Equine Joint Disease

Question 1

Asymptomatic synovitis.

Answer 1

Inflammation of the synovium.
Presentation:
- effusion of joint or sheath.
- no pain/lameness.
- no radiological changes.
Uncertain aetiology:
- conformation?
- minor trauma?
No tx necessary.

Question 2

Reactive synovitis (“joint flares”).

Answer 2

Present acute onset joint flare ~24hr after joint injection.
Clinical signs:
- lameness.
- effusion and heat.
- resents palpation/flexion.
DDx iatrogenic septic arthritis:
- synoviocentesis.
– TNCC<30 x 10^9 cells/L.
– minimal increase in TP.
– resolves in 1-3d.
Aetiology:
- injection induces inflammation.
- chemical reaction.
– steroid induced arthropathy (MPA).
– hyaluron flares.
Tx = oral NSAIDs.
- can instill antimicrobials locally in the joint if still worried about septic arthritis.

Question 3

Traumatic synovitis.

Answer 3

Any horse, often young in training.
Clinical signs:
- effusion.
- pain on flexion.
- lame?
- heat?
Clin path:
- TNCC<10x10^9 cells/L.
- Poss. haemarthrosis painful.
Aetiology - trauma (single or repeat).
Pathology varied - synovitis, capsulitis, cartilage damage, articular fracture, ligament injury, luxation.
Progression:
- chronic thickening.
- beginning of OA?
Not usually associated with an open wound.

Question 4

Investigating traumatic synovitis.

Answer 4

Rads, US, synoviocentesis, arthroscopy.
Tx = Box rest whilst acute, on NSAIDs and with cold hosing.
Rehabilitation - controlled exercise plan.
Specific surgery?
Hyaluronic acid / polysulphated glycosaminoglycans.

Question 5

Septic arthritis.

Answer 5

Presentation:
- foals with bacteriaemia – check umbilicus.
- any horse w/ a penetrating injury.
– tiny puncture to vast wound.
Clinical signs:
- lame – progressive to NWB.
- resents palpation/flexion.
- effusion and heat.