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.
Ball MA, Allen D, Parks A.A 13 year-old pony was evaluated because of right hind limb lameness of acute onset. Radiographs of the right tarsus obtained shortly after the onset of lameness were normal, but results of nuclear scintigraphy were abnormal. Two radiolucent subchondral cyst-like lesions of the distal part of the tibia were seen on radiographs obtained 9 months later. The lesions were surgically decompressed, and the pony was sound 1 year later. It is hypothesized that a traumatic insult created a crack or split in the articular cartilage that allowed subsequent development of the cyst-like lesions.
Theoret CL, Barber SM, Moyana T, Townsend HG, Archer JF.The reparative ability of equine synovium was determined by gross, histological, and ultrastructural examination. The functional potential of the synovium was estimated by examination of synovial cell organelles with transmission electron microscopy. Results from rested and exercised horses were compared to determine the effect of exercise on synovial healing. The response of synovectomized joint to exercise was evaluated with a standardized lameness examination and by gross, histological, and histochemical observations of the articular cartilage. A 7-mm diameter motorized synovial resector wa...
Dabareiner RM, White NA, Sullins KE.Case records and radiographs of 71 horses with subchondral lucency, without radiographic evidence of fracture, located on the distal radial carpal bone were examined retrospectively. All horses had lameness and/or joint effusion referable to the carpus. Distal radial carpal bone subchondral lucency was found as a solitary lesion or as a lesion concurrent and symmetric to a contralateral distal radial carpal bone chip fracture. The lesion appeared radiographically as a lucency or shadow on the distal dorsal margin of the radial carpal bone and was most evident on the flexed lateromedial and dor...
Clegg PD, Butson RJ.A nine-year-old Shetland pony gelding, with a history of recurrent upward fixation of the patella, suddenly developed severe lameness in its right hindlimb. A luxation of the coxofemoral joint was diagnosed by a clinical and radiographic examination. The initial treatment of the luxation by closed reduction was not maintained, and the limb was placed in an Ehmer sling for four days after a second closed reduction. This allowed the femoral head to remain in the acetabulum, although a persistent subluxation remained, presumably owing to a rupture of the round ligament. The pony remained comforta...
Reppas GP, Canfield PJ.A 12-year-old Arab stallion was presented with a chronically swollen right carpus resulting in profound lameness of the same leg. An incisional biopsy of subcutaneous tissue from the right carpus submitted for cytology and histopathology revealed large numbers of eosinophils interspersed by substantial numbers of variably sized and granulated mast cells. Fungal culture of a subcutaneous tissue sample taken from the right carpus was negative. Serial full blood counts revealed persistent mature eosinophilia, not accompanied by a mastocytaemia, neutrophilia without left shift and persistent hyper...
Bell BT, Bridge IS, Sullivan ST.Seventeen horses diagnosed as having navicular syndrome on the basis of history, clinical findings, regional local anaesthesia and radiography were subjected to bilateral navicular suspensory desmotomy. Before surgery, the duration of navicular lameness ranged from 6 weeks to 4 years. Previous unsuccessful treatments prior to surgery included nonsteroidal anti-inflammatories, corrective shoeing, rest and isoxsuprine. For the seventeen horses subject to surgery, twelve horses were sound, one horse was improved and four horses were lame at a minimum of 6 months after surgery.
Pollitt CC.Thirty-two dorsal, mid-hoof wall, lamellar sections from 8 Standardbred horses, humanely killed 48 h after the administration of an alimentary carbohydrate overload, were sectioned and examined by light microscopy. Sections were stained with the connective tissue and basement membrane stains periodic acid-Schiff (PAS), Azan and periodic acid silver methanamine (PASM) and with routine haematoxylin and eosin (H&E). Lesions of the epidermal lamellae, attributable to laminitis, were graded in order of increasing severity from Grade N (normal), Grade 1 (mild), Grade 2 (moderate) to Grade 3 (severe ...
Stolk PW, de Waal Malefijt MC, Buma P, Barneveld A.In this paper the successful replacement of an equine metatarsophalangeal joint by a human total condylar knee prosthesis is reported. In the period of observation following implantation of the endoprosthesis the experimental animal showed almost no lameness when exercised at walk, bearing weight on the operated limb. Flexion and extension of the joint were markedly reduced. The clinical and histological observations clearly support further investigation into the equine metatarsophalangeal joint replacement by an endoprosthesis.
Cornelissen BP, Rijkenhuizen AB, Barneveld A.The sesamoidean nerve branches from the palmar nerve and runs towards the proximal sesamoid bone. To study the structures innervated by this nerve, a technique for blocking it was developed. The effect of this nerve block was determined in ponies with an induced lameness located in the lateral proximal sesamoid bone (5 ponies) or in the distal part of the lateral branch of the suspensory ligament (5 ponies), and in 10 horses with clinical sesamoidosis. A lameness provoked by the implantation of an expansion plug in the proximal sesamoid bone could, to a large extent, be anaesthetized by a sesa...
Keg PR, Schamhardt HC, van Weeren PR, Barneveld A.The practice of applying diagnostic nerve blocks relies on the assumption that the blocks in themselves do not alter the horse's gait. This assumption has recently been challenged. In the present paper a series of sequential nerve blocks (low palmar digital block, abaxial sesamoid block, high palmar block) was applied to clinically sound horses. Before and after each block the gait was clinically scored and Ground Reaction Forces (GRF) were measured. Clinical scoring did not change after any of the nerve blocks. None of the GRF variables changed significantly except for a slight alteration of ...
Buchner HH, Savelberg HH, Schamhardt HC, Barneveld A.The kinematic patterns of head and trunk were studied in horses during induced supporting limb lameness to understand the mechanisms horses use to compensate for lameness and to evaluate different symmetry indices for their significance as lameness indicators. Using the locomotion analysis system CODA-3 the kinematics of 11 clinically nonlame Dutch Warmblood horses were recorded while walking (1.6 m/s) and trotting (3.5 m/s) on a treadmill. A transient lameness model, evoking pressure induced pain on the hoof sole, was used to induce 3 degrees of fore- and hindlimb lameness. Peak vertical disp...
Buchner HH, Savelberg HH, Schamhardt HC, Barneveld A.The kinematic patterns of all limbs of 11 clinically nonlame Dutch Warmblood horses were studied during induced supporting limb lameness to gain insight into the compensation mechanisms horses use to manage lameness and to test kinematic limb variables for their significance as lameness indicators. Using the locomotion analysis system CODA-3, the kinematics of the horses were recorded while walking (1.6 m/s) and trotting (3.5 m/s) on a treadmill. A transient lameness model, evoking pressure on the hoof sole, was used to induce 3 degrees of fore- and hindlimb lameness. Joint angle patterns and ...
Keg PR, Schamhardt HC, van Weeren PR, Barneveld A.Controversy exists with respect to the innervation of the suspensory ligament (SL) in the fore limb of the horse. It is uncertain whether this structure is exclusively innervated by branches of the ulnar nerve or also to some extent by median nerve branches. Ground Reaction Forces (GRF) were determined in horses before and after the induction of a tendonitis in the lateral branch of the SL by the injection of collagenase, and before and after a high palmar and an ulnar block respectively. The high palmar block succeeded in bringing all GRF variables back to their original values which the ulna...
Denoix JM, Jacot S, Bousseau B, Perrot P.This paper describes normal ultrasound images of the soft tissues of the dorsal and abaxial aspects of the equine fetlock. The palmar aspect of the fetlock is not discussed because it is related to the suspensory apparatus and flexor tendon anatomy which has been previously described. Ultrasound scanning was performed with 7.5 MHz linear or 10 MHz sector probes and recorded on 7.5 cm U-matic videocassettes allowing further retrospective data analysis, computer manipulation and good image reproducibility. Sagittal, parasagittal, frontal and transverse ultrasound scans of 13 lameness free mature...
McDiarmid AM.A mature thoroughbred cross gelding with an acute onset forelimb lameness was found to have sustained a fracture to the distal phalanx. The fracture traversed the distal phalanx In a lateromedial direction dividing the phalanx into two halves, dorsally and palmarly and was classed a frontal fracture. The horse was treated conservatively and after 14 months rest it returned to work. Three years later the horse has remained sound.
Schneider RK, Andrea R, Barnes HG.An open, contaminated, comminuted fracture of the radius of a 500-kg adult horse was diagnosed. Antibiotic-impregnated polymethyl methacrylate implants were placed into the fracture site to help eliminate infection from the limb. Later in the course of treatment, lag screws were placed across the fracture to generate compression and healing. The fracture healed, and the horse was released to its owners. The implants were not removed, and only a mild lameness existed 90 days later.
van den Berg MJ, Rijkenhuizen AB, Németh F, Gruys E.Chronic changes of several structures in around the fetlock tunnel can be a cause of the so-called fetlock tunnel syndrome (FTS) in the horse. Forty-nine annular ligaments (AL) from dead horses without a known history or clinical evidence of lameness and/or digital tendon sheath problems in these legs and 30 AL biopsies from horses suffering from FTS were studied macroscopically and microscopically. Macroscopically, the normal AL had a shiny white appearance, whereas the affected AL were often thicker and less white. Microscopically, the normal AL were about +/- 1 mm thick and were composed of...
Hinckley KA, Fearn S, Howard BR, Henderson IW.The present study applies near infrared spectroscopy (NIRS) to the haemodynamics of the pedal circulation in normal and laminitic horses. NIRS is a noninvasive technique which uses changes in light absorption at 4 wavelengths to provide information on the changes in cytochrome aa3 (cyt aa3) reduction-oxidation (redox) status, and changes in the tissue concentration of oxyhaemoglobin (O2Hb), deoxyhaemoglobin (HHb) and therefore total haemoglobin (tHb). Other studies have shown NIRS to be sensitive to changes in tissue oxygenation and perfusion in human cerebral and limb circulation. In this stu...
Gibson KT, Burbidge HM.Three horses were presented for treatment of chronic infections of the digital flexor tendon sheath. Clinical signs included severe lameness, and heat, pain and swelling of the digital flexor tendon sheath. The horses were treated with surgical lavage of the tendon sheath, systemic and local antibiotics, and analgesics. In each case, resolution of the lameness occurred over weeks to months. Only one horse returned to athletic activity, while the other two became comfortable at pasture. Response to treatment in cases of chronic tenosynovitis may not be as rapid or complete as that reported for ...
Back W, Schamhardt HC, Hartman W, Barneveld A.In literature, it has been hypothesized that the concussion at impact in the equine forelimb is larger than that in the hind limb, and therefore, eventually more clinical lameness may develop in the distal portion of the forelimbs. As the functional anatomy of the distal forelimb and hind limb segments is similar, a study was undertaken to compare the kinematics of hoof and fetlock in the forelimbs and hind limbs. For this purpose, the trot of 24 clinically normal (sound) horses on a treadmill (4 m/s) was recorded, using modern gait analysis equipment. It appeared that vertical hoof velocity a...
Clegg PD.A mature thoroughbred-cross gelding developed chronic severe hindlimb lameness. Despite intensive clinical investigation, the diagnosis of infective arthritis of the coxofemoral joint was difficult, and a definitive diagnosis was reached only after synoviocentesis of the joint. The horse was euthanased and examined thoroughly post mortem but no definitive aetiology for the condition was discovered.
Nixon AJ, Pool RR.Osteochondral fragments from the axial proximoplantar/proximopalmar region of the proximal phalanx were removed from 38 joints in 30 horses. Ninety-three percent of the horses were Standardbreds, and 28 of the 30 had a low-grade lameness. All but 1 of the horses had hind limb involvement. A total of 43 fragments were removed. Most (71%) of the fragments involved the medial aspect of the joint and had to be dissected from a covering of synovial tissue. Histologically, the circumference of most fragments consisted of a transition zone at the attachment of the joint capsule, a region of nonarticu...
Strand E, Martin GS, Crawford MP, Kamerling SG, Burba DJ, Kearney MT.A study was done to determine whether intra-articular pressure is increased in equine metacarpophalangeal joints with increasing degrees of synovial distention, and to correlate elastance of the soft tissue forming the dorsal pouch of the metacarpophalangeal joint to maximal range of motion in flexion. Sixty seven metacarpophalangeal joints in 36 horses were categorized by palpation and visual inspection of the palmar pouch into 1 of 4 increasing grades of distention. Intra-articular pressures were then measured, using 2 pressure transducers attached to 22 gauge needles, from the dorsal and pa...
Lillich JD, Ruggles AJ, Gabel AA, Bramlage LR, Schneider RK.Medical records of 17 horses in which a distal sesamoid bone fracture was diagnosed between 1982 and 1992 were reviewed. There were 8 Standardbreds, 6 Quarter Horses, 2 Thoroughbreds, and 1 Arabian. Mean age was 4.7 years. A forelimb was affected in 15 horses, and a hind limb was affected in 2. All horses were lame, and most were grade III/V lame at the trot. In all horses, the diagnosis was confirmed by means of radiography. Five horses were treated with stall rest alone; 5 underwent neurectomy; 4 were treated with stall rest and corrective shoeing; and 1 was treated with stall rest and exter...
Riber C, Rubio MD, Marquez F, Pinedo M, Muñoz A, Castejon F.Clinical blood chemistry was studied on 13 Andalusian horses with laminitis. Ten healthy horses were used as controls. Blood samples were taken within the first 24 hr after the onset of the disease in Obel grade 3 before any type of treatment was given. No significant differences were observed in the number of red blood cells and white blood cells between Andalusian horses affected by laminitis and healthy animals. Significant decrease in the number of neutrophils and increased number of lymphocytes were noted. A significant increase in the enzymatic activity of CPK, LDH and AST in these anima...
Eaton SA, Allen D, Eades SC, Schneider DA.Starling forces and hemodynamics in the digits of 5 horses were studied during early laminitis induced by oral administration of an aqueous extract of black walnut (Juglans nigra). The black walnut extract was prepared from heartwood shavings and was administered by nasogastric tube. Heart and respiratory rates, rectal temperature, central venous and arterial pressures, digital pulses, and signs of lameness were monitored. Blood samples were collected for determination of WBC count, hemoglobin concentration, and PCV and for endotoxin and tumor necrosis factor assays. Total WBC count and centra...
Gaustad G, Larsen S.A randomised double blind and placebo controlled clinical study was carried out. Standardbred trotters (n=77), age 3-4 years) with moderate to severe lameness were grouped according to number of affected joints and, within each group, were randomised for treatment with polysulphated glycosaminoglycan (PSGAG), sodium hyaluronate (SH) or placebo for 3 weeks. The horses were inspected weekly with a final examination 2-4 weeks after the end of treatment. Mean initial lameness score was significantly reduced during treatment and at the last examination in all 3 groups (P<0.01). Additionally, the...
Buchner HH, Savelberg HH, Schamhardt HC, Barneveld A.The kinematic pattern of mild bilateral lameness was studied by inducing a supporting limb lameness in both fore-limbs of 11 sound Dutch Warmblood horses. The kinematics of the horses were recorded while they trotted (3.5 m/s) on a treadmill. The locomotion analysis system CODA-3 was used to determine the temporal stride patterns, limb movements as well as head and trunk movement patterns. The transient lameness model, by which pressure-induced pain is evoked on the hoof sole, was used. Differences between left and right limbs as well as between the sound and the lame condition were tested usi...
Barr AR, Dyson SJ, Barr FJ, O'Brien JK.Twenty-four horses with ultrasonographic evidence of tendonitis of the deep digital flexor tendon in the metacarpal/metatarsal region were seen over a 7 year period. Most horses had mild to moderate lameness and distension of the digital flexor tendon sheath in the affected limb. Intrasynovial analgesia of the digital flexor tendon sheath consistently improved the degree of lameness. Ultrasonography most commonly revealed small, distinct, often circular, focal hypoechoic areas within the deep digital flexor tendon which usually extended less than 1 cm proximodistally. The degree of lameness an...
Smanik LE, Selberg KT, Mason GL, Brock M, Stewart HL, Goodrich LR, Kawcak CE.To perform a pilot study with the intent of assessing the feasibility of a modified subchondroplasty (mSCP) technique in a validated preclinical equine model of full-thickness articular cartilage loss and evaluate the short-term patient response to the injected materials. Methods: 3 adult horses. Methods: Two 15-mm-diameter full-thickness cartilage defects were created on the medial trochlear ridge of each femur. Defects were treated with microfracture and then filled by 1 of 4 techniques: (1) autologous fibrin graft (FG) via subchondral injection of fibrin glue (FG), (2) autologous fibrin gra...
Tomlinson F, Terschuur J, Henson F.Soft tissue injuries and joint disease are the predominate causes of lameness in the equine athlete and these pathologies carry a guarded prognosis for a return to previous performance. Recently the use of autologous products has become more widespread as a treatment in equine sports medicine. However, the efficacy of these products is yet to be fully established. To evaluate the current published evidence base regarding the efficacy of autologous products in soft tissue injuries and joint disease. A systematic review of English articles using MEDLINE, EMBASE and Web of Science databases from ...
Lewis D, Scott M, Fischer CD, Bond SL, Léguillette R.Desmitis of the collateral ligament of the distal interphalangeal joint is a cause of lameness in performance horses. The objective of this prospective, experimental, ex vivo feasibility study was to evaluate the success of ultrasound-guided injection of the collateral ligaments of the distal interphalangeal joint in the equine forelimb. Seventy-six ultrasound-guided dye injections of the collateral ligament of the distal interphalangeal joint were performed on horses' cadaver limbs. The hooves were sectioned transversely to verify the location of the dye relative to the collateral ligaments a...
McDiarmid AM.A mature thoroughbred cross gelding with an acute onset forelimb lameness was found to have sustained a fracture to the distal phalanx. The fracture traversed the distal phalanx In a lateromedial direction dividing the phalanx into two halves, dorsally and palmarly and was classed a frontal fracture. The horse was treated conservatively and after 14 months rest it returned to work. Three years later the horse has remained sound.
Dahlberg JA, Ross MW, Martin BB, Davidson EJ, Leitch M.Horses with cranial rib abnormalities may exhibit severe acute lameness and may have unusual gait deficits characterized by forelimb abduction during protraction at the walk. Horses with caudal rib abnormalities may resent being saddled and ridden. In a retrospective evaluation of 20 horses with a documented rib lesion, 25 sites of increased radiopharmaceutical uptake were found in one or more ribs. Thirteen (52%) scintigraphic lesions involved the first rib; four were located immediately dorsal to the sternal articulation, eight were near the costochondral junction and one was at the costover...
Ekfalck A, Rodriguez H, Obel N.LAMINITIS after abdominal surgery is a well known
complication that may occur after the horse has recovered from
colic (McIlwraith and Turner 1987). We had the opportunity to
examine a horse with post-surgical laminitis with a peracute
course whose early death made it possible to gain material from
the acute stage for histopathological investigations. We consider
that our observations may be of some value for colleagues
interested in the pathogenesis of laminitis.
Uhlhorn H, Carlsten J.The aim was to investigate radiographic findings of subchondral sclerosis and subchondral lucency in the dorsoproximal-dorsodistal (DPr-DDi) projection of the third carpal bone (C3) in relation to clinical appearance and to prognosis for racing. In a retrospective study, case records of 89 Standardbred trotters diagnosed with traumatic carpitis confirmed with intra-articular anaesthesia were examined. Records included data on degree of lameness at presentation and after flexion tests and a radiographic examination of the carpus, including a DPr-DDi projection of the C3. Subchondral lucency was...
Updike SJ.Tendons of insertion of the equine tibialis cranialis muscle and peroneus tertius muscle (PT) were dissected grossly. Precise areas of tendon attachment and fiber arrangements within the tendons were described for the dorsal and medial tendons of the tibialis cranialis, and for the superficial lateral, deep lateral, dorsal, and medial tendons of the PT. Direct attachment of the dorsal and medial tendons of the PT into the periosteum of the central and 3rd tarsal bones and the 3rd metatarsal bone indicates that the PT may be involved in the pathogenesis of hock lamenesses.