{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:43:54Z","timestamp":1787741034654,"version":"build-2784847793"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T00:00:00Z","timestamp":1665446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["beva.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Equine Veterinary Journal"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Digital flexor tendon sheath (DFTS) pathology is an important cause of lameness in horses. The outcome after surgical treatment is variable and depends on the exact diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To (1) describe the prevalence of lesions associated with lameness caused by nonseptic DFTS tenosynovitis in a large population of German sports and pleasure horses; (2) determine the sensitivity and specificity of diagnostic imaging techniques for identifying lesions within the DFTS with tenoscopic diagnosis being the gold standard; (3) explore associations between tenoscopically diagnosed lesions and signalment, purpose, and limb affected; and (4) describe the outcome following DFTS tenoscopy with nonseptic DFTS tenosynovitis in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Retrospective case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Medical records of horses admitted for tenoscopic surgery of nonseptic DFTS tenosynovitis between 2011 and 2020 were reviewed. Follow\u2010up information was obtained via telephone contact. Sensitivity and specificity of ultrasonography and contrast tenography were determined using tenoscopic diagnosis as gold standard and univariable analysis was used to explore associations between signalment, case history, and tenoscopic diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Medical records from 131 horses were retrieved, of which 8 horses had bilateral disease and 6 horses were presented for tenoscopy on two separate occasions (3 for tenoscopy in the same limb, 3 in a different limb), thus, making a total of 145 limbs. Lesions were most commonly diagnosed in the deep (DDFT;\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a055 limbs) and superficial (SDFT;\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a055 limbs) digital flexor tendons. Manica flexoria (MF) lesions were detected in 44 limbs and palmar\/plantar annular ligament (PAL) constriction in 99 limbs. In 36 limbs, only one structure within the DFTS was injured, whereas in 109 limbs a combination of lesions was noted, the most common being the combination of a SDFT lesion with PAL constriction. All affected limbs were examined with diagnostic ultrasonography; contrast tenography was performed in 86 limbs. For diagnosis of MF and DDFT tears, tenography was more sensitive (89% [confidence interval, CI: 65.4%\u201395.2%]; 72% [CI: 46.4%\u201389.3%], respectively) than specific (64% [CI: 52.5%\u201377.6%]; 53% [CI: 42.2%\u201373.3%], respectively) whereas ultrasonography was more specific (92% [CI: 84.5%\u201396.3%]; 92% [CI: 83.6%\u201396.0%]) with lower sensitivity (64% [CI: 47.7%\u201377.2%]; 54% [CI: 39.5%\u201367.9%]). For SDFT lesions, ultrasonography was highly specific (94% [CI: 86.9%\u201397.9%]) with lower sensitivity (66% [CI: 51.3%\u201377.4%]). Follow\u2010up information following first surgery was obtained for 118 horses (132 limbs): 18 (15.3%) of 118 horses remained chronically lame, 40 (33.8%) performed at a reduced level and 60 (50.8%) performed at the same or higher level following rehabilitation after tenoscopy. Horses with DDFT lesions had the poorest outcomes with only 36.6% returning to the same or higher level of exercise.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main limitations<\/jats:title>\n                    <jats:p>Retrospective analysis of clinical records and subjective outcome assessment based on owner follow\u2010up with potential recall bias. Findings on diagnostic imaging are impacted by many factors including equipment quality and operator expertise and experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Diagnostic imaging techniques were complimentary and contrast tenography was sensitive and ultrasonography was specific for the diagnosis of MF and DDFT lesions. Following tenoscopic surgery for nonseptic tenosynovitis of the DFTS, approximately half the cases were able to return to preinjury level of exercise.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/evj.13856","type":"journal-article","created":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T05:08:26Z","timestamp":1657688906000},"page":"48-58","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Diagnosis and outcome following tenoscopic surgery of the digital flexor tendon sheath in German sports and pleasure horses"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4500-2304","authenticated-orcid":false,"given":"Andrea N.","family":"Cender","sequence":"first","affiliation":[{"name":"Equine Clinic at the Faculty of Veterinary Medicine Free University of Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"M\u00e4hlmann","sequence":"additional","affiliation":[{"name":"Equine Clinic at the Faculty of Veterinary Medicine Free University of Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5338-6195","authenticated-orcid":false,"given":"Anna","family":"Ehrle","sequence":"additional","affiliation":[{"name":"Equine Clinic at the Faculty of Veterinary Medicine Free University of Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roswita","family":"Merle","sequence":"additional","affiliation":[{"name":"Equine Clinic at the Faculty of Veterinary Medicine Free University of Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Pieper","sequence":"additional","affiliation":[{"name":"Equine Clinic at the Faculty of Veterinary Medicine Free University of Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph J.","family":"Lischer","sequence":"additional","affiliation":[{"name":"Equine Clinic at the Faculty of Veterinary Medicine Free University of Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/S0749-0739(17)30358-9","article-title":"Functional anatomy of tendons and ligaments in the distal limbs (manus and pes)","volume":"10","author":"Denoix J\u2010M","year":"1994","journal-title":"Vet Clin North Am Equine Pract"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"528","DOI":"10.2746\/0425164044877396","article-title":"Tenoscopic surgey for treatment of lacerations of the digital flexor tendon sheath","volume":"36","author":"Fraser BS","year":"2004","journal-title":"Equine Vet J"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"270","DOI":"10.2746\/042516403776148183","article-title":"Tenosynovitis of the digital flexor tendon sheath and annular ligament constriction syndrome caused by longitudinal tears in the deep digital flexor tendon: a clinical and surgical report of 17 surgeries in warmblood horses","volume":"35","author":"Wilderjans H","year":"2003","journal-title":"Equine Vet J"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1111\/j.1532-950X.2012.01044.x","article-title":"Tenoscopic surgical treatment of tears of the manica flexoria in 53 horses","volume":"41","author":"Findley JA","year":"2012","journal-title":"Vet Surg"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"134","DOI":"10.2746\/042516406776563350","article-title":"Noninfected tenosynovitis of the digital flexor tendon sheath: a retrospective analysis of 76 surgeries","volume":"38","author":"Smith MRW","year":"2006","journal-title":"Equine Vet J"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1111\/j.2042-3306.2010.00341.x","article-title":"Nonseptic tenosynovitis of the digital flexor tendon sheath caused by longitudinal tears in the digital flexor tendons: a retrospective study of 135 tenoscopic procedures","volume":"43","author":"Arensburg L","year":"2011","journal-title":"Equine Vet J"},{"key":"e_1_2_11_8_1","first-page":"368","volume-title":"Diagnostic and surgical arthroscopy in the horse","author":"McIlwraith CW","year":"2005"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1111\/evj.13166","article-title":"Improved diagnostic criteria for digital flexor tendon sheath pathology using contrast tenography","volume":"52","author":"Kent AV","year":"2019","journal-title":"Equine Vet J"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1111\/j.2042-3306.2012.00573.x","article-title":"The use of intrathecal analgesia and contrast radiography as preoperative diagnostic methods for digital flexor tendon sheath pathology","volume":"45","author":"Fiske\u2010Jackson AR","year":"2013","journal-title":"Equine Vet J"},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/S0749-0739(17)30317-6","article-title":"Aseptic tenosynovitis of the digital flexor tendon sheath, fetlock and pastern annular ligament constriction","volume":"11","author":"Dik KJ","year":"1995","journal-title":"Vet Clin North Am Equine Pract"},{"key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1111\/j.2042-3292.2005.tb00376.x","article-title":"Indications and techniques for tenoscopic surgery of the digital flexor tendon sheath","volume":"17","author":"Fortier LA","year":"2010","journal-title":"Equine Vet Educ"},{"key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1111\/j.1740-8261.2010.01676.x","article-title":"MRI features of metacarpo(tarso)phalangeal region lameness in 40 horses","volume":"51","author":"Gonzalez LM","year":"2010","journal-title":"Vet Radiol Ultrasound"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1111\/j.1740-8261.2012.01983.x","article-title":"MRI findings in 232 horses with lameness localized to the metacarpo(tarso)phalangeal region and without a radiographic diagnosis","volume":"54","author":"King JN","year":"2013","journal-title":"Vet Radiol Ultrasound"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.2460\/javma.2000.217.1343","article-title":"Palmar\u2010plantar axial sesamoidean approach to the digital flexor tendon sheath in horses","volume":"217","author":"Hassel DM","year":"2000","journal-title":"J Am Vet Med Assoc"},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1111\/j.1532-950X.1990.tb01182.x","article-title":"Endoscopy of the digital flexor tendon sheath in horses","volume":"19","author":"Nixon AJ","year":"1990","journal-title":"Vet Surg"},{"issue":"2","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1111\/vsu.13336","article-title":"Ex vivo evaluation of an alternative technique for resection of the proximal manica flexoria in horses","volume":"49","author":"Noguera Cender A","year":"2020","journal-title":"Vet Surg"},{"key":"e_1_2_11_18_1","first-page":"210","article-title":"Extrasynovial palmar\u2013plantar annular ligament desmotomy","volume":"44","author":"Hawkins D","year":"1998","journal-title":"Proc Am Assoc Equine Pract"},{"key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1111\/j.2042-3306.1999.tb03785.x","article-title":"Tenosynovitis associated with longitudinal tears of the digital flexor tendons in horses: a report of 20 surgeries","volume":"31","author":"Wright IM","year":"1999","journal-title":"Equine Vet J"},{"key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/j.2042-3306.1995.tb03029.x","article-title":"How the horse moves: 1. Significance of graphical representations of equine forelimb kinematics","volume":"27","author":"Back W","year":"1995","journal-title":"Equine Vet J"},{"key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1111\/j.2042-3306.1995.tb03030.x","article-title":"How the horse moves: 2. Significance of graphical representations of equine hind limb kinematics","volume":"27","author":"Back W","year":"1995","journal-title":"Equine Vet J"},{"key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"237","DOI":"10.2746\/042516408X271217","article-title":"Retrospective study of palmar\/plantar annular ligament injury in 71 horses: 2001\u20132006","volume":"40","author":"Owen KR","year":"2008","journal-title":"Equine Vet J"},{"key":"e_1_2_11_23_1","first-page":"1411","volume-title":"Equine surgery","author":"Kummerle JM","year":"2018"},{"key":"e_1_2_11_24_1","first-page":"9","article-title":"Long\u2010term results of tenoscopic treatment of lesions in the digital flexor tendon sheath: a retrospective study of fifty horses","volume":"88","author":"Th\u00fcnker F","year":"2019","journal-title":"Vlaams Diergeneeskd Tijdschr"},{"issue":"4","key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"337","DOI":"10.2746\/042516406777749155","article-title":"What is the likelihood that a horse treated for septic digital tenosynovitis will return to its previous level of athletic function?","volume":"38","author":"Smith LJ","year":"2006","journal-title":"Equine Vet J"},{"key":"e_1_2_11_26_1","first-page":"56","article-title":"Identification of surgically\u2010induced longitudinal lesions of the equine deep digital flexor tendon in the digital flexor tendon sheath using contrast\u2010enhanced ultrasonography: an ex\u2010vivo pilot study","volume":"25","author":"Bertuglia A","year":"2014","journal-title":"Acta Vet Scand"}],"container-title":["Equine Veterinary Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/evj.13856","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/evj.13856","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/beva.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/evj.13856","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T13:37:34Z","timestamp":1762090654000},"score":1,"resource":{"primary":{"URL":"https:\/\/beva.onlinelibrary.wiley.com\/doi\/10.1111\/evj.13856"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,11]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1111\/evj.13856"],"URL":"https:\/\/doi.org\/10.1111\/evj.13856","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/EVJ.13856\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/EVJ.13856\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/EVJ.13856\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/EVJ.13856\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/EVJ.13856\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/EVJ.13856\/v3\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/EVJ.13856\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/EVJ.13856\/v1\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/EVJ.13856\/v3\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/EVJ.13856\/v1\/decision1","asserted-by":"object"}]},"ISSN":["0425-1644","2042-3306"],"issn-type":[{"value":"0425-1644","type":"print"},{"value":"2042-3306","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,11]]},"assertion":[{"value":"2020-11-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}