Osteochondral fragments involving the dorsomedial aspect of the proximal interphalangeal joint in young horses: 6 cases (1997-2006)

OBJECTIVE: To determine clinical and diagnostic imaging findings in young horses with osteochondral fragments involving the dorsomedial aspect of the proximal interphalangeal (PIP) joint. DESIGN: Retrospective case series. ANIMALS: 6 horses. PROCEDURES: Medical records were reviewed. Follow-up information was obtained through telephone conversations with owners or trainers or by examining race records. RESULTS: Horses were between 1 and 4 years old. Three had bilateral osteochondral fragments in the forelimbs (n = 2 horses) or hind limbs (1). Radiographically, all but 1 fragment seemed to originate from the dorsomedial aspect of the distal end of the first phalanx. Fragment size ranged from 6 x 9 mm to 11 x 21 mm. Three horses had lameness referable to the region of the affected joint; the other 3 horses did not have clinical signs referable to affected PIP joints. Two horses were euthanized shortly after diagnosis at the owners' request because of concerns that the horses would be unsuited for their intended athletic use. Two of the 3 horses in which fragments were incidental findings were able to race successfully, although 1 received intra-articular corticosteroid treatments; the third was retired because of unrelated orthopedic problems. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that osteochondral fragments involving the dorsomedial aspect of the PIP joint may be an incidental finding in young horses. Given the absence of clinical signs in 5 of 9 affected joints and the fact that 3 of 6 horses were affected bilaterally, a developmental origin of the fragments was suspected.     

Large colon resection and anastomosis in horses

Large colon resection and anastomosis was performed in 11 horses at various levels of the colon, using several surgical methods. The level of resection ranged from the pelvic flexure to the cecocolic ligament. Nine of 11 horses survived and at follow-up (4 months to 7 years) were free of clinical signs referable to disease of the gastrointestinal tract. Seven horses could be evaluated as to athletic or reproductive function and all returned to original potential.     

Retrospective study of the effect of intra-articular treatment of osteoarthritis of the distal tarsal joints in 51 horses

Osteoarthritis of the distal tarsal joints, affecting the centrodistal and tarsometatarsal joints, is a common cause of hindlimb lameness in horses. This paper describes the outcome of the intra-articular treatment of 51 horses with the condition with either methylprednisolone acetate (mpa) or triamcinolone acetonide (tr), either with or without hyaluronic acid (ha). The outcome was assessed in terms of the changes in the horses' grade of lameness. Follow-up information was obtained from the owners by means of a telephone questionnaire. Horses treated once with mpa or tr, either with or without ha, improved after a median of 56 days (P<0.0001), and there was no significant difference between mpa and tr. There was no significant further improvement in the horses treated twice. In the horses in which there was a diffuse increase in the uptake of a radiopharmaceutical by the distal tarsal joints, identified by scintigraphy, the lameness tended to improve (P=0.032), whereas in the horses in which the uptake was focal, it did not. At telephone follow-up 13 of 34 horses were reported to have had a positive outcome, but the outcome in the other 21 was reported to have been negative.     

Prevalence of carpal fractures in thoroughbred and standardbred racehorses

The prevalence of carpal fractures was determined for 211 thoroughbred and 75 standardbred racehorses. Statistically significant differences were found in the location of fractures between the 2 breeds. In the thoroughbred and standardbred groups, total fractures (460) were distributed nearly equally between the left (224) and right (236) carpi. The most common site of fracture in the thoroughbred group was the distal aspect of the radiocarpal bone (112), whereas the most common site of fracture in standardbred horses was the proximal surface of the third carpal bone (61). Slab fractures were more common in the right carpus of thoroughbred horses (29 right/11 left), but were distributed equally between the left (11) and right (11) carpi of the standardbred group. Fractures of the distal border of the radius and intermediate carpal bone were more common in the left carpi of the thoroughbred group and were relatively uncommon among standardbred horses. Fractures within the intercarpal joints (313) were more common than those within the radiocarpal joints (147) in thoroughbred and standardbred horses.     

Qualitative assessment of corticosteroid cervical articular facet injection in symptomatic horses

Cervical stenotic myelopathy (CSM) is the most common cause of noninfectious spinal cord ataxia in horses. Intra‐articular injection of corticosteroids into the facet joints of horses with CSM may relieve clinical signs of the disease process. However, there is a paucity of literature regarding the efficacy of facet injection therapy in horses with CSM. This retrospective study describes the return to normal function or improvement in performance of horses after ultrasound‐guided cervical facet injection that had previously shown signs of ataxia, obscure lameness or neck pain, prior to injection.     

A retrospective clinical study of osteochondrosis dissecans in 21 horses

Osteochondrosis dissecans was diagnosed clinically and radiographically in 31 joints of 21 horses. The horses ranged in age from 8 months to 5 years at the time of presentation. The usual age of onset of clinical signs was 18 to 24 months. Presenting complaints included joint effusion and lameness of either gradual or sudden onset. In Thoroughbred horses, the stifle joint was the most common site of lesions and in Standardbred horses lesions occurred more commonly in the hock. In 16 of the 21 horses, the contralateral joint was radiographed and 9 of these horses had bilateral lesions. Thoroughbred horses were affected most commonly, followed by Standardbred horses. The prevalence was higher in males than females, the male: female ratio being 2.5:1.     

Lameness and poor performance in horses used for team roping: 118 cases (2000-2003)

OBJECTIVE: To determine the types of musculoskeletal problems that result in lameness or poor performance in horses used for team roping and determine whether these problems are different in horses used for heading versus heeling. DESIGN: Retrospective study. ANIMALS: 118 horses. PROCEDURE: Medical records of team roping horses that were evaluated because of lameness or poor performance were reviewed to obtain information regarding signalment, primary use (ie, head horse or heel horse), history, results of physical and lameness examinations, diagnostic tests performed, final diagnosis, and treatment. RESULTS: Among horses evaluated by lameness clinicians, the proportion with lameness or poor performance was significantly greater in horses used for heading (74/118) and lower in horses used for heeling (44/118) than would be expected under the null hypothesis. Most horses examined for poor performance were lame. A significantly greater proportion of horses used for heading had right forelimb lameness (26/74 [35%]), compared with horses used for heeling (7/44 [16%]). Horses used for heading had more bilateral forelimb lameness (18/74 [24%]), compared with horses used for heeling (4/44 [9%]). Horses used for heeling had more bilateral hind limb lameness (3/44 [7%]), compared with horses used for heading (0%). The most common musculoskeletal problems in horses used for heading were signs of pain limited to the distal sesamoid (navicular) area, signs of pain in the navicular area plus osteoarthritis of the distal tarsal joints, and soft tissue injury in the forelimb proximal phalangeal (pastern) region. Heeling horses most commonly had signs of pain in the navicular area, osteoarthritis of the metatarsophalangeal joints, and osteoarthritis of the distal tarsal joints. CONCLUSIONS AND CLINICAL RELEVANCE: Horses used for heading were most commonly affected by lameness in the right forelimb. Horses used for heeling had more bilateral hind limb lameness than horses used for heading.     

Laser-Facilitated arthrodesis of the distal tarsal joints

Arthritis of the distal tarsal joints is a common cause of lameness in performance horses. Clinical signs of distal tarsal arthritis are variable and may include gait abnormalities typical for tarsal lameness, including accentuated elevation of the affected limb, shortened cranial phase of the stride, and decreased arc of the foot. Affected horses frequently resent palpation of the lumbar and gluteal musculature. The lameness is usually increased after a hind limb flexion test. This condition is most commonly treated with intra-articular injections of sodium hyaluronate and corticosteroids in conjunction with controlled exercise and systemic nonsteroidal anti-inflammatory medication. Horses that are refractory to this form of treatment have traditionally been treated by cunean tenectomy with inconsistent results. Various surgical techniques have been used to achieve arthrodesis of these joints in an effort to eliminate the lameness associated with arthritic changes in these joints. Laser-assisted arthrodesis offers a minimally invasive surgical procedure with a relatively short convalescent period that eliminates the clinical signs of lameness in a high number of cases.     

High detail radiography and histology of the centrodistal tarsal joint of Icelandic horses age 6 months to 6 years

REASONS FOR PERFORMING STUDY: Osteoarthrosis (OA) in the distal tarsal joints, bone spavin, is a well known condition which is common in Icelandic horses age 6-12 years. OBJECTIVES: To determine the nature, location and age of appearance of early radiographic and histological changes in the centrodistal tarsal joint (CD) of young Icelandic horses. METHODS: Slab sections from the CD of young Icelandic horses were examined by high detail radiography (age 6 months to 6 years, n = 111) and histology (age 6 months to 4 years, n = 82) to detect and describe the early changes indicative of OA. Horses younger than 5 years were unridden. RESULTS: Chondronecrotic lesions histologically similar to those described in the early pathogenesis of OA were seen in 33% of the joints, located both medially and laterally. Radiographic sclerosis of the subchondral bone was recorded in 60% of the specimens, most often medially. Medial location was not associated with chondronecrosis, but was strongly related to age. Sclerosis was an infrequent finding on the lateral side, and was probably secondary to chondronecrosis in the corresponding part of the joint. Small defects in the subchondral bone were considered to be the most specific radiographic sign of OA as they were strongly associated with chondronecrosis. CONCLUSIONS: The high prevalence of chondronecrosis in the young horses indicates an early onset and slow progression of the disease. The early appearance also shows that the initiation of the disease is unrelated to the use of horses for riding. As clinical manifestation of OA in the distal tarsal joints is most often described in mature or old horses, the first stages of the disease are not likely to result in clinical signs. Subchondral bone sclerosis did not appear to be a primary factor in the development of OA in the CD but was considered to reflect an uneven distribution of biomechanical forces within the joint. POTENTIAL RELEVANCE: The development of OA in the CD of young Icelandic horses seems to be due to poor conformation or joint architecture rather than trauma or overloading. These aetiological factors are likely to be of importance for OA in the distal tarsal joints in other breeds as well. The influence of hindlimb conformation and the architecture of the distal tarsal joints on the biomechanics of joints need to be investigated, preferably by locomotion analysis in young horses.     

Concentrations of substance P and prostaglandin E2 in synovial fluid of normal and abnormal joints of horses

OBJECTIVE: To correlate substance P content of synovial fluid with prostaglandin E2 content, radiographic evidence of joint abnormality, and anatomic location of the joint for normal and osteoarthritic joints of horses. SAMPLE POPULATION: Synovial fluid from 46 normal joints in 21 horses and 16 osteoarthritic joints in 10 horses. PROCEDURE: Normal and osteoarthritic joints were identified by clinical and radiographic examination, by response to nerve blocks, during scintigraphy or surgery, or by clinicopathologic evaluation. Substance P and prostaglandin E2 contents of synovial fluid were determined by radioimmunoassay. Radio-graphs of joints were assigned a numeric score reflecting severity of lesions. Joints were assigned a numeric score reflecting anatomic location. RESULTS: Median concentrations of substance P and prostaglandin E2 were significantly increased in osteoarthritic joints, compared with normal joints. A significant correlation was found between concentrations of substance P and prostaglandin E2 in synovial fluid, but a correlation was not detected between substance P concentration in synovial fluid and anatomic location of the joint or between radiographic scores of osteoarthritic joints and concentrations of substance P or prostaglandin E2. CONCLUSIONS AND CLINICAL RELEVANCE: A correlation existed between concentrations of substance P and prostaglandin E2 in synovial fluid obtained from normal and osteoarthritic joints. However, content of substance P in synovial fluid cannot be predicted by the radiographic appearance of the joint or its anatomic location. Substance P and prostaglandin E2 may share an important and related role in the etiopathogenesis of osteoarthritis, lending credence to the importance of neurogenic inflammation in horses.     

Prevalence of osteochondrosis in the limb joints of South German Coldblood horses

This study aimed to quantify the factors associated with the prevalence of the radiological signs of osteochondrosis (OC) and osteochondrosis dissecans (OCD) in South German Coldblood (SGC) horses. The prevalence of OC and OCD in fetlock and hock joints was analysed in 167 young coldblood horses with a mean age of 14 months. The presence of at least one osteochondrotic lesion (OC) in fetlock or hock joints was documented for 61.7% of the horses and 26.9% of the horses had osseus fragments. Osteochondrotic findings at the dorsal aspect of the sagittal ridge of the third metacarpal/metatarsal bone were seen in 53.9% of the horses and palmar/plantar osseous fragments in fetlock joints in 16.2% of the horses. Hock joint OC was found in 40.1% of the horses and hock OCD in 0.6%. Osteochondrotic findings in the distal part of the tibia were prevalent in 28.1% and in the lateral trochlea tali in 17.4% of the horses. The sex of the investigated horses significantly influenced the prevalence of OC in fetlock and hock joints, as well as the findings in the distal part of the tibia and lateral trochlea tali. Age at radiological examination was significant for the prevalence of OC in hock joints, palmar/plantar osseous fragments in fetlock joints and osteochondrotic findings in the distal part of the tibia. Female horses showed a 2-fold higher risk for OC in fetlock and hock joints than male horses. The distribution of the affected horses by age classes showed that radiographic signs of OC in fetlock and hock joints significantly increased at an age of about 1 year. We can conclude from our study that fetlock and hock OC is a prevalent radiographic finding in more than 1-year-old female and male SGC horses.     

Prevalence of hereditary diseases in three-year-old Swiss Warmblood horses

The objective of this study was to investigate clinical signs indicating hereditary diseases like equine sarcoid, osteochondrosis (OC) and the idiopathic laryngeal hemiplegia (ILH), and to demonstrate relationships between environment, feeding habits and conformation ("exterieur" evaluation) of the horses. For this purpose, we analyzed veterinary examinations of 403 stallions at the approvals since 1994 examined 493 three-year-old Swiss Warmblood horses, which were shown at the Swiss-Field-Tests in 2005.With the help of the owners a questionnaire on health, environment and feeding habits of the animals was completed. At the same time, the horses were assessed and graded for their "exterieur" (type, conformation, gaits) by judges of the Swiss Sporthorse breeding association. In 11.5% of horses sarcoids were found, 8.7% showed one and 2.8% several tumors.The prevalence of sarcoids in offspring of sires with known sarcoids was not significantly higher than in descendants from stallions without a known history of sarcoids. We found distended joints as a possible symptom of OC in 11.4% of the horses, 3.9% (n = 19) in both tarsal joints.We did not find a relationship between enlarged joints in the offspring and the presence of OC in the sires. Abnormal respiratory noise at work, as a possible sign for ILH, was heard only in 1.2% (n = 6). It is important to note that while we found a high number of sarcoid affected horses compared to other studies, presence of enlarged joints was not very frequent and very few horses showed abnormal respiratory noise. Additionally, we found no correlation between "exterieur" marks and the horse's general health.     

Metacarpophalangeal Joint Synovial Pad Fibrotic Proliferation in 63 Horses

Medical records, radiographs, and sonograms of 63 horses with metacarpophalangeal joint synovial pad proliferation were examined retrospectively. All horses had lameness, joint effusion, or both signs associated with one or both metacarpophalangeal joints. Bony remodeling and concavity of the distodorsal aspect of the third metacarpal bone (Mc3) just proximal to the metacarpal condyles was identified by radiography in 71 joints (93%); 24 joints (32%) had radiographic evidence of a chip fracture located at the proximal dorsal aspect of the proximal phalanx. Fifty-four joints (71%) were examined by ultrasound. The mean ± SD sagittal thickness of the synovial pad was 11.3 ± 2.8 mm. Seventy-nine percent of the horses had single joint involvement with equal distribution between the right and left forelimbs. Sixty-eight joints in 55 horses were treated by arthroscopic surgery. Sixty joints (88%) had debridement of chondral or osteochondral fragmentation from the dorsal surface of Mc3 beneath the synovial pad and 30 joints (44%) had a bone chip fracture removed from the medial or lateral proximal dorsal eminence of the proximal phalanx. Complete or partial excision of both medial and lateral synovial pads was completed in 42 joints. Only the medial synovial pad was excised or trimmed in 21 joints, and 5 joints had only the lateral pad removed. Eight joints in eight horses were treated by stall rest, administration of intra-articular medication and systemic nonsteroidal anti-inflammatory drugs. Follow-up information was obtained for 50 horses treated surgically and for eight horses treated medically. Forty-three (86%) that had surgery returned to racing; 34 (68%) raced at an equivalent or better level than before surgery. Three (38%) of the medically treated horses returned to racing; only one horse raced better than the preinjury level. Horses that returned to racing at a similar or equal level of performance were significantly younger in age than horses returning at a lower level or not racing (P≤.05). Overall, horses with synovial pad proliferation treated by arthroscopic surgery had a good prognosis for return to racing at a level equal or better than before injury.     

Radiological investigations of osteochondrosis dissecans in Standardbred Trotters and Swedish Warmblood horses

A total of 106 Standardbred Trotters and 27 Swedish Warmblood horses, with a radiological diagnosis of osteochondrosis dissecans, were studied over a six year period. The majority were young horses. No statistical difference in frequency between the sexes was demonstrated. In both breeds osteochondrosis was most common in the hock joints, the site of predilection being the distal dorsal tip of the intermediate tibial ridge. On radiographs the lesions of the hock joints were graded on a scale from 0 to 5 according to size, number and localisation of defects and visible loose bodies. The sizes of the loose bodies estimated radiologically were fairly closely correlated with those found at surgery or autopsy.     

Injuries to the cranial cruciate ligament and associated structures: summary of clinical, radiographic, arthroscopic and pathological findings from 10 horses

The clinical, radiographic, arthroscopic and pathological findings of 10 horses with injury to the cranial cruciate ligament are presented. The most consistent clinical signs included moderate to severe distension of the femoropatellar joint and a Grade III to a Grade V out of V lameness. Craniocaudal instability could be elicited in five horses under general anaesthesia and in one conscious horse. Radiographic evaluation of the stifles revealed that avulsion fracture of the medial intercondylar eminence was the most common finding in six out of 10 horses. Arthroscopic examination of the affected femorotibial joints were performed in five horses. This confirmed the presumptive diagnosis of cranial cruciate ligament injury or rupture. Post mortem examinations were performed on two horses which documented partial tears of the cranial cruciate ligament.     

Postmortem lesions in the intercarpal ligaments of the equine midcarpal joint

Objective To determine the frequency of damage to the medial palmar intercarpal ligament (MPICL), and the range of sizes of the dorsomedial intercarpal ligament (DMICL) of the midcarpal joint in horses with no history of carpal joint disease.
Materials and methods
Cadaver limbs were collected from 72 horses with no history of carpal joint disease. One hundred and forty-two midcarpal joints were dissected and the MPICL and DMICL were examined. Measurements were made with a digital micrometer.
Results MPICL tearing was present in 88 of 96 joints from horses 2 years and older. Tears were predominantly of the dorsolateral bundle and complete rupture of the dorsolateral and dorsomedial bundles was not observed. Tearing was not present in foals less than 4 months of age and the severity of tearing increased significantly with age (P < 0.0001). Severity of tearing was significantly greater in racing Standardbreds than racing Thoroughbreds (P < 0.01), but there was no significant difference between racing and non-racing horses. The lateromedial thickness of the DMICL ranged from 0.4 mm to 2.6 mm in horses 2 years and older. Lateromedial thickness increased significantly with age, and was significantly greater in racing Standardbreds than racing Thoroughbreds (P < 0.01). There was no significant difference between racing and nonracing horses.
Conclusions Damage confined to the dorsolateral bundle of the MPICL is a common finding in horses over 1 year of age and is probably of little clinical significance. Complete rupture of both dorsolateral and dorsomedial bundles is uncommon in horses with no history of midcarpal joint disease. Variation in size of the DMICL is observed in horses of all ages, but is most marked in 2-year-old horses.     

Glycosaminoglycans in horses with osteoarthritis

Horse articular cartilage glycosaminoglycans (GAGs) were measured in synovial fluids from 48 joints affected with osteoarthritis (OA), 22 normal joints, four joints with osteochondritis, three joints with traumatic arthritis and seven joints infected with bacteria. Serum and urine from individual horses were also examined for the presence of GAGs. High levels of GAGs were found in synovial fluids (SF) from horses with OA. In each case, the level was higher in the synovial fluid than in the serum or urine from the same horse. Horses with OA showed high GAG levels in SF, serum and urine compared to horses with normal and infected joints. High levels were also found in horses with osteochondritis and traumatic arthritis. Levels of synovial fluid GAG reflect cartilage destruction in arthritis and may be useful for monitoring disease progression in the equine species.     

Anatomical and functional communications between the synovial sacs of the equine stifle joint

The anatomical and functional communications of the synovial sacs of the equine stifle joint were evaluated in 50 stifle joints of 25 horses. Femoropatellar joint (FPJ) sacs were injected with 50 ml of gelatin-based dye and horses were then walked for 50 m. Horses were subsequently killed, the stifle joints dissected and the location of the dye recorded. Twenty-three horses (46 joints) had clinically normal stifle joints and in this group, anatomical communications of the stifle joints were bilaterally symmetrical in each horse. In 15 of these 23 horses (65 per cent), direct anatomical communication between the FPJ sac and the medial sac of the femorotibial joint (FTJ) was demonstrated. The FPJ sac communicated with both the medial and lateral sacs of the FTJ in four of these 23 horses (17.5 per cent). There were no anatomical communications between the FPJ sac and either sac of the FTJ in the remaining four horses (17.5 per cent). Functional communication, which was established by finding dye in the FTJ sacs were anatomical communication with the FPJ sac existed, was demonstrated in 14 of 19 horses (74 per cent). Two horses were affected with degenerative joint disease of one stifle joint. In both of these joints the FPJ sac communicated with both the medial and lateral FTJ sacs. This distribution was different from that of the contralateral joint. When performing intra-articular anaesthesia of equine stifle joints, each synovial sac needs to be injected separately to ensure that anaesthesia of the appropriate synovial sac is obtained.     

Musculoskeletal problems associated with lameness and poor performance among horses used for barrel racing: 118 cases (2000-2003)

OBJECTIVE: To identify types of musculoskeletal problems associated with lameness or poor performance in horses used for barrel racing. DESIGN: Retrospective case series. ANIMALS: 118 horses. PROCEDURE: Medical records were reviewed for information on signalment, history, physical and lameness examination findings, diagnostic tests performed, diagnosis, and treatment. RESULTS: Most horses were examined because of lameness (n = 72 [61%]) rather than poor performance (46 [39%]), but owner complaint was not significantly associated with age or body weight of the horse. The most common performance change was refusal or failure to turn properly around the first barrel (19/46 [41%]). The right forelimb (n = 57 [48%]) was most commonly affected, followed by the left forelimb (51 [43%]), the left hind limb (31 [26%]), and the right hind limb (25 [21%]). In 31 horses (26%), both forelimbs were affected, and in 6 (5%), both hind limbs were affected. The most common musculoskeletal problems were forelimb foot pain only (n = 39 [33%]), osteoarthritis of the distal tarsal joints (17 [14%]), suspensory ligament desmitis (15 [13%]), forelimb foot pain with distal tarsal joint osteoarthritis (11 [9%]), and bruised feet (10 [8.5%]). In 81 (69%) horses, the affected joint was treated with intra-articular medications. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that in horses used for barrel racing that are examined because of lameness or poor performance, the forelimbs are more likely to be affected than the hind limbs, with forelimb foot pain and osteoarthritis of the distal tarsal joints being the most common underlying abnormalities.