medial and lateral meniscal horns are not easily discernable with
ultrasonography. Arthroscopic debridement of meniscal tears may be
rewarding and upto 50% of horses with grade I or II meniscal tearsmay
return to athletic activities sound, though often at a lower level of
performance.
Mature horses may develop synovitis and OA of any one or a combination
of the stifle joints. Often the femoropatellar and medial femorotibial joints
are involved. Intraarticular injection of corticosteroids and hyaluronan
usually has favorable though finite results. Recurrent lameness of a stifle
that has been injected repeatedly is suggestive of a more serious injury
such as meniscal damage.
Sacroiliac joint or ligament pain
Sacroiliac pain is common in all Sporthorses. Sacroiliac joint region pain
often develops
secondarily to hindlimb PSD. The horse may have a history of
unwillingness to perform certain movements, stiffness, loss of impulsion
and cadence, loss of action, or being less easy to work in a correct outline.
Sometimes bucking or other nappy (resistant) behavior remain the
only clinical observations. A problem is that there are few specific clinical
or imaging signs that confirm the presence of sacroiliac pathology.
Rocking the pelvis or lifting one hindlimb high may cause the horse to
grunt. Injection of local anesthetic can be dangerous and the result difficult
to interprete as many horses with sacroiliac joint pain are not overtly lame.
Transrectal ultrasonographic examination may reveal irregular margins of
the caudal aspect of the sacroiliac joint. Abnormal IRU on nuclear
scintigraphy was traditionally used as the gold standard of diagnosis but
more recent reports suggest that many horses with positive diagnostic
analgesia have normal bone scans. Rest and time are the most important
factors influencing the outcome. Horses with less severe injuries may be
managed successfully by local injections of corticosteroids in the
periarticular tissues. Proper and careful rehabilitation is paramount to
strengthen the croup muscles adequately and avoid recurrence of the
problem. Regular lunge work in a Pessoa may be of benefit. Exercises to
increase core muscle strength are important. Slow warm-up in a pace that
the horse finds easy is also valuable.
Selected Bibliography
Arkell M, Archer RM, Guitian FJ, May SA. Evidence of bias affecting the interpretation of the results of local
anesthetic nerve blocks when assessing lameness in horses. Vet Rec 2006;159:346–349.
Keegan KG, Dent EV, Wilson DA, Janicek J, Kramer J, Lacarrubba A, Walsh DM, Cassells MW, Esther TM,
Schiltz P, Frees KE, Wilhite CL, Clark JM, Pollitt CC, Shaw R, Norris T. Repeatability of subjective evaluation of
lameness in horses. Equine Vet J. 2010 ;42(2):92-7.
Keegan KG, Wilson DA, Wilson DJ, et al. Evaluation of mild lameness in horses trotting on a treadmill by
clinicians and interns or residents and correlation of their assessments with kinematic gait analysis. Am J Vet
Res 1998;59:1370–1377.
Philippe Benoit et Emmanuel Grange. Aspects spécifiques de la boiterie: cas particulier du cheval de CSO.
Pratique Vétérinaire Equine, Volume 47, Numéro Spécial, 2015; 47(S): 58-67
Singer E. Aspects spécifiques de la boiterie: cas particulier du cheval de concours complet. Pratique Vétérinaire
Equine, Volume 47, Numéro Spécial, 2015; 47(S): 86-95
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February
2016
East
London
Convention
Centre,
East
London,
South
Africa
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