## Overview Lesions of the deep digital flexor tendon (DDFT) within the hoof capsule are a common cause of chronic foot lameness. These include core lesions, dorsal border tears, and insertional injuries, most often identified by magnetic resonance imaging (MRI) because they lie beyond the reach of ultrasound. ## Causes Repetitive loading as the tendon passes over the navicular bone, combined with degenerative change or acute overload. Concurrent navicular bone or ligament pathology is frequent. ## Diagnosis Lameness that improves with palmar digital nerve block but may not fully block to the coffin joint. MRI gives the most complete characterization of lesion type, size, and associated structures; CT can also identify some DDFT lesions. ## Treatment Rest, corrective shoeing, anti-inflammatories, and intralesional or navicular bursa therapies. Selected cases undergo bursoscopy or other surgical debridement. Rehabilitation is prolonged. ## Recovery and Prognosis Guarded to fair. Many horses return to a lower level of work; extensive or multifocal lesions carry a poorer outlook. ## Prevention Early management of foot balance and workload in at-risk performance horses.
chronic low-grade forelimb lameness; positive palmar digital nerve block; worse on soft footing; intermittent or waxing and waning lameness
## Overview Lesions of the deep digital flexor tendon (DDFT) within the hoof capsule are a common cause of chronic foot lameness. These include core lesions, dorsal border tears, and insertional injuries, most often identified by magnetic resonance imaging (MRI) because they lie beyond the reach of ultrasound. ## Causes Repetitive loading as the tendon passes over the navicular bone, combined with degenerative change or acute overload. Concurrent navicular bone or ligament pathology is frequent. ## Diagnosis Lameness that improves with palmar digital nerve block but may not fully block to the coffin joint. MRI gives the most complete characterization of lesion type, size, and associated structures; CT can also identify some DDFT lesions. ## Treatment Rest, corrective shoeing, anti-inflammatories, and intralesional or navicular bursa therapies. Selected cases undergo bursoscopy or other surgical debridement. Rehabilitation is prolonged. ## Recovery and Prognosis Guarded to fair. Many horses return to a lower level of work; extensive or multifocal lesions carry a poorer outlook. ## Prevention Early management of foot balance and workload in at-risk performance horses.
chronic low-grade forelimb lameness; positive palmar digital nerve block; worse on soft footing; intermittent or waxing and waning lameness