Bone oedema like lesion of the second phalanx causing a non-weight bearing lameness in a 4 years old Trakehnen mare

Abstract

Bone marrow oedema like lesions (BMELLs) are described in both human athletes and sport horses. Most commonly runners and track and field athletes are affected. BMELLs are described in young military recruits at the beginning of their training, too. While all kinds of sport horses are affected, BMELLs are described most commonly in racehorses. Like in humans the bones of the distal limb are affected the most. BMELLs in the horse are described for the navicular bone, the middle phalanx and the metacarpal and metatarsal bone. The diagnosis is based on scintigraphical and MRI findings. In humans, the treatment depends on the severity of clinical, radiological and MR findings. Rest and reduced training is part of every treatment regime. Surgical treatment like bone drilling is described for severe cases. A correlation between BMELLs and osteoarthritis is discussed. This article describes a young dressage horse with a non-weight bearing lameness of sudden onset. Because clinical and radiological findings did not explain the lameness conclusively the horse underwent low field MR imaging (0, 27T). On STIR images in sagittal and frontal planes a hyperintense focus with a hypointense rim was seen in the bone marrow in the dorsomedial part of the second phalanx. A corresponding hypointense focus was seen on T2*-weighted gradient echo sequences. On T2-weighted spin echo sequences the bone marrow appeared normal. The horse was treated with a Robert Jones bandage, NSAIDs for 14 days, disodium clodronate for ten days and box rest over a period of eight weeks. After that, the horse was walked at hand for four weeks. Fourteen weeks after the sudden onset of the lameness the horse was sound and started light dressage work.