b'HIND-LIMB ENIGMASanti- inflammatory effects and encouragebone underneath it become irregular inarthroscopy, where he or she passes a healing, or for harvesting platelets.thickness and weaker than in normalsmall camera into the joint to view the Platelet-rich plasma (PRP) and IRAPjoints. This can lead to the formation oflesion, then inserts surgical instruments (interleukin-1 receptor antagonist pro- cartilage and bone flaps that can remainto remove it. tein) are common biologic products usedpartially attached to the bone or breakArthroscopic removal is typically in joint injections that replicate theseoff and float around in the joint. Looseperformed for smaller to moderate-sized features. Durham says polyacrylamideflaps and areas of abnormal cartilage andfragments and generally has a very good gels show promise in the future of equinebone cause inflammation in the joint andprognosis, says Trostle. The more joint injections. These devices mimic theover time may lead to the development ofdifficult OCD conditions are those that physical qualities of synovial fluid andarthritis. are large and on direct weight-bearing stay present in the joint. We dont fully understand the exactsurfaces. In those cases some (surgeons) cause of OCD. While genetics play a role,have moved away from removal and Osteochondrosis Dissecans (OCD) researchers are working to understanddebridement and are now trying to secure Osteochondrosis dissecans is a diseaseother potentially influential factors. Onethe OCD flap with pins and augmenting that mostly affects younger horses. Care- key area of study is nutrition, becausewith (injectable) biological therapies.takers often recognize it just as horses aremany suspect excess energy intake con-starting under saddle. The horse can betributes to OCD lesions.Sacroiliac (SI) Joint Diseaseprogressing well, then suddenly comes upThe disease can occur in any equineMore and more veterinarians are rec-lame with a swollen stifle, for instance. joint but most often manifests in theognizing sacroiliacthe area where the The bone and the cartilage infetlocks, hocks, and stifles. While ownersspinal column meets the pelvispain as a joints with OCD dont form normally,can pursue conservative therapies suchcause of hind-limb discomfort, particular-says Steve Trostle, DVM, Dipl. ACVS,as oral medications and joint injections,ly in performance horses. Common signs ACVSMR, co-owner of Blue Ridgesurgery remains the gold standard inof pain in this region include a reluctance Equine Clinic, near Charlottesville,most cases. Today the most common wayto go forward, lack of impulsion, and Virginia. Subsequently, the cartilage andsurgeons address OCD lesions is withan uncoordinated bunny hop canter, among others.The sacrum is a section of five fused vertebrae located between the lumbar spine and coccygeal (tail) segments, explains Luvie Abell, DVM, of Grand Prix Equine, a sports medicine practice in Hawleyville, Connecticut. Its widest point, known as the sacrum, connects to the underside of the pelvis, known as the ilium. This connection forms the sacro-iliac joint. Subluxation (misalignment) and osteoarthritis are the main causes of discomfort to the sacroiliac joint, she continues. This may be exacerbated by a more pressing source of pain, often pointing to problems in the hock or stifle that force the SI to compensate. Because the SI joint is beneath inches of muscle, imaging the area can be chal-lenging. This region is far too large to simply shoot a radiograph the way that we can with a hock or stifle, says Abell. So, we are left primarily with ultrasound and nuclear scintigraphy (bone scan).Treatment options exist but can be lim-ited. If your veterinarian has diagnosed a source of pain specifically to the sacroiliac joint, you will likely be discussing cortico-steroid injections and chiropractic adjust-ments as treatment options, she says. If these therapies resolve the lameness (and youve addressed any other sources 18August 2020The Horse|TheHorse.com'