Page 155 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

130 CHAPTER 1

VetBooks.ir be insidious in onset or be a sequela to other joint cases difficulty entering the joint may be encoun-
tered. Standard radiographic projections usu-
insults (e.g. fracture, sepsis, subluxation). Poor limb
conformation can be associated with uneven loading
(Fig. 1.228), and changes can be moderate/severe
across the joint and contribute to its development. ally show classic signs of OA, particularly dorsally
but not necessarily correlated to the degree of lame-
Clinical presentation ness shown.
Pastern OA usually presents clinically as a low-
grade lameness/performance issue but is occasion- Management
ally associated with acute flare-up. Pastern OA may Early management of pastern OA includes rest/
be suspected with the presence of bony thicken- light exercise, intra-articular medication and correc-
ing, particularly dorsally, over the pastern articu- tive trimming/shoeing. Progression of the disease is
lation (‘ringbone’). Joint effusion is rarely detected often seen, leading to persistent lameness. Palliative
but horses may be positive to distal limb flexion treatment through the use of NSAIDs and/or joint
(Fig. 1.227). supplementation is common and may help to manage
a significant proportion of cases. Since the pastern
Differential diagnosis joint is a low motion/high loading joint, arthrodesis
Foot or fetlock lameness; subluxation; synovial is a viable and successful option in the management
sepsis; soft-tissue injury. of pastern OA. Methods for attaining arthrodesis
include chemical (ethanol) and surgical (transarticular
Diagnosis screws with or without plate) (Fig. 1.229) procedures.
Diagnosis of pastern OA can be confirmed through Laser-facilitated arthrodesis has also been described
intra-articular anaesthesia, although with advanced and can be used as an adjunct to internal fixation.

1.227 1.228

Fig. 1.227 View of the right forelimb of a horse with Fig. 1.228 Lateromedial radiograph of the pastern
osteoarthritis of the proximal interphalangeal joint. region of a horse with osteoarthritis of the proximal
Note the swelling around the pastern joint on the interphalangeal joint. Note the spikey new bone
medial, lateral and dorsal aspects. dorsally on P1 and P2.