Lameness in horses is a condition characterized by an abnormal gait or stance due to pain or mechanical dysfunction affecting the limbs or spine. It is a common issue in equine practice and can result from a variety of causes, including injury, infection, or degenerative diseases. Lameness can affect a horse's performance and quality of life, making accurate diagnosis and management important for equine health. Diagnostic techniques often include physical examination, imaging, and gait analysis. This page aggregates peer-reviewed research studies and scholarly articles that explore the etiology, diagnostic methods, and management strategies for lameness in horses.
Stanek C.A retrospective study (1984-1994) was made of 10 cases of septic arthritis of the distal interphalangeal joint in horses aged 7 months to 17 years. In 6 cases a hind limb was affected, in 4 cases a front limb. The arthritis was caused either by a puncture wound in the sole area (8 cases), by a perforating wound in the coronary region (1) or iatrogenic (1). All horses exhibited a severe lameness at the walk. Radiography showed no typical lesions in fresh cases, whilst later an increasing subluxation of the joint was observed followed by periosteal reactions. Therapy included partial resection o...
Hendrickson DA.The determination of poor performance in the young or unproven horse can be a difficult experience for the practitioner. This article describes an incremental exercise test that may be helpful in determining the cause of poor performance in horses when a complete physical examination and a lameness examination fail to elucidate the causes of poor performance. Included are values from normal yearling and 2-year-old horses that have undergone the incremental exercise test.
Gaughan EM.Skeletal origins of exercise intolerance and performance failure can reside in multiple tissues. Diagnosis of injury that results in an ability to continue to exercise, yet inefficiently do so, requires familiarity with evaluation of subtle lameness and often with the specific demands of the different equine sports. Imaging is usually vital to diagnosis development and understanding of lesion influences on locomotion. Therapy is lesion dependent. Return to competitive exercise and performance is dictated by an understanding of skeletal tissue response to injury, rational progressive treatment,...
Lilich JD, Gaughan EM.The diagnostic approach to the exercise intolerant racehorse depends on sound, fundamental steps to allow complete examination of the entire horse in a logical, time-efficient fashion. Availability of referral diagnostic modalities should not overshadow the need for collecting a clinical history or performing a complete physical examination. The diagnostic approach to exercise intolerance can be divided into a few basic steps. The first step, conducted without the horse, is a thorough discussion about the horse with the trainer and/or owner. Many clinical histories are complex and therefore fo...
Anderson BH, Turner TA, Kobluk CN.Successful treatment of a comminuted frontal plane fracture of the distal phalanx in a horse is described. The bone fractured through the solar canal, close to the insertion of the deep digital flexor tendon. A hoof case was used to reduce bending and tensile stresses on the solar surface by limiting expansion of the hoof wall during weightbearing. In addition, the heel was elevated, using 3 degrees wedge pads incorporated within the hoof cast, to reduce distraction at the fracture site caused by the pull of the deep digital flexor tendon. Two casts were used over a 4-month period. Complete ra...
Hinckley KA, Fearn S, Howard BR, Henderson IW.Laminitis, a microvascular disease of the equine hoof leads to severe lameness. Exogenous iv 1-arginine and transdermal nitric oxide donors, such as GTN, applied to the pasterns improve lameness during acute laminitis. Near Infrared spectroscopy in an earlier study showed haemostasis and ischaemia in the hoof during acute laminitis, both were alleviated by 1-arginine. Quantitative NIRS in the present study shows that transdermal GTN increases blood flow in the equine hoof. It is concluded that glyceryl trinitrate enhances nitric oxide mediated perfusion within the equine hoof in normal and chr...
Vickers KL, Ross MW.A 4-year-old sexually intact male Standardbred trotter was evaluated for left forelimb lameness. A presumptive diagnosis of severe cartilage damage was made because the horse had a history of infectious arthritis involving the left metacarpophalangeal joint. Arthroscopic evaluation revealed what was presumed to be a large villonodular lesion. The mass was surgically removed, and the horse was treated with procaine penicillin G, trimethoprim-sulfamethoxazole, phenylbutazone, and polysulfated glycosaminoglycans and eventually returned to racing. Histologic examination of the mass revealed a bed ...
Hanson JA, Seeherman HJ, Kirker-Head CA, O'Callaghan MW.Seven horses with severe, persistent lameness of sudden onset were evaluated with scintigraphy and/or computed tomography. The lameness was localised to the front fetlock joint in 2 horses and to the tibiotarsal joint in 5 horses. Five of the horses had a history of intra-articular injections of the involved joint prior to presentation. All horses had effusion of the affected joint and were positive to flexion tests. Intraarticular anaesthesia eliminated or improved the lameness in 4 cases and a nerve conduction block proximal to the affected joint improved the lameness in another. Cytology ex...
Sysel AM, Pleasant RS, Jacobson JD, Moll HD, Modransky PD, Warnick LD, Sponenberg DP, Eyre P.Amphotericin B-induced synovitis of the left tarsocrural joint was used to create a grade 3 of 4 lameness in 11 horses. Caudal epidural catheters were placed and advanced to the lumbosacral region. Baseline heart and respiratory rates were recorded and horses were videotaped at a walk and trot. Morphine sulphate (0.2 mg/kg) and detomidine hydrochloride (30 micrograms/kg) were administered to treated horses (n = 8) through the epidural catheter; an equivalent volume of physiologic saline solution was administered to control horses (n = 3) through the catheter. At hourly intervals after epidural...
Caron JP, Kaneene JB, Miller R.To determine the patterns of use and perceived efficacy of polysulfated glycosaminoglycan (PSGAG) for the treatment of degenerative joint disease in horses. Methods: Cross-sectional mail survey. Methods: 1,522 equine practitioners. Methods: Information was obtained on frequency and route of administration of PSGAG for the treatment of each of 4 forms of degenerative joint disease, the efficacy of PSGAG, and its efficacy compared with that of sodium hyaluronate. Data were analyzed by nonparametric and multivariate regression methods. Results: Response rate was 40.5%. Of practitioners responding...
Weiss DJ, Monreal L, Angles AM, Monasterio J.Carbohydrate-induced laminitis has been associated with decreased platelet survival, decreased blood flow to the hoof wall and with the deposition of platelets and microthrombi within venules in the dermal laminae. To evaluate further the systemic prothrombotic events occurring in the prodromal stages of laminitis, plasma samples from control and laminitis-affected ponies and horses were tested for the presence of thrombin-antithrombin (TAT) complexes and fibrin fragment D (D-dimer). No statistically significant differences between the control and laminitis-affected animals were observed for e...
Clayton HM.The success of a clinical gait laboratory depends on choosing the right equipment, installing it correctly, running calibration checks, and having skilled technical and professional personnel. For kinematic analysis, videographic or optoelectronic systems are the method of choice, with 2-D data being adequate for the majority of equine evaluations. A force plate provides a precise description of the 3-D ground reaction force; transmission of the force through the body tissues is measured using strain gauges attached to the bones and tendons. Accelerometers bonded to the hoof wall provide infor...
Peham C, Scheidl M, Licka T.The aim of this paper is to present a method of signal processing necessary for motion analysis in the trotting horse. Motion analysis is widely used to assess lameness in horses. By definition, lameness in trot is present if the movements during the stance phases of both fore or hind limbs differ. The motion of the horse is recorded using a system for motion analysis (Selcom, 1983, SELSPOT II User Manual, Pad Nr. 6710) and the vertical motion of the head during both stance phases is compared. The symmetry is analyzed comparing the values of the Fourier coefficients. Additional head movements ...
Ruggles AJ, Moore RM, Bertone AL, Schneider RK, Bailey MQ.To determine clinical signs, radiographic and scintigraphic findings, and performance outcome of racing Standardbreds with tibial stress fractures. Methods: Retrospective case series. Methods: 13 racing Standardbreds with tibial stress fractures. Methods: Information concerning clinical signs, diagnostic evaluation, and recommendations was obtained by review of the medical records. Performance information before and after diagnosis of the fracture was collected from racing records, and follow-up information was obtained from the owners or trainers by use of a telephone questionnaire. Results: ...
Mair TS, Dyson SJ, Fraser JA, Edwards GB, Hillyer MH, Love S.The case records of 23 horses and one donkey affected by hypertrophic osteopathy (HO) (Marie's disease) were reviewed. All affected animals presented with limb swellings, which were bilaterally symmetrical and usually involved both fore- and hindlimbs. Associated signs included stiffness/lameness and weight loss. Radiological features included periosteal new bone formation over the diaphyses and metaphyses of affected bones. The metacarpal and metatarsal bones were most frequently affected. Articular surfaces remained free of disease. Seventeen animals were destroyed on humane grounds, 3 horse...
Owens JG, Kamerling SG, Stanton SR, Keowen ML.Detomidine (10, 20 and 40 micrograms/kg i.v.) and saline were administered to eight adult horses with hoof pain and lameness associated with chronic laminitis. Mechanical noxious stimulation was applied to 16 loci over the solar surface of each forefoot by means of an electronic hoof tester to determine chronic pain thresholds. Horses were evaluated before and at 25, 55 and 120 min after treatment for lameness and to determine hoof compression thresholds (HCTs), the percentage of responsive loci and the subjective grade of hoof withdrawal response at each responsive locus. Detomidine produced ...
Johnston C, Roepstorff L, Drevemo S, Kallings P.Fast trotting Standardbred horses were filmed along a straight on an oval dirt track. Five consecutive stance phases were analysed to describe the planar kinematics of the distal hindlimb. The rapid changes in the geometry of the distal hindlimb that occur during the early stance phase were studied. The hoof segment was initially braked vertically and moved in the direction of the horse. The hoof moved forward on the track surface for more than 20% of the stance time (ST). Two specific deviations in the otherwise smooth course of the fetlock joint angle appeared at 16 and 29% of ST. Tarsal ang...
Owens JG, Kamerling SG, Stanton SR, Keowen ML, Prescott-Mathews JS.To compare the analgesic and anti-inflammatory effects of the nonsteroidal anti-inflammatory drugs (NSAID), ketoprofen (2.20 and 3.63 mg/kg of body weight) and phenylbutazone (4.40 mg/kg), in an acute equine synovitis model. Methods: 4 groups of 6 horses received NSAID or saline solution in a randomized design. Methods: 24 clinically normal mares and geldings. Methods: Left intercarpal joints were injected with sterile carrageenan to induce synovitis at the same time as IV administration of NSAID or saline solution. Clinical assessments were made and synovial fluid was withdrawn at 0, 1, 3, 6,...
Dolvik NI, Gaustad G.The degree of lameness of 265 randomly selected three-year-old standardbred trotters was assessed on a fixed point scale with 0 indicating soundness and 5 indicating that the animals were not weightbearing. Two variables were used to describe the signs of lameness; one was the continuous variable: the sum of the initial lameness score and the lameness scores after separate flexion tests of the carpal, stifle/tarsal and phalangeal joints and the second was the bivariate variable; the ratio of lame/sound horses. The mean (sd) heritability of the continuous variable was estimated to be 0.25 (0.21...
Tulamo RM, Houttu J, Tupamäki A, Salonen M.To investigate the presence of large molecular weight (MW) proteoglycans (PG) and hyaluronate (HA) in synovial fluid (SF) from horses with various arthritides and from control joints. Methods: Horses with acute (< 2 weeks) or chronic (> 4 weeks) lameness were examined by clinical examination, intrasynovial anesthesia, radiography, arthroscopy, and SF analysis. Joints were grouped on the basis of diagnosis: acute traumatic arthritis, chronic traumatic arthritis (with a subgroup of degenerative joint disease), intra-articular fracture, and infectious arthritis. Methods: 31 horses with arthritis ...
Carter BG, Bertone AL, Weisbrode SE, Bailey MQ, Andrews JM, Palmer JL.To evaluate joint function and healing of surgically created full-thickness articular cartilage defects in exercised horses after intra-articular administration of methylprednisolone acetate (MPA; 120 mg) and sterile saline solution in the contralateral limb. Methods: Experimental investigation. Methods: 12 healthy, sound, radiographically normal horses with induced full-thickness osteochondral lesions on the medial and lateral trochlear ridges of the tali. Methods: Two 8.4-mm-diameter full-thickness articular cartilage lesions were created in each tarsocrural joint (12 horses [24 tarsocrural ...
Butson RJ, Schramme MC, Garlick MH, Davies JV.Gentamicin-impregnated polymethylmethacrylate beads were used in the treatment of infective synovitis in 12 horses and 10 cattle. They had either proved refractory to standard treatments (lavage, debridement, joint drainage and systemic antibiotics) or had evidence of osteomyelitis adjacent to a synovial cavity. All the animals were severely lame. All the cattle and six of the horses had radiological evidence of osteomyelitis in communication with a synovial cavity. The beads were placed intrasynovially under general anaesthesia and left in place for 14 days. One horse and one calf were euthan...
Dabareiner RM, White NA, Sullins KE.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...
Ray CS, Baxter GM, McILWRAITH CW, Trotter GW, Powers BE, Park RD, Steyn PF.The objective of this study was to determine if damage to the articular cartilage alone or articular cartilage plus subchondral bone of the distal medial femoral condyle of young, exercised horses resulted in the formation of subchondral cystic lesions. Twelve Quarter Horses (age 1-2 years), free of clinical and radiographic signs of osteochondrosis and lameness were used. In 6 horses (Group 1), a 15 times 1 mm linear full thickness defect in the articular cartilage was made arthroscopically on the weightbearing surface of the distal aspect of the medial femoral condyle. In the other 6 horses ...
Vatistas NJ, Pascoe JR, Wright IM, Dyson SJ, Mayhew IG.To determine the clinical outcome of horses treated for infection of the intertubuercular bursa (infectious bicipital bursitis). Methods: Retrospective analysis of case records. Methods: Four horses referred for treatment of infectious bicipital bursitis. Methods: Medical records of horses that were severely lame on admission were reviewed. Results: In 3 horses, palpation over the bicipital bursa as well as flexion and extension of the scapulohumeral joint were resented. Ultrasonography performed in 1 horse revealed that the bicipital bursa was large and that excessive amounts of fluid contain...
Keegan KG, Wilson DA, Lattimer JC, Twardock AR, Ellersieck MR.To evaluate distribution and intensity of 99mTc-methylene diphosphonate (99mTc-MDP) uptake in the navicular area in horses with forelimb lameness isolated to the palmar aspect of the foot. Methods: Prospective, case-controlled study. Methods: 7 horses with clinical signs of navicular syndrome and 7 control horses. Methods: Palmar view, soft tissue-phase scintigraphic images of the foot were obtained between 7 and 12 minutes after injection of 120 to 170 mCi of 99mTc-MDP. Lateral and palmar view, bone-phase images were obtained at 30 minutes and 1, 2, and 4 hours after injection. Palmar views w...
Hjertén G, Drevemo S.The initial forelimb loading of a horse trotting at 3.7 ms-1 on a treadmill was studied by use of an instrumented shoe, accelerometers and high-speed cinematography. At the beginning of the stance phase the forelimb was loaded successively from the hoof. This is suggested to be an important factor for effective shock force absorbency in the extremities. Shearing forces may appear in the carpus before the onset of the longitudinal loading of the limb. These forces are proposed to depend on speed, locomotion pattern and the friction and hardness of the surface. It is suggested that shearing forc...
Wright IM.The technique of navicular suspensory desmotomy for the treatment of navicular disease is described and the rationale behind its development is discussed. To date 16 horses involved in a clinical evaluation of the technique have been assessed six months after surgery. Thirteen of these horses are able to work without lameness.
Brommer H, Schipper P, Barneveld A, van Weeren PR.Records of lame horses (2004-2007) with (peri-)synovial pain of the metacarpophalangeal joint (MCPJ, n = 53), digital flexor tendon sheath (DFTS, n = 20), and distal interphalangeal joint (DIPJ, n = 31) were evaluated (n = 104). Cases were grouped according to the following treatments: (1) systemic administration of NSAIDs (n = 40); (2) intrasynovial administration of glucocorticosteroids (n = 30); (3) combination treatment (n = 34). Outcome was defined as successful when the owner reported that the horse had returned to its previous level of performance within a period of up to six months aft...
Bonilla AG, Santschi EM.A 16-year-old American paint horse gelding was presented for evaluation of a left forelimb lameness grade III/V. Radiographs and computed tomography revealed a comminuted fracture of the accessory carpal bone involving the entire articulation with the distal radius and the proximal aspect of the articulation with the ulnar carpal bone. Multiple fragments were present in the palmar pouch of the antebrachiocarpal joint. An arthroscopic-assisted open approach was necessary to remove all fractured fragments. Subsequently the horse was re-admitted for lameness and was treated successfully with anti...
Booth TM, Clegg PD, Singer ER, Cheeseman MT.A four-year-old gelding was lame owing to a chronic septic common digital extensor tendon and sheath. The horse had been treated by open surgical lavage but the sepsis had recurred after three months. Physical, ultrasonographic, cytological and histological examinations confirmed chronic septic tenosynovitis and tendonitis. The entire intrathecal component of the common digital extensor tendon was resected under general anaesthesia and the synovial lining of the sheath was ablated. Postoperatively the horse regained good limb function and became sound.