[Septic arthritis of the hoof joint in the horse–diagnosis, radiologic changes and therapy].

This research is a retrospective study of ten equine septic arthritis of the distal interphalangeal (hoof) joint cases over a decade. The arthritis was caused either by puncture wounds or iatrogenically and manifested through severe lameness. Radiographic changes were observed and treatments involved partial resection of the deep flexor tendon, joint washing, and broad-spectrum antibiotics, with half of the horses treated successfully.

Case Background

• The study is a detailed examination of 10 arthritis cases, caused by infection in the distal interphalangeal joint, which is the horse equivalent of a human’s hoof joint.
• The cases span a decade from 1984-1994 and features horses of various ages ranging from 7 months to 17 years.
• In the majority of cases, the infection was a result of a puncture wound on the foot region of the horse, but in one case each, it was either due to a perforating wound on the coronary region or an inadvertent result (‘iatrogenic’) of a medical treatment or procedure.

Manifestations and Diagnosis

• All horses in the study displayed severe discomfort while walking, a clear indication of lameness, which is a typical symptom of arthritis.
• X-rays of fresh cases of the arthritis did not display any typical indicators of the condition. However, over time, the X-ray images showed a gradual subluxation (misalignment) of the joint alongside periosteal reactions (abnormal changes in the bone related to injury or inflammation) which helped in confirming the diagnosis.

Treatment

• The treatment strategies employed to manage these cases spanned from surgical procedures to regular medication.
• One surgical approach was the partial resection of the deep flexor tendon and fenestration (creating a hole for drainage or other surgical needs) of the Lig.impar in cases arising from nail punctures.
• Other procedures included a single or recurrent washing (lavage) of the joint. This was sometimes conducted under general anesthesia or with the horse standing.
• On the pharmacological treatment front, a broad-spectrum antibiotic therapy was used, primarily incorporating penicillin and gentamicin.

Outcomes

• Of the 10 horses that underwent these interceptive treatments, five of them experienced successful outcomes.