Repetitive stress-related injury of the proximal metacarpus in a seven-year old Thoroughbred racehorse with emphasis on diagnostic analgesia of the proximopalmar metacarpus

This report describes the diagnosis and management of repetitive stress-related injury (RSRI) of the proximal metacarpus in a seven-year old Thoroughbred racehorse. Intra-articular analgesia of the middle carpal joint (MCJ) as well as perineural analgesia of the lateral palmar nerve (LPN) abolished lameness and a diagnosis of RSRI of the proximopalmar metacarpus was made after nuclear scintigraphic examination. Given the response to intra-articular analgesia, the authors undertook a cadaver study in order to better describe the relationship between the medial and lateral palmar pouches of carpo-metacarpal joint (CMCJ), the LPN and the deep branch of the lateral palmar nerve (DBLPaN).