Pastern conditions

Question 1

What is articular ringbone?

Answer 1

Osteoarthritis of pastern

Question 2

A radiograph of the pastern shows progressive destruction of the articular cartilage, with subchondral bone thickening and osteophyte production. The bony thickening is mainly over the dorsal pastern. What is the likely diagnosis?

Answer 2

Osteoarthritis of pastern

Ringbone

Question 3

Articular ringbone (pastern OA) may be primary or secondary to other conditions. Give examples of secondary conditions

Answer 3

Trauma
Sepsis
Osteochondrosis

Question 4

What is the treatment/management for articular ringbone/pastern OA?

Answer 4

Rest, managed exercise
Intra-articular medication
Shoeing
Analgesia - NSAIDs
Arthrodesis if severe

Question 5

Osteochondrosis is fairly uncommon in the pastern. Give examples of manifestations

Answer 5

Osseous cysts
Osteochondral fragmentation
Secondary OA

Question 6

What is the prognosis and treatment for osteochondrosis?

Answer 6

Guarded Px
Treatment palliative (arthrodesis)

Question 7

Soft tissue injuries to the pastern bone may involve which structures

Answer 7

SDFT

Distal sesamoidean ligament injury (oblique or straight)

Question 8

How are soft tissue injuries to the pastern managed?

Answer 8

Rest
NSAIDs
Monitor healing with ultrasound

Question 9

Fractures of P1 are often sagittal. Which horses are the most commonly seen in?

Answer 9

Racehorses, other athletic disciplines

Question 10

P2 fractures are less common. What usually causes them?

Answer 10

Acute overload injury

Question 11

How are P1 and P2 fractures treated?

Answer 11

Zone 1 external coaptation
Surgical internal fixation (most cases - some may be conservative)
Euthanasia if comminuted, open or unstable

Question 12

Pastern subluxation is often following a traumatic event and is diagnosed with radiography. How are subluxations managed?

Answer 12

Zone 1 external coaptation

Pastern arthrodesis