Pain associated with the sacroiliac joint region: a clinical study of 74 horses (original) (raw)
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Veterinary Radiology & Ultrasound, 2009
Nuclear bone scintigraphy is commonly used in the diagnosis of sacroiliac disease in horses. The aim of the present retrospective study was to determine if there was an association between radiopharmaceutical uptake pattern and radiographic appearance of the sacroiliac region in horses. Seventy-nine horses undergoing bone scintigraphy with Tc-99 m-HDP and radiography of the pelvis because of lameness or poor performance were studied. Subjective and semiquantitative methods were used to characterize and compare radiopharmaceutical uptake between horses. Ventrodorsal radiographs of the region were obtained and were evaluated. Subjectively, 70 horses (88.6%) had an abnormal uptake pattern. In nine horses, the sacroiliac region was normal (11.4%). There was no association between subjective evaluation of the scintigraphic images and semiquantitative methods. There was a significant association between radiopharmaceutical uptake and conformation (T-or Y-like form) and shape (butterfly-, wing-, leaf-, or horn-like) of the sacrum. The radiopharmaceutical uptake of the tubera sacralia was significantly higher in males (left side P ¼ 0.002, right side P ¼ 0.003). In conclusion, the conformation of the sacrum may play an important role in the scintigraphic appearance and may be the cause of increased radiopharmaceutical uptake.
Veterinary Radiology & Ultrasound
The sacroiliac region in 33 clinically normal riding horses was examined with scintigraphy to determine the normal scintigraphic appearance, to evaluate a semiquantitative method used to calculate a sacroiliac joint (SI joint) ratio, and to identify factors that affect the scintigraphic appearance of the pelvis. The scintigraphic examination included dorsal views of each SI joint region and one lateral view of the urinary bladder. Two predefined areas (the SI joint and the area between the tuber sacrale and the SI joint) were evaluated subjectively by comparing the intensity in each area to the intensity in the tuber sacrale, and a semiquantitative method was applied on the images to calculate an SI joint ratio. The thickness of the muscle mass overlying each SI joint was measured by using ultrasound. A corrected ratio was calculated based on a corrected pixel count for each SI joint. Of 29 evaluated horses, 28 had normal radiotracer uptake in the SI joints and 10 horses had symmetric normal radiotracer uptake in the area between the tuber sacrale and the SI joint. The mean SI joint ratio was 0.53 on both the left and right sides, and the mean corrected SI joint ratio was 2.15 on the left side and 2.13 on the right side. Factors that affect the scintigraphic appearance of the pelvis were identified and included attenuation, radioactive urine, and muscle symmetry. The muscle thickness ranged from 8-11 cm, causing 71-82% attenuation. Radioactive urine in the urinary bladder was located ventral to the SI joint region in 16 horses, and four of these were excluded from further evaluation because of risk of misinterpretation. A visual assessment of symmetry of the horses' gluteal muscle mass was compared with the ultrasound measurements. Fourteen horses (14/33) were regarded symmetric by both techniques. Soft tissue attenuation was found to severely compromise the result and indicated that only lesions in the SI joint with severely increased radiotracer uptake can be detected with scintigraphy. Knowledge about presence of radioactive urine ventral to the SI joint region and assessment of muscle symmetry is essential for a correct subjective evaluation. Any situation with difference in muscle mass between the left and right side of the pelvis will give a false impression of increased radiotracer uptake on the side with lesser muscle mass.
Equine Science [Working Title]
Proximal suspensory desmopathy/desmitis (PSD) of the hindlimb is a well understood condition with widely accepted treatment protocols; however, there is little research demonstrating understanding or potential correlation between hindlimb PSD and sacroiliac disease (SID). Several studies have examined the coexistence of hindlimb PSD and SID each investigating unique predisposing factors. This has led to little direct correlation of cause and effect with no definitive conclusions drawn. The need to be objective is highlighted by the limited number of studies and that two studies used anecdotal evidence to support their hypothesis and thus creating the question does hindlimb proximal suspensory desmopathy predispose horses to sacroiliac disease? This review looks at the two conditions and compares the literature for each, including the incidence, biomechanics, anatomy, and treatment. The review further discusses whether one disorder predisposes horses/equids to the other.
Radiographic Technique and Anatomy of the Equine Sacroiliac Region
Veterinary Radiology & Ultrasound, 2007
Radiography is part of evaluating horses with poor performance and pelvic limb lameness; however, the radiographic appearance of the sacroiliac region is poorly described. The goal of the present study was to describe the use of a simple technique to obtain radiographs of the sacroiliac region in the anesthetized horse and to describe the radiographic appearance of this region. Seventy-nine horses underwent radiography of the pelvis under general anesthesia in dorsal recumbency. During a 5s exposure time the horse was actively ventilated to blur the abdominal viscera, which allowed assessment of individual bone structures in 77 horses. A large variation in the shape of the sacral wings, their articulation with the transverse processes of L6, and the relation of the sacrum to the ilium were observed. Females had significantly narrower width of the sacral wings. Broad sacral wings and bony proliferations at the caudal aspect were commonly observed features and their size was highly correlated with gender. In males, caudal osteophytes were significantly larger than in females. Five horses had transitional or hemitransitional vertebrae. Radiography with the ventilation-induced blurring technique is a simple approach that results in diagnostic quality radiographs and delineation of the highly variable bone structures of the sacroiliac region.
Osteoarthritis of the talocalcaneal joint in 18 horses
Equine Veterinary Journal, 2010
(TO) is an uncommon cause of moderate to severe hindlimb lameness, on which only isolated case reports have been published to date. Objectives: To review the clinical features of TO and determine optimal methods for diagnosis, management and prognosis.
Veterinary Surgery, 1997
Objective-To determine if intra-articular anesthesia of the distal interphalangeal joint could alleviate lameness associated with the navicular bursa in horses. Study Design-Experimental investigation. Animals-Six clinically normal horses. Methods-Lameness was induced in each horse by injecting either the left or right front navicular bursa with 5 mg of amphotericin-B. Forty-eight hours later each horse was videotaped walking and trotting before, and 5, 30, and 60 minutes after injecting the distal interphalangeal joint of the treated limb with 5 mL, of 2% mepivacaine hydrochloride. All video recordings were then rerecorded onto master tapes in a random sequence. Four clinicians, unaware of the animal identity related to observation time or limb treated, independently viewed these tapes and graded the lamenesses. Results-There was a significant reduction in lameness 5 and 30 minutes after anesthetic was injected into the distal interphalangeal joint. Lameness scores 60 minutes after anesthetic administration were not significantly different than baseline values. Gross pathological examination confirmed marked inflammation of the treated navicular bursae and normal appearance of the distal interphalangeal joints. Conclusions-Intra-articular anesthesia of the distal interphalangeal joint can alleviate lameness associated with the naviculitr bursa. Clinical Relevance-Intra-articular anesthesia of the distal interphalangeal joint is not specific only for lameness originating in the distal interphalangeal joint.
2012
An astute clinician can gain insight into the location and cause of a horse’s lameness by carefully examining the feet. Even though many foot problems produce similar clinical signs, careful physical examination of the foot may provide clues as to which method of perineural or intrasynovial analgesia is likely to be the most helpful in localizing the source of pain. By using different techniques of digital analgesia, a clinician may be able to determine the structure within the foot that is the source of pain. As well as identifying a specific lesion that is the cause of pain and lameness, it is equally important to identify poor foot conformation that may precipitate foot pain. Authors’ addresses: Equine Sports Medicine Program (John Schumacher) and Department of Clinical Sciences (Taylor), College of Veterinary Medicine, Auburn University, Auburn, AL 36849; Equine Clinic, National Veterinary School of Lyon, 69280 Marcy L’Etoile, France (Schramme); and Department of Large Animal Cl...
Equine Veterinary Journal, 2009
Aims: To describe the radiographic appearance and location of facet joint lesions, the clinical signs and to determine if there was any breed, gender, age, bwt or discipline predilection. Methods: Data from 77 horses examined at the Animal Health Trust between January 1997 and September 2007 with evidence of thoracolumbar pain and radiographic changes of the facet joints were reviewed. The presence of either other osseous abnormalities of the thoracolumbar region or other problems potentially contributing to poor performance were recorded. Facet joint lesions were graded radiographically and their location determined. Influence of breed, gender and discipline on the presence of lesions, effect of location on the type of lesion and the influence of impinging dorsal spinous processes on the clinical features were assessed using Chi-squared tests. Results: There was no effect of breed, gender, age or bwt on prevalence of facet joint lesions. Showjumpers were less affected than horses from other disciplines (P<0.0001). There were commonly 2-5 affected facet joints, usually in the caudal thoracic and cranial lumbar spine (T15-L1). Sclerosis, periarticular new bone and narrowed joint space were the most frequent radiographic lesion types. Clinical features were different between horses with and without impinging dorsal spinous processes (P<0.0001). Conclusions and Practical Significance: Osteoarthritis of the facet joints of the thoracolumbar spine can occur alone in horses with back pain, or in association with other osseous abnormalities. Severity of clinical signs was related to the presence of other osseous abnormalities, not the number of facet joints involved or the severity of lesion type. Further investigation of the prevalence of osteoarthritis in horses without clinical signs of back pain is merited.
Equine Veterinary Journal, 2010
The diagnosis of foot-related lameness often remains elusive and it can be difficult to offer rational treatment, or to predict outcome. Objectives: To describe the spectrum of injuries of the foot identified using magnetic resonance imaging (MRI), to determine their relative prevalence among MRI diagnoses and to establish the long-term results of treatment. Methods: The MR images of horses examined from January 2001-December 2003 were reviewed. Horses were selected for MRI if the pain causing lameness was localised to the foot using perineural analgesia but any clinical, radiological or ultrasonographic abnormalities were insufficient to explain the degree of lameness. The clinical significance of lesions identified using MRI was determined with reference to the results of local analgesia, radiography, ultrasonography and nuclear scintigraphy. Follow-up information was obtained in January 2004 for horses which had been examined 6-36 months previously and the outcome classified as excellent (horse returned to full athletic function without recurrent lameness), moderate (sound, but only in light work), or poor (persistent or recurrent lameness).
Clinical assessment and grading of back pain in horses
Journal of Veterinary Science, 2020
Background: The clinical presentation of horses with back pain (BP) vary considerably with most horse's willingness to take part in athletic or riding purpose becoming impossible. However, there are some clinical features that are directly responsible for the loss or failure of performance. Objectives: To investigate the clinical features of the thoracolumbar region associated with BP in horses and to use some of the clinical features to classify equine BP. Methods: Twenty-four horses comprised of 14 with BP and 10 apparently healthy horses were assessed for clinical abnormality that best differentiate BP from normal horses. The horses were then graded (0-5) using the degree of pain response, muscular hypertonicity, thoracolumbar joint stiffness and overall physical dysfunction of the horse. Results: The common clinical features that significantly differentiate horses with BP from non-BP were longissimus dorsi spasm at palpation (78.6%), paravertebral muscle stiffness (64.3%), resist lateral bending (64.3%), and poor hindlimb impulsion (85.7%). There were significantly (p < 0.05) higher scores for pain response to palpation, muscular hypertonicity, thoracolumbar joint stiffness and physical dysfunction among horses with BP in relation to non-BP. A significant relationship exists between all the graded abnormalities. Based on the cumulative score, horses with BP were categorized into mild, mild-moderate, moderate and severe cases. Conclusions: BP in horse can be differentiated by severity of pain response to back palpation, back muscle hypertonicity, thoracolumbar joint stiffness, physical dysfunctions and their cumulative grading score is useful in the assessment and categorization of BP in horses.