Does sesamoids vascular channel are associated with suspensory branch changes?

Concurrent radiological and ultrasonographical findings in the forelimb proximal sesamoid bones and adjacent suspensory ligament branches in yearling and 2-year-old Thoroughbred sales horses

Frances J. Peat, Christopher E. Kawcak, C. Wayne McIlwraith, Jeffrey T. Berk, David P. Keenan

Background:
This study investigates the prevalence and relationships between radiological changes in forelimb proximal sesamoid bones and ultrasonographic changes in adjacent suspensory ligament branches in yearling and 2-year-old Thoroughbred horses at sales. Radiological findings like vascular channels and sesamoid morphology often influence sales decisions, yet little is known about their association with subclinical or clinical ligament changes. The study aimed to determine thresholds for when ultrasonography may add diagnostic value in sales settings.

Methods:
A prospective cohort study was conducted on Thoroughbred yearlings and 2-year-olds at six public auctions in the USA (2016–2017). Horses with both radiological and ultrasonographic imaging available were included, resulting in 2204 yearling and 1336 2-year-old sesamoid-branch units. Radiological findings were categorized into grades (0–3) based on vascular channels and abaxial morphology. Concurrent ultrasonographic changes in the adjacent suspensory branches were assessed for fibrillar patterns, hyperechoic foci, and periligamentous tissue measurements.

Results:
Yearling sesamoids with grade ≤1 vascular channels showed adjacent grade ≥2 fibrillar branch changes in only 1.2% of cases, while this proportion was 3.8% in 2-year-olds.
In yearlings, 31% of sesamoids with grade 2 vascular channels and 59% with grade 3 vascular channels had adjacent grade ≥2 branch changes. In 2-year-olds, the proportions were 47% and 67%, respectively.
Abaxial concavity in sesamoids rarely correlated with adjacent branch changes, supporting a distinct etiology unrelated to suspensory branch injuries.
Bone surface irregularities at branch insertions were more frequent with higher grades of vascular channels in both yearlings and 2-year-olds.

Limitations:
The study excluded hindlimb sesamoids and did not assess clinical examinations or inflammatory statuses, limiting the ability to infer active disease. The scope was confined to a sales environment, potentially restricting applicability to other populations or training conditions.

Conclusions:
Radiological findings of grade ≥2 vascular channels in sesamoids are frequently associated with significant adjacent suspensory branch changes, warranting selective ultrasonography in sales horses. Grade 1 medial forelimb sesamoids in 2-year-olds also demonstrated clinically relevant concurrent changes. These findings provide practical guidelines for diagnostic imaging and highlight thresholds for interpreting radiological changes.

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