1-year-old female Thoroughbred

Draining wound right hind metatarsophalangeal joint region for 1 month. Had a grade V/V lameness.

  • Candidates were expected to describe intracapsular and extracapsular soft tissue swelling, gas opacities in the soft tissues, and absence of bone lysis or proliferation. Noting overexposure artifacts was accepted, but not required.
  • Cellulitis, tendonitis/tenosynovitis, arthritis.


Additional imaging was requested by some patients…

  • Sinogram to assess extent of involvement of draining wound
  • Candidates were expected to describe contrast opacification of the draining wound and digital flexor tendon sheath. Description of irregular filling defects in the tendon sheath was also expected. Candidates were expected to state that opacification of the metatarsophalangeal joint was not seen.
  • Candidates were expected to indicate that both the clinical and imaging findings were consistent with tendonitis/tenosynovitis secondary to penetrating soft tissue trauma. A poor prognosis was warranted.
  • The horse was euthanized and a necropsy was performed. The skin wound communicated with the tendon sheath and there was also a laceration in the superficial digital flexor tendon. Exudate and proliferative synovial tissue were present within the tendon sheath.
  • Most candidates performed adequately on this case. A few noted that the soft tissue swelling was both intracapsular and extracapsular. Nearly all asked for the sinogram. Some neglected to mention whether the joint was involved without prompting. A few diagnosed the tendon as a wooden foreign body in the sinogram.