Association between sesamoiditis, subclinical ultrasonographic suspensory ligament branch change and subsequent clinical injury in yearling Thoroughbreds

Plevin S, McLellan J, O'Keeffe T. Equine Vet J. 2016 Sep; 48 (5): 543-7.

REASONS FOR PERFORMING STUDY: Sesamoiditis is a common radiological finding in yearling Thoroughbreds. The condition is believed to be associated with suspensory ligament branch injury (SLBI), which is known to affect racing performance. The presence of subclinical suspensory ligament branch change (SSLBC) in untrained yearlings has not been investigated. Associations between sesamoiditis, SSLBC and subsequent SLBI would allow more accurate prognoses to be made regarding the development of SLBI. They could also provide opportunity for intervention and prevention of SLBI.

OBJECTIVES: To test our hypotheses that untrained yearling Thoroughbreds with sesamoiditis would be more likely to have ultrasonographic findings of SSLBC and those horses with concurrent sesamoiditis and SSLBC would be more likely to develop clinical suspensory ligament branch injury with training.

STUDY DESIGN: Prospective, cohort, observational study.

METHODS: Yearling Thoroughbreds located at a single training centre were evaluated at the onset of their training careers and for the next 9 months. Radiographic and ultrasonographic examination of bilateral forelimb proximal sesamoid bones and suspensory ligament branches was performed.

RESULTS: Fifty horses were eligible, resulting in 200 forelimb sesamoid/suspensory ligament branch pairs. A significant relationship existed between possibly significant (PS) sesamoiditis and PS SSLBC (P<0.001). The odds ratio of sesamoids with PS sesamoiditis also demonstrating concurrent PS SSLBC was 5.1 (95% confidence interval 2.68-9.70, P<0.001). A significant relationship also existed between the concurrent presence of PS sesamoiditis and PS SSLBC and the subsequent development of clinical signs of SLBI (P<0.001, odds ratio 11.7, 95% confidence interval 4.1-33.4).

CONCLUSIONS: The associations identified in this study highlight the importance of ultrasonographic examination of suspensory ligament branches in horses with PS sesamoiditis. This information should allow more accurate prognostic advice regarding potential SLBI development and also provide opportunities for intervention and prevention of clinical SLBI.