Iranian Journal of Veterinary Surgery

Iranian Journal of Veterinary Surgery

Comparison of Synovial Fluid Composition in Distended and Normal Digital Flexor Tendon Sheath of Horses (A Pilot Study)

Document Type : Original Article

Authors
Zahra Noori
Samaneh Ghasemi
Ali Mirshahi
Mehdad Mohri
Ahmadreza Mohamadnia
Department of Clinical Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran.
10.30500/ivsa.2021.296292.1273
Abstract
Diagnosis of tenosynovitis is usually confirmed on the basis of synovial fluid analysis (such as cytological and biochemical examinations). This study was designed to examine biochemical (serum amyloid A (SAA), haptoglobin (Hp) and D-dimer) and cytological (total nucleated cell count (TNCC), neutrophil, lymphocyte, and monocyte count) characteristics of serum and synovial fluid of the equine digital flexor tendon sheath (DFTS). Synovial fluid samples were aseptically collected in EDTA from 43 limbs in 20 horses with (study group) and 8 limbs in 8 horses without (control group) distention of DFTS and serum samples were collected from each horse. Lymphocyte, monocyte, neutrophil, and TNCC in the synovial fluid were statistically higher in the distended sheath that shows an inflammatory nature of the distention, however, concentrations of D-dimer was lower in serum (0.1, 0.10-3.80) and (0.2, 0.10-0.20) than synovial fluid (19.2, 17.78-20.00) and (20, 19.90-20.00)) in both groups. The serum SAA concentrations of the control group (1.7, 0.10-2.16) were significantly higher than the study group (1, 0.86-1.05) and the concentration of SAA in serum was higher than synovial fluid (0.89, 0.86-0.98) in the control group. Results of this current study show that a cytological evaluation of the synovial fluid is more valuable than biochemical findings in the diagnosis of the inflammatory nature of this condition.
Keywords
Digital flexor tendon sheath
Haptoglobin
Total nucleated cell count
Serum amyloid A
D-dimer
Subjects
  1. Steel CM. Equine synovial fluid analysis. Veterinary Clinics of North America: Equine Practice. 2008;24:437-454.
  2. Forsyth S. Equine synovial fluid analysis. Vet script. 2018;52-54.
  3. Malark J, Nixon A, Skinner K, Mohammed H. Characteristics of digital flexor tendon sheath fluid from clinically normal horses. American Journal of Veterinary Research.1991;52:1292-1294.
  4. Hassel DM, Stover SM, Yarbrough TB, Drake CM, Taylo KT. Palmar-plantar axial sesamoidean approach to the digital flexor tendon sheath in horses. Journal of the American Veterinary Medical Association. 2000;217:1343-1347.
  5. Wright I, McMahon P. Tenosynovitis associated with longitudinal tears of the digital flexor tendons in horses:a report of 20 cases. Equine Veterinary Journal. 1999;31:12-18.
  6. Agass R, Dixon J, Fraser B. Computed tomographic contrast tenography of the digital flexor tendon sheath of the equine hindlimb. Veterinary Radiology and Ultrasound. 2018;59:279-288.
  7. Fortier L. Indications and techniques for tenoscopic surgery of the digital flexor tendon sheath. Equine Veterinary Education. 2005;17:218-224.
  8. Dykgraaf S, Dechant JE, Johns JL, Christopher MM, Bolt DM, Snyder JR. Effect of intrathecal amikacin administration and repeated centesis on digital flexor tendon sheath synovial fluid in horses. Veterinary Surgery. 2007;36:57-63.
  9. Nixon AJ. Endoscopy of the digital flexor tendon sheath in horses. Veterinary Surgery. 1990;19:266-271.
  10. Sanchez-Teran A, Bracamonte J, Hendrick S, Riddell L, Musil K, Hoff B, Rubio-Martínez L. Effect of repeated through-and-through joint lavage on serum amyloid A in synovial fluid from healthy horses. The Veterinary Journal. 2016;210:30-33.
  11. Hagberg L, Heinegard D, Ohlsson K. The contents of macromolecule solutes in flexor tendon sheath fluid and their relation to synovial fluid: a quantitative analysis. The Journal of Hand Surgery: British and European Volume. 1992;17:167-171.
  12. Andreassen SM, Vinther AM, Nielsen SS, Andersen PH, Tnibar A, Kristensen AT, Jacobsen S. Changes in concentrations of haemostatic and inflammatory biomarkers in synovial fluid after intra-articular injection of lipopolysaccharide in horses. BMC Veterinary Research. 2017;13(1):1-7.
  13. McGillicuddy DC, Shah KH, Friedberg RP, Nathanson LA, Edlow JA. How sensitive is the synovial fluid white blood cell count in diagnosing septic arthritis? The American Journal of Emergency Medicine. 2007;25:749-752.
  14. Belgrave RL, Dickey MM, Arheart KL, Cray C. Assessment of serum amyloid A testing of horses and its clinical application in a specialized equine practice. Journal of the American Veterinary Medical Association. 2013;243:113-119.
  15. Satue K, Calvo A, Gardon J.C. Factors influencing serum amyloid type A (SAA) concentrations in horses. Open Journal of Veterinary Medicine. 2013;3:58.
  16. Witkowska‐Piłaszewicz O, Zmigrodzka M, Winnicka A, Miskiewicz A, Strzelec K, Cywinska A. Serum amyloid A in equine health and disease. Equine Veterinary Journal. 2019;51:293-298.
  17. Barrachina L, Remacha AR, Soler L, Garcia N, Romero A, Vazquez FJ, Vitoria A, Alava MA, Lamprave F, Rodellar C. Acute phase protein haptoglobin as inflammatory marker in serum and synovial fluid in an equine model of arthritis. Veterinary Immunology and Immunopathology. 2016;182:74-78.
  18. Qin L, Li F, Gong X, Wang J, Huang W, Hu, N. Combined measurement of D-dimer and C-reactive protein levels: Highly accurate for diagnosing chronic periprosthetic joint infection. The Journal of Arthroplasty. 2020;35:229-234.
  19. Xu H, Xie J, Huang Q, Lei Y, Zhang S, Pei F. Plasma fibrin degradation product and D-dimer are of limited value for diagnosing periprosthetic joint infection. The Journal of Arthroplasty. 2019;34:2454-2460.
  20. Ribera T, Monreal L, Armengou L, Rios J, Prades M. Synovial fluid D‐dimer concentration in foals with septic joint disease. Journal of Veterinary Internal Medicine. 2011;25:1113-1117.
  21. Ribera T, Monreal L, Delgado M, Rios J, Prades M. Synovial fluid D-dimer concentration in horses with osteochondritis dissecans and osteoarthritis. Veterinary and Comparative Orthopaedics and Traumatology. 2013;26:54-60.
  22. Stokol T, Erb HN, De Wilde L, Tornquist SJ, Brooks M. Evaluation of latex agglutination kits for detection of fibrin (ogen) degradation products and D‐dimer in healthy horses and horses with severe colic. Veterinary Clinical Pathology. 2005;34:375-382.
  23. Jacobsen S, Thomsen M. H, Nanni, S. oncentrations of serum amyloid A in serum and synovial fluid from healthy horses and horses with joint disease. American Journal of Veterinary Research. 2006;67:1738-1742.
  24. Sanchez Teran A, Rubio‐Martinez LM, Villarino NF, Sanz, MG. Effects of repeated intra‐articular administration of amikacin on serum amyloid A, total protein and nucleated cell count in synovial fluid from healthy horses. Equine Veterinary Journal. 2012;44:12-16.
  25. Koenig RD. Synovial Fluid Analysis of the Horse. In: Veterinary Cytology. Leslie C, Sharkey MJR, Seelig D. ed. John Wiley & Sons. 2021.
  26. Baran S, Price C, Hak DJ. Diagnosing joint infections: synovial fluid differential is more sensitive than white blood cell count. European Journal of Orthopaedic Surgery & Traumatology. 2014;24:1469-1474.
  27. Steel CM. Equine synovial fluid analysis. Veterinary Clinics of North America: Equine Practice. 2008;24:437-454.
  28. Huggons N, Bell R, Puchalski S. Characterization of digital sheath fluid in horses with deep digital flexor tendinopathy. The Australian Equine Veterinarian. 2010;29:82-82.
  29. Robinson CS, Singer ER, Piviani M, Rubio-Martinez LM. Are serum amyloid A or D-lactate useful to diagnose synovial contamination or sepsis in horses? The Veterinary Record. 2017;181:425.
  30. Jacobsen S, Niewold TA, Halling-Thomsen M, Nanni S, Olsen E, Lindegaard C, Andersen PH. Serum amyloid A isoforms in serum and synovial fluid in horses with lipopolysaccharide-induced arthritis. Veterinary Immunology and Immunopathology. 2006;110:325-330.
  31. Ludwig EK, Brandon Wiese R, Graham MR, Tyler AJ, Settlage JM, Werre SR, Petersson‐Wolfe CS, Kanevsky‐Mullarky I, Dahlgren LA. Serum and synovial fluid serum amyloid A response in equine models of synovitis and septic arthritis. Veterinary Surgery. 2016;45:859-867.
  32. Hulten C, Gronlund, U, Hirvonen J, Tulamo RM, Suominen M, Marhaug G, Forsberg M. Dynamics in serum of the inflammatory markers serum amyloid A (SAA), haptoglobin, fibrinogen and α2‐globulins during induced noninfectious arthritis in the horse. Equine Veterinary Journal. 2002;34:699-704.
  33. Filippo PAD, Lannes ST, Meireles MA, Nogueira AF, Quirino CR. Concentrations of acute-phase proteins and immunoglobulins in serum and synovial fluid in clinically healthy heifers and steers. Pesquisa Veterinária Brasileira. 2019;39:388-392.
  34. Smith RKW, Heinegård D. Cartilage oligomeric matrix protein (COMP) levels in digital sheath synovial fluid and serum with tendon injury. Equine Veterinary Journal. 2010;32 (1):52-58.
  35. Skioldebrand E, Lorenzo P, Zunino L, Rucklidge GJ, Sandgren B, Carlsten J, Ekman S. Concentration of collagen, aggrecan and cartilage oligomeric matrix protein (COMP) in synovial fluid from equine middle carpal joints. Equine Veterinary Journal. 2001;33(4):394-402.
  36. Plaas A, Sandy J, Liu H, Diaz M, Schenkman D, Magnus R, Bolam-Bretl C, Kopesky P, Wang M, Galante J. Biochemical identification and immunolocalizaton of aggrecan, ADAMTS5 and inter-alpha-trypsin–inhibitor in equine degenerative suspensory ligament desmitis. Ortopedic Research. 2011;29(6):900-906.
  37. Basso R, Andred D, Alves C, Lufer R, Borges A, Oliveira-Filho P. Aggrecan, IL-1β, IL-6, and TNF-α profiles in the articular cartilage of miniature horses with chondrodysplastic dwarfism. 2021;103.
  38. Witkowska‐Piłaszewicz O, Żmigrodzk, M, Winnicka A, Miśkiewicz A, Strzelec K, Cywińska A. Serum amyloid A in equine health and disease. Equine veterinary journal. 2019;51:293-298.
Iranian Journal of Veterinary Surgery
Volume 16, Issue 2 - Serial Number 35
October 2021
Pages 107-114

  • Receive Date 22 July 2021
  • Revise Date 20 August 2021
  • Accept Date 23 August 2021
  • First Publish Date 23 August 2021