Tendinitis and Desmitis
Basic Information 
Definition
• Tendinitis: Inflammatory conditions of tendons, their muscle or bone attachments, or both encompassing a broad range of injuries from strains to severe fiber pattern disruption
• Desmitis: Inflammatory conditions of the ligaments, their bone attachments, or both encompassing a broad range of injuries from strains to severe fiber pattern disruption
Synonym(s)
Sprains, “bowed” tendon (specifically tendinitis of the superficial digital flexor tendon)
Epidemiology
Risk Factors
• Tendon and ligament injuries are a leading cause of decreased performance and loss of use in equine athletes. The true incidence is largely unknown but some estimate that as high as 40% of equine athletes develop some degree of tendinitis or desmitis.
• There are significant risk factors for tendon and ligament injuries, particularly in Equine athletes. In addition to those listed below, breed, occupation, age, and level of performance play roles in determining the probability of injury and which tendon(s) or ligament(s) is involved and the prognosis for return to use. For example, superficial digital flexor tendinitis is a more common and severe injury in racehorses and event horses. Familiarity with the patient’s occupation and associated tendon and ligament conditions are invaluable in the diagnosis and treatment of tendon and ligament conditions.
Clinical Presentation
Physical Exam Findings
• Visible or palpable swelling with heat and sensitivity. Lameness is variable and may be mild to severe depending on the duration of the injury and the structure involved.
• Lameness without visible or palpable swelling, heat, or sensitivity.
• Visible or palpable distension of synovial structure such as the digital flexor tendon sheath or carpal canal.
Etiology and Pathophysiology
• Single event of supraphysiologic force.
• Maladaptive remodeling: Microdamage accumulates as the tendon or ligament is unable to adapt to the level of training or exercise placed upon it. This culminates with a strain or fiber pattern disruption but differs from the above in that there is a subclinical phase.
• Trauma: Direct physical force such as an overreaching injury and pressure-induced inflammation as seen in poor bandaging technique.
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