Chronic eosinophilic granulomatous tenosynovitis in a Quarter Horse mare

A 5-year-old Quarter Horse mare was presented to the Michigan State University Equine Surgery Service for evaluation of a right hind metatarsophalangeal joint injury. On presentation, the horse was a grade 4/5 lame. Radiographs and ultrasonography showed peritendinous ossification/mineralisation of soft tissue structures and digital flexor tenosynovitis with profound intracapsular mineralisation. A digital flexor tendon sheath tenoscopy was performed with a plantar annular ligament desmotomy and a manica flexoria ligament tenotomy. During surgery, a significant amount of tan granular material was found within the digital tendon sheath. Approximately 80% of this material was removed, and a sample was sent for histopathology. The horse was diagnosed with eosinophilic granulomatous tenosynovitis. Long-term follow-up revealed improvement with four treatments of intralesional triamcinolone given 2-4 weeks apart. The horse became serviceably sound (grade 1/5) and was beginning light work under the saddle approximately 5 months post-tenoscopy.