Conditions or ailments that are the cause of a problem that you see - your observation.

Your vet may diagnose

Strain or Injury Distal Ligaments Proximal Sesamoid

Synonyms: Oblique or Straight, or Cruciate Sesamoidean Ligament Strain


The distal ligaments of the proximal sesamoids are short, thick ligaments on the back of the pastern that attach the sesamoid bones on the rear of the fetlock joint to the pastern bones. There are several sets of ligaments, any of which can be injured.

These are relatively uncommon injuries that are better recognized today with the development of modern ultrasound equipment and techniques that can adequately image this anatomically complicated area.

These injuries can still be difficult to tell from other injuries in the pastern area - the ultrasound changes are notoriously subtle in many cases. MRI is the gold standard for precise diagnosis of these injuries.

Signs may not be obvious but may consist of slight swelling, pain to pressure on the back of the pastern, and positive response to lower limb flexion. Lameness is localizes to this region using nerve blocks. X-ray is usually negative and ultrasound makes the diagnosis (sometimes).

Prolonged rest is the cornerstone of treatment, although many other treatments are used today in the interest of providing higher quality and faster healing.

my role


I might observe

You might make these observations when a horse has this condition.

Very Common
Less Common
more observations

Questions To Ask Your Vet:
  • What are the treatment options, and the costs, advantages and disadvantages of each option?
  • Is there any proof that more sophisticated treatment options are better than rest and rehabilitation?

Prevention involves many of the same factors that reduce the likelihood of other tendon and ligament injury. Appropriate shoeing and shoeing intervals is critical to reducing excessive leverage on this area. Horses should be fit for the job.

further reading & resources

Related References:

Higgins AJ, Snyder JR eds. The Equine Manual. 2nd Ed. Edinburgh: Elsevier Saunders 2006.

Author: Doug Thal DVM Dipl. ABVP