Page 396 - The Veterinary Care of the Horse

Diagnosis is made on:

• the clinical signs
VetBooks.ir • intra-articular nerve blocks

•
radiography
• ultrasonography

• synovial fluid analysis to rule out infection if the joint is acutely inflamed

• scintigraphy may help to localize the problem in some cases.
• arthroscopy is sometimes used to examine the tissues and help establish the prognosis.

TREATMENT

Treatment may include:

• box rest with short periods of in-hand walking exercise. Adequate rest is essential to
allow the injury to repair

• cold treatment in the early stages

• non-steroidal anti-inflammatory drugs, e.g. phenylbutazone, to reduce the pain and
inflammation

• ultrasound, low intensity laser or magnetic field therapy

• passive flexing of the knee several times a day to keep the joint mobile

• intra-articular administration of hyaluronan, polysulphated glycosaminoglycan (PSGAG)
or corticosteroid. At the time of writing PSGAG is only available in the USA.

A thick bed should be provided to minimize the risk of further trauma when lying down.

PROGNOSIS

This depends on the degree of damage that has occurred before treatment begins. If faulty
conformation is the cause, the prognosis is poor. Affected racehorses should have their

training and racing programmes reassessed. Ongoing joint inflammation ultimately leads to
osteoarthritis.

Carpal chip and slab fractures

Carpal chip and slab fractures are predominantly a racehorse injury. Chip fractures are small
fragments of bone that break off the top or bottom of individual carpal bones in response to

the stresses of training and racing. The radial, intermediate or third carpal bones and the
distal aspect of the radius are most commonly involved. The pieces can remain attached or