Pastern and Fetlock

Question 1

What does osteoarthritis of the pastern present with?

Answer 1

Mild/moderate lameness

Bony thickening over dorsal pastern

Question 2

What is found on radiography of pastern OC?

What is the prognosis and treatment?

Answer 2

Osseous cysts
Osteochondral fragmentation (palmar/plantar)
Guarded, palliative treatment

Question 3

What is the best way to diagnose and monitor soft tissue injuries?

Answer 3

Ultrasound

Question 4

What is the most common pastern fracture in racehorses?

Answer 4

Sagittal P1

Question 5

What is the treatment for pastern fractures?

When should you euthanise?

Answer 5

First aid: Zone 1 external coaption
Surgical: Internal fixation
PTS is comminuted, open, unstable

Question 6

What is the treatment for pastern subluxation?

Answer 6

First aid: Zone 1 external coaption, then pastern arthrodesis

Question 7

Why is important to check the suspensory ligament via ultrasound in proximal sesamoid fractures?

Answer 7

Determine whether axial or biaxial fracture

If biaxial “dropped” fetlock and loss of suspensory apparatus

Question 8

When is euthanasia warranted for PSB fractures?

Answer 8

If biaxial or comminuted

Question 9

What type of diagnostics warrant stress radiographs?

Answer 9

Fetlock/pastern subluxation

Question 10

What is sesamoiditis?
What kind of horses is it seen in?
What may it be an indicator of?
What is the treatment?

Answer 10

Inflammation around the soft tissues of the PALMAR fetlock
Young performance horses
SL branch/annular ligament injury (check by ultrasound)
Rest/NSAIDs + cold therapy
Shockwave therapy if refractory

Question 11

Which pastern disease can be an incidental finding, that may not be clinically relevant?

Answer 11

Osteochondral fragmentation of P1

Question 12

What is involved in osteochondrosis of the fetlock?

Answer 12

OCD of sagittal ridge of Mc/MtIII

Osseous cysts of distal McIII

Question 13

What horses is osteochondrosis of the fetlock usually seen?

What is the treatment?

Answer 13

Young horses
Surgical removal of fragments
Curettage of the cyst

Question 14

What radiographic signs are seen in fetlock OA?

What can it eventually lead to?

Answer 14

Joint effusion
Osteophyte formation
Subchondral bone sclerosis
Joint space reduction
Joint collapse

Question 15

What is IRAP?

Answer 15

Interleukin receptor antagonist protein
Naturally anti-inflammatory produced from the horse’s own blood, injected into joints to treat joint injuries and lameness

Question 16

What is sclerosis of bone?

Answer 16

Increased bone density

Question 17

What is chronic proliferative synovitis caused by?
How does it present?
What do you see on radiography?

Answer 17

Chronic repetitive trauma to dorsal aspect of fetlock
Due to HYPEREXTENSION
Leads to supracondylar bone lysis
Usually one forelimb, lameness, reduced ROM, heat/pain
Soft tissue swelling and CRESCENT shaped bone loss distal MC III