Superficial digital flexor tendonitis occurs commonly in horses of all ages and disciplines with a high incidence of reinjury. Injuries are most commonly reported in flat and national hunt race horses with the most frequent site of injury located at the level of the mid metacarpus. Prevalence reportedly increases with age suggesting that changes in the material properties of the superficial digital flexor tendon may occur with aging. Tendonitis affecting the proximal superficial digital flexor tendonat the level of the carpal canal and/or proximal metacarpus occurs less commonly and is reported to affect an older population of horses. Cases of superficial digital flexor tendonitis located at this level represent a therapeutic challenge with fewer horses able to return to athletic function. Rupture of the superficial digital flexor tendon has also been described in older horses at this level and can occur spontaneously without previous evidence of injury. Ultrasound examination remains the primarydiagnostic imaging modality for identification and monitoring of superficial digital flexor tendon injury at the level of the metacarpus. The ultrasound exam should be extended proximally to include the palmar carpus and antebrachium in horses with carpal sheath effusion, regional palpable swelling and/or when injuries of the superficial digital flexor tendon extend to the proximal extent of the metacarpal exam.
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