1. MRI Findings Focus of severe hyperintensity associated with the lateral branch of the superficial digital flexor tendon with involvement of the middle scutum Marked proximal interphalangeal joint effusion Thickening of the palmar/lateral soft tissues including the distal digital annular ligament Lateral oblique distal sesamoidean ligament desmopathy

4. Follow-Up This imaging was performed in early December 2012. Since that time the horse was rested further, and recently the tendon lesion was treated using shockwave therapy. Following therapy the swelling decreased and the patient is at the trotting stage of rehabilitation with no signs of lameness

5. Commentary This case was chosen because of the severe injury to the distal superficial digital flexor tendon and scutum in combination with pastern joint effusion It is suspected that the peripheral, dorsal nature of the tendon injury may have resulted in hemorrhage into the pastern joint Due to the severity of the swelling in the area joint sampling was not performed following imaging in this case

6. Commentary It was also interesting to see a case of severe lameness following PDN block and distal interphalangeal joint injection No unusual events or limb retraction took place during this block It is believed that a mild injury to the tendon was pre-existing and was exacerbated following turn- out after the exam (while the area was still under the influence of local anesthesia)