INFLAMMATION OF THE SESAMOID SHEATH. 1037 



the opposite foot. When either tendon is injured the prognosis is 

 always unfavourable, as necrosis almost always follows. Necrosis, 

 however, not infrequently occurs even without the tendon being 

 wounded. Treatment may succeed if commenced early, and consists 

 in the most careful disinfection of the parts ; in some cases it is 

 advisable to operate and open the affected sheath. 



Diagnosis is sometimes difficult because of the swelling which 

 always exists around' the wound. One symptom which always 



Fig. 555. — Position of the limb, in suppurative inflammation of the sesamoid sheath 

 in the pastern (from a photograph). 



accompanies inflammation of the tendon sheath should, therefore, be 

 particularly remembered, viz., lifting of the limb, as in gonitis ; in 

 this case, however, the foot is carried further forwards (Fig. 555). 

 This peculiar position is common, and seems absolutely pathogno- 

 monic. Accurate diagnosis is very important, because treatment is 

 scarcely advisable, except in valuable horses. The treatment, which 

 consists in daily cleansing of the parts, washing out with disinfectants, 

 and bandaging, is not often successful. Continuous irrigation is 

 seldom more beneficial. In a few instances, however, recovery occurs, 

 though the fetlock usually remains somewhat knuckled ; two cases 



