\"async\" width=\"500\" height=\"375\" src=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-1b-500x375.jpg\" class=\"attachment-4-by-3-cropped-500 size-4-by-3-cropped-500\" alt=\"\" \/><\/div><\/div><div class=\"image-gallery__thumb js-stagger-animation__child\"><div class=\"image-gallery__thumb-inner\"><img loading=\"lazy\" decoding=\"async\" width=\"131\" height=\"171\" src=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-2ae.jpg\" class=\"attachment-4-by-3-cropped-500 size-4-by-3-cropped-500\" alt=\"\" \/><\/div><\/div><div class=\"image-gallery__thumb js-stagger-animation__child\"><div class=\"image-gallery__thumb-inner\"><img loading=\"lazy\" decoding=\"async\" width=\"299\" height=\"352\" src=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-2be.jpg\" class=\"attachment-4-by-3-cropped-500 size-4-by-3-cropped-500\" alt=\"\" srcset=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-2be.jpg 299w, https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-2be-255x300.jpg 255w\" sizes=\"auto, (max-width: 299px) 100vw, 299px\" \/><\/div><\/div><div class=\"image-gallery__thumb js-stagger-animation__child\"><div class=\"image-gallery__thumb-inner\"><img loading=\"lazy\" decoding=\"async\" width=\"134\" height=\"116\" src=\"https:\/\/hallmarq.net\/app\/uploads\/2020\/07\/Fig-3e-1.jpg\" class=\"attachment-4-by-3-cropped-500 size-4-by-3-cropped-500\" alt=\"\" \/><\/div><\/div><\/div><\/div>\n\n\n<h4 class=\"has-black-color has-text-color wp-block-heading\">Diagnosis<\/h4>\n\n\n\n<p>Bilateral chondral lesions of the palmaro-lateral aspect of the distal interphalangeal joint with associated secondary synovitis.<\/p>\n\n\n\n<h4 class=\"has-black-color has-text-color wp-block-heading\">Treatment and prognosis<\/h4>\n\n\n\n<p>Arthroscopic exploration with a view to debridement of the lesions was advised, but this treatment option was declined by the owner on the basis of the age of the horse and subsequent expected use. The horse was treated with intra-articular DIP joint medication (steroids and hyaluronic acid) and intramuscular glycosaminoglycans. The horse returned to work and the condition was managed with regular assessment and DIP joint medication as required.<\/p>\n\n\n\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Bilateral chondral lesions of the distal interphalangeal joint in a warmblood History An 18-year-old Warmblood gelding was presented with a right forelimb lameness of chronic duration. The horse&hellip;<\/p>\n","protected":false},"author":1,"featured_media":1003,"parent":0,"template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"_uag_custom_page_level_css":"","footnotes":""},"studies_category":[120],"class_list":["post-1186","studies","type-studies","status-publish","has-post-thumbnail","hentry","studies_category-equine-mri-us"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Bilateral Chondral Lesions of Distal Interphalangeal Joint - Hallmarq Veterinary Imaging<\/title>\n<meta name=\"description\" content=\"Bilateral chondral lesions of the distal interphalangeal joint in a warmblood History An 18-year-old Warmblood gelding was presented with a right forelimb\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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chondral lesions of the distal interphalangeal joint in a warmblood History An 18-year-old Warmblood gelding was presented with a right forelimb lameness of chronic duration. 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