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Equine veterinary journal2006; 38(4); 305-311; doi: 10.2746/042516406777749236

Arthrogenic lameness of the fetlock: synovial fluid markers of inflammation and cartilage turnover in relation to clinical joint pain.

Abstract: Joint pain is one of the most common causes of lameness in the horse but its pathogenesis is poorly understood. Objective: To investigate which synovial fluid markers may be related to the presence of clinically detectable joint pain in the horse. Methods: Concentrations of structural (CPII, C2C, GAG) and inflammatory markers (PGE2, LTB4, CysLTs, bradykinin and substance P) were measured in fetlock joint fluid from 22 horses in which lameness was localised to the fetlock region by perineural anaesthesia. Levels of these markers were then compared in horses that responded (n = 15) to those that did not (n = 7) to subsequent intra-articular anaesthesia (IAA). Results: Of all markers analysed, only substance P levels were significantly higher (P = 0.0358) in synovial fluid of horses that showed a positive response to IAA compared to those with a negative response to IAA. Notably, while PGE2 levels were found to be elevated in all 22 lame horses compared to sound controls (P = 0.0025), they were not related to the response to IAA. Conclusions: While levels of PGE2 are elevated in synovial fluid of lame horses that respond to perineural anaesthesia, only substance P is related to joint pain as detected by the response to intra-articular anaesthesia. Conclusions: Substance P is associated with clinically detectable joint pain in the horse. Elevated levels of PGE2 in fetlock-lame horses, regardless of their response to IAA, indicate that either this mediator does not reflect intra-articular pain or that IAA might have limitations in differentiating between intra- and peri-articular sources of pain. Either way, a negative response to IAA may not exclude intra-articular pathology.
Publication Date: 2006-07-27 PubMed ID: 16866196DOI: 10.2746/042516406777749236Google Scholar: Lookup
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  • Journal Article

Summary

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The research article investigates markers present in the synovial fluid found in horses to understand their possible relationship to joint pain causing lameness. The study identified that substance P was more prevalent in horses that demonstrated joint pain, while elevated levels of PGE2, another inflammatory marker, did not necessarily correlate with intra-articular pain.

Research Methodology

  • The study focused on 22 horses where lameness was localized to the fetlock region using perineural anesthesia. This anesthesia method was used to isolate and numb specific nerves to identify the source of the lameness.
  • Synovial fluid was examined from these horses noting concentrations of structural (CPII, C2C, GAG) and inflammatory markers (PGE2, LTB4, CysLTs, bradykinin, and substance P).
  • The response to subsequent intra-articular anesthesia (IAA), an anesthetic injected directly into the joint space, was observed and categorized based on response or no response to help identify internal joint pain.

Findings

  • Of all the markers tested, only substance P showed significantly higher levels in the synovial fluid of horses that positively responded to IAA.
  • While PGE2 levels were elevated in all horses compared to sound (healthy) controls, the elevated levels didn’t correlate with a response to IAA.

Conclusions

  • Substance P was identified as a significant marker associated with clinically detectable joint pain in horses.
  • Despite being more abundant in lame horses, PGE2 was not connected to the presence of intra-articular pain. This suggests that it might not be a reliable indicator of this specific type of pain or that there could be limitations to intra-articular anesthesia in differentiating pain sources.
  • The study concludes that a negative response to intra-articular anesthesia may not completely rule out intra-articular pathology as PGE2 was elevated in both groups.

Cite This Article

APA
de Grauw JC, van de Lest CH, van Weeren R, Brommer H, Brama PA. (2006). Arthrogenic lameness of the fetlock: synovial fluid markers of inflammation and cartilage turnover in relation to clinical joint pain. Equine Vet J, 38(4), 305-311. https://doi.org/10.2746/042516406777749236

Publication

ISSN: 0425-1644
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 38
Issue: 4
Pages: 305-311

Researcher Affiliations

de Grauw, J C
  • Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
van de Lest, C H A
    van Weeren, R
      Brommer, H
        Brama, P A J

          MeSH Terms

          • Animals
          • Arthralgia / diagnosis
          • Arthralgia / metabolism
          • Arthralgia / veterinary
          • Biomarkers / analysis
          • Bone and Bones / metabolism
          • Cartilage / metabolism
          • Case-Control Studies
          • Dinoprost / analysis
          • Female
          • Horse Diseases / diagnosis
          • Horse Diseases / metabolism
          • Horses
          • Lameness, Animal / diagnosis
          • Lameness, Animal / metabolism
          • Male
          • Nerve Block / veterinary
          • Substance P / analysis
          • Synovial Fluid / chemistry
          • Tarsal Joints / pathology

          Citations

          This article has been cited 14 times.
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