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                                                                                                   CHAPTER

             Principles of Musculoskeletal

             Disease





             JOINT INJURIES AND DISEASE

             AND OSTEOARTHRITIS


                                                                 C. Wayne MCIlWraIth




               Arthritis may be defined simply as inflammation of a   the extremities. Because these are the joints that we are
             joint. It is a nonspecific term and does little to describe   essentially concerned with in equine lameness, their
             the nature of the various specific entities that affect   anatomy and physiology are described in detail.
             equine joints. The role of inflammation also varies con­
             siderably among the different conditions. Such general
             terms are no longer appropriate in the management   General Anatomy
             of equine joint conditions. Specific diagnoses must be   The synovial or diarthrodial joint consists of the
             made to effectively treat the horse and make accurate   articulating surfaces of bone that are covered by articu­
             prognoses.                                          lar  cartilage  and  secured  by  a  joint  capsule  and  liga­
               Updated knowledge of etiology, pathogenesis, diag­  ments  and  a  cavity  within  these  structures  containing
             nosis, and treatment of each of the different equine joint   synovial fluid (Figure  7.1).  The joint capsule is com­
             conditions has been recently published in a separate   posed of two parts: the fibrous layer, which is located
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             textbook on equine joint disease.  To understand joint   externally and is continuous with the periosteum or
             disease in the horse, a basic knowledge of the anatomy   perichondrium (and, ultimately, bone), and the synovial
             and physiology of joints, as well as their pathobiologic   membrane, which lines the synovial cavity where articu­
             responses, is necessary.                            lar cartilage is not present.
                                                                   The fibrous portion of the joint capsule is composed
                                                                 of dense fibrous connective tissue that provides some
             ANATOMY AND PHYSIOLOGY OF JOINTS                    mechanical stability to the joint. The collateral ligaments
                                                                 are associated with the joint capsule. Intra‐articular liga­
             Classification                                      ments normally have a synovial membrane cover. Type I
               Joints are most often classified according to their   collagen predominates in the fibrous connective tissues
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               normal range of motion. Three groups are recognized:   of the joint.  It is vascular and has afferent pain fibers.
             synarthroses (immovable joints), amphiarthroses (slightly   Using immunohistochemistry with substance P as a
             movable joints), and diarthroses (movable joints), also   more  sensitive way of identifying the distribution  of
             known as synovial joints. Synovial joints have two   nociceptor fibers, it has been shown that sensory nerve
             major functions: (1) to enable movement and (2) to   fibers are present in the synovial membrane and subinti­
             transfer load.   The entire structure is invested by a   mal layers  as well as collateral  ligaments, suspensory
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             fibrous capsule. Diarthroses include most of the joints of   ligament, and distal sesamoid ligament attachments. 10



             Adams and Stashak’s Lameness in Horses, Seventh Edition. Edited by Gary M. Baxter.
             © 2020 John Wiley & Sons, Inc. Published 2020 by John Wiley & Sons, Inc.
             Companion website: www.wiley.com/go/baxter/lameness
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