46TH
ANNUAL
CONGRESS
OF
THE
SAEVA
SKUKUZA
16-‐20
FEBRUARY
2014
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Intra-articular corticosteroid injections may predispose to fungal osteitis although
the actual frequency of occurrence in horses is unknown (Sherman et al. 2006).
Sequestrum formation has also been described following PSB osteitis, and contrary
to the rapid healing of sequestra in long bones of horses that undergo surgical
treatment, PSB sequestration carries a prolonged healing period (Dunkerley et al.
1997).
Debate exists on the long-term outcome and prognosis of axial osteitis. Several
studies indicate a poor prognosis for return to full work (Richardson & Dyson 2011;
Wisner et al. 1991) whilst others indicate a more favourable prognosis for the
aseptic form treated with arthroscopic debridement (Dabareiner et al. 2001). Five
out of 6 horses in Dabareiner et al.'s (2001) study that returned to work had the
aseptic form, and all had arthroscopic debridement as part of their treatment
protocol. In Wisner’s (1991) study, none of the seven horses returned to work,
however, none had surgical intervention. Only three of the seven horses underwent
treatment, which consisted of systemic antibiotics and metacarpophalangeal joint
lavage.
Septic forms generally carry a poor prognosis and the general consensus appears to
be that of a poor to guarded prognosis (Sedrish et al. 1996; Dunkerley et al. 1997;
Wisner et al. 1991). Lawrence and Fraser (2013) reported findings on two foals with
septic axial osteitis in which a successful outcome was obtained with the use of oral
doxycycline, which is not an antibiotic administered previously for this condition.
Unfortunately the effect of axial osteitis on sesamoid strength and future athletic
performance is not known despite resolution in the two foals, as they were not old
enough to enter training at the time of the reported findings (Lawrence & Fraser
2013).
In conclusion, axial osteitis is a clinical entity in which the imaging findings are well
documented and rewarding, but treatment and long term outcome is often
disappointing and a poor prognosis can be expected in the majority of cases.
References:
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Barclay, W.P., Foerner, J.J. & Phillips, T.N., 1985. Axial sesamoid injuries associated with
lateral condylar fractures in horses. Journal of the American Veterinary Medical Association,
186(3), pp.278–279.
Barr, E.D. et al., 2005. Destructive lesions of the proximal sesamoid bones as a complication
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Butler, J. et al., 2000. Clinical Radiology of the Horse 2nd ed., Blackwell Science, Oxford, United
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Cornelissen, B.P., Rijkenhuizen, A.B. & Barneveld, A., 1996. The arterial shift features in the
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