Contrast tenography keeps a role in equine tendon sheath workups

Contrast tenography is getting renewed attention as a practical way to evaluate injuries within the equine digital flexor tendon sheath, especially in settings where MRI or CT may be unavailable or cost-prohibitive. A recent dvm360 article framed the technique as a readily available option for general practitioners assessing horses with suspected sheath pathology, including lesions involving the deep digital flexor tendon and manica flexoria. That fits with a broader literature base showing that digital flexor tendon sheath disease can be difficult to characterize with standard imaging alone, and that contrast-based studies remain part of the diagnostic toolkit. (pmc.ncbi.nlm.nih.gov)

Why it matters: For equine veterinarians, the value proposition is access. Digital flexor tendon sheath injuries are a common source of lameness and tenosynovitis, but advanced imaging is not always feasible in first-opinion practice. Published work has shown that contrast tenography can help outline key intrathecal structures and support lesion detection, while newer studies suggest it still compares favorably with some advanced options for selected lesions. In a 2025 study of naturally occurring manica flexoria tears, contrast radiography and low-field MRI tenography each showed 71% sensitivity and 100% specificity, with MRI tenography adding better lesion laterality information. Another 2025 prospective clinical trial found that contrast radiographic tenography remained useful, although cone-beam CT tenography and tenoscopy provided more complete lesion detection in some cases. (pubmed.ncbi.nlm.nih.gov)

What to watch: Expect more discussion around where contrast tenography fits in the workup pathway, particularly as newer studies refine diagnostic criteria and compare it head-to-head with cone-beam CT, MRI tenography, ultrasonography, and tenoscopy. (pubmed.ncbi.nlm.nih.gov)