Changes in Head, Withers, and Pelvis Movement Asymmetry in Lame Horses as a Function of Diagnostic Anesthesia Outcome, Surface and Direction.

Evaluation of diagnostic anesthesia during equine lameness examination requires comparison of complex movement patterns and can be influenced by expectation bias. There is limited research about how changes in movement asymmetries after successful analgesia are affected by different exercise conditions. Movement asymmetry of head, withers and pelvis was quantified in N = 31 horses undergoing forelimb or hindlimb diagnostic anesthesia. Evaluation on a straight line and a circle was performed with subjective diagnostic anesthesia outcome and quantitative changes recorded. Mixed linear models (P < .05) analyzed the differences in movement asymmetry before/after diagnostic anesthesia - random factor: horse, fixed factors: surface (soft, hard), direction (straight, inside, outside, inside-outside average), diagnostic anesthesia outcome (negative, partially positive, positive) and two-way interactions. Forelimb diagnostic anesthesia influenced primary movement asymmetry (all head and withers parameters) and compensatory movement asymmetry (two pelvic parameters) either individually (P≤.009) or in interaction with surface (P≤.03). Hindlimb diagnostic anesthesia influenced primary movement asymmetry (all pelvic parameters) and compensatory movement asymmetry (two head and two withers parameters) either individually (P≤.04) or in interaction with surface (P≤.01;) or direction (P≤.006). Direction was also significant individually for two pelvic parameters (P≤.04). Changes in primary movement asymmetries after partially positive or positive outcomes indicated improvement in the blocked limb. Compensatory changes were mostly in agreement with the 'law of sides'. The changes were more pronounced on the hard surface for hindlimb lameness and on the soft surface for forelimb lameness. Withers asymmetry showed distinct patterns for forelimb and hindlimb lameness potentially aiding clinical decision-making.

Computed tomographic arthrography, gross anatomy and histology demonstrate a communication between synovial invaginations in the proximal aspect of the third interosseous muscle and the carpometacarpal joint in horses.

This descriptive anatomical study investigates the relationship between the third interosseous muscle, also known as the suspensory ligament, and the carpometacarpal joint in forelimbs of horses, with the hypothesis that there was a direct synovial communication between these structures as shown by computed tomographic arthrography, histology, and gross anatomy sections. Computed tomography of the carpus and metacarpal region was performed on two groups. Group 1 consisted of eight cadaver limbs undergoing computed tomographic arthrography following injection of a mixture of positive contrast medium, saline, and color-pigmented fluid solution into the middle carpal joint. Group 2 consisted of eight forelimbs assessed using plain computed tomography. The images were interpreted subjectively for contrast medium distribution and objectively by comparing Hounsfield values of the proximal suspensory ligament at 0.5 cm intervals starting at the origin and extending 3 cm distal to the proximal subchondral bone plate of the third metacarpal bone. Of the 16 limbs, two were sectioned for gross anatomy and one was documented histologically. The proximal suspensory ligament was visualized with clear margins on computed tomography images. The positive contrast medium was found within the lateral and medial lobes of the suspensory ligament in all eight (100%) limbs. Hounsfield units within the suspensory ligament following contrast injection were significantly higher than in those in the plain CT group between 0.5 and 2.5 cm distal to the proximal subchondral bone plate of the third metacarpal bone (p < 0.05). The gross anatomy sections showed color pigmentation within the suspensory ligament correlating to the contrast medium distribution evident on computed tomography images. Histology confirmed a synovial lined cavity within the suspensory ligament. The demonstration of a direct synovial communication between the internal structure of the proximal suspensory ligament and the carpometacarpal joint in horses offers further explanation for commonly encountered interactions of diagnostic local anesthesia of the carpal and subcarpal regions. When performing diagnostic or therapeutic injections into the middle carpal joint, the likely effect on the proximal suspensory ligament should be considered. Furthermore, as the proximal suspensory ligament was identified clearly on CT images, further studies are needed to elucidate the utility of CT in clinical cases with suspected soft tissue pathology in the subcarpal region.

Linear Discriminant Analysis for Investigating Differences in Upper Body Movement Symmetry in Horses before/after Diagnostic Analgesia in Relation to Expert Judgement.

Diagnostic analgesia and lunging are parts of the equine lameness examination, aiding veterinarians in localizing the anatomical region(s) causing pain-related movement deficits. Expectation bias of visual assessment and complex movement asymmetry changes in lame horses on the lunge highlight the need to investigate data-driven approaches for optimally integrating quantitative gait data into veterinary decision-making to remove bias. A retrospective analysis was conducted with inertial sensor movement symmetry data before/after diagnostic analgesia relative to subjective judgement of efficacy of diagnostic analgesia in 53 horses. Horses were trotted on the straight and on the lunge. Linear discriminant analysis (LDA) applied to ten movement asymmetry features quantified the accuracy of classifying negative, partial and complete responses to diagnostic analgesia and investigated the influence of movement direction and surface type on the quality of the data-driven separation between diagnostic analgesia categories. The contribution of movement asymmetry features to decision-making was also studied. Leave-one-out classification accuracy varied considerably (38.3-57.4% for forelimb and 36.1-56.1% for hindlimb diagnostic analgesia). The highest inter-category distances (best separation) were found with the blocked limb on the inside of the circle, on hard ground for forelimb diagnostic analgesia and on soft ground for hindlimb diagnostic analgesia. These exercises deserve special attention when consulting quantitative gait data in lame horses. Head and pelvic upward movement and withers minimum differences were the features with the highest weighting within the first canonical LDA function across exercises and forelimb and hindlimb diagnostic analgesia. This highlights that movement changes after diagnostic analgesia affect the whole upper body. Classification accuracies based on quantitative movement asymmetry changes indicate considerable overlap between subjective diagnostic analgesia categories.