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"6 Facts Every Horse Owner Should Know"

Learn More About The Most Common Joint Problems That Can Affect Your Horse and How We Can Help You Succeed!

Join Me On The Complete Horseman's Guide to The Fetlock Joint, Bone Issues!

Joint problems in horses are the number one performance-limiting factor worldwide.

In this series, I will be talking about the fetlock joint. Each series will focus on a different joint or section of the horse

Alberto Rullan, VMD

We Can Provide Full Service From Consulting to Diagnosing to Treating all Equine Orthopedic Problems.

Below is a guide for horsemen and horsewomen to have a good understanding of fetlock problems in horses, how can they affect their performance, and what can be done about them. This is by no means all the possible problems of the fetlock.

The fetlock Joint

Mild sesamoiditis

Sesamoiditis should be interpreted very carefully. It is a very subjective diagnosis and prognosis depends upon the relationship to the branch of the suspensory ligament. Ultrasound of the suspensory branch is a great help to this diagnosis.

Mild to moderate sesamoiditis

Moderate Sesamoiditis

This image is related to the radiograph and ultrasound, which is always the perfect complement when we talk about problems in the sesamoid bones. In the main image we can see a moderate sesamoiditis and if you click on the imagen you will see a longitudinal ultrasound of the medial suspensory branch insertion.

Moderate Sesamoiditis

Transverse view of the medial branch of the suspensory ligament showing a lesion related to the images on the left.

Proximal dorsal P1 chip

The preferred treatment method for Dorso Proximal P1 chip is surgical removal. Prognosis is excellent!

Multiple chips proximo dorsal P1

This radiograph shows multiple dorso proximal P1 chips. Surgical removal is the preferred method of treatment for this cases.

Mineralization proximal lateral to sesamoid

This lesion should be ultrasound in order to evaluate the significance

Defect from abaxial surface of lateral sesamoid

Sesamoid and suspensory branch ultrasound is paramount in order to evaluate the full damage. There is a high chance that if your horse has this problem it might never bother him/her

Distal Lateral MT 3 Condyle Cyst

This radiograph shows a distal lateral condyle cyst. In this radiograph, we see a small communication with the articular surface. Screw placement across the cyst is a very good option as the treatment for this problem. Some trainers chose not to do anything until it causes a problem. I dont recommend this approach as is too conservative and the screw technique is very effectice.

Apical Sesamoid Fragment

This lesion should be ultrasound in order to evaluate the significance of the problem, the involvement of the suspensory ligament branch. Surgery of this chip could be complicated because of the proximity to the suspensory branch. Some horses might be able to run and perform with this fragment without ever causing lamness.

Enlarged Proximal Sesamoid

Enlarged sesamoids are a relatively common finding in yearlings. Sometimes this radiographs look like this because the horse might have had a fracture that healed when he/she was younger

Distal Lateral MT 3

This radiograph shows a distal MT3 cyst. Screw placement across the cyst is a very good option as the treatment for this problem. Some trainers chose not to do anything until it causes a problem. I don't recommend this approach as is too conservative and the screw technique is very effectice.

Apex of Sesamoid Missing

When this is seen in a Pre Purchase Radiograph; the first thing that should come to mind is the possibility that this horse had surgical removal of the top part (apex) of the sesamoid. It is paramout to utrasond this leg in order to find out what is the health of the suspensory ligament.

Feltlock Distal MT3 Condyle Shallow Lucency

This problen is a bit more common that we think. It will cause a lot of fetlock bone pain and sometimes the joint itself will look normal. Most often is confirmed with a Bone Scan.

Moderate to Severe Fetlock Arthritis

This radiograph shows proliferation around the joint bones, indicating the horse has had this condition for a prolonged period of time. This condition carries a guarded prognosis for racing.

Moderate to Severe Fetlock Arthritis

This radiograph shows proliferation around the joint bones, indicating the horse has had this condition for a prolonged period of time. This condition carries a guarded prognosis for racting.

Physitis

Unilateral physitis such as the one noted on this weanling, could be due to periosteal elevation or injection of irritatns in the physis which are commonly done to correct angular limb deformities. Prognosis is good,

Proximal Sagital Ridge OCD

Typically these OCDs do not cause a lot of trouble. Some surgeons will recommend removal of them so that the horse gets very little chance to be bothered by it. Carries a good prognosis for racing.

Moderate to Severe Fetlock Arthritis

This radiograph shows proliferation around the joint bones, indicating the horse has had this condition for a prolonged period of time.

Articular surface of the base of sesamoid spur

This spurs carry a good prognosis usually. The start as a small avulsion or fragment from the base of the sesamoid. If detected early it can be removed via arthroscopy and prognosis is excellent.

Articular surface of the base of sesamoid spur

This spurs carry a good prognosis usually. The start as a small avulsion or fragment from the base of the sesamoid. If detected early it can be removed via arthroscopy and prognosis is excellent.

Articular surface of the base of sesamoid axial lucency

Axial sesamoiditis can be a very troublesome disease. This could be career-limiting and/or career-ending. Early diagnosis sometimes is a challenge because the disease starts earlier than radiographic findings appear. Treatment is usually conservative.

Supracondylar Lysis

This is could be an indication of remodeling in the attachment of the joint capsule of the fetlock joint.

Distal Lateral MT3 cyst

Distal Displacement of the Proximal Sesamoid bones

This could be an indication of failure of suspension of the fetlock joint.

Mid sagital ridge flattening

This is could be an indication of remodeling in the attachment of the joint capsule of the fetlock joint.

Distal Lateral lucency

This radiograph shows a distal lateral lucency.

Distal Displacement of the Proximal Sesamoid bones

This could be an indication of failure of suspension of the fetlock joint.

The Pastern Joint

Subluxation of the pastern joint

The subluxation of the pastern joint. The treatment for this horses depends on how lame they are. Sometimes pastern arthrodesis is required. Othertimes, they can perform low level exercises relatively comfortable.

Distal lateral P1 condyle cyst

This radiograph shows a small cyst in the lateral condyle of P1. This is usually an incidental finding during pre-purchase examinations. If there is no lameness associated with it, there is no treatment required. If the horse is lame, treatments could vary from intra articular injetions to surgical treatments.

Normal centro distal P1 lucency

Distal central P1 lucency: normal finding

Pastern arthritis - "high ring bone"

Pastern arthritis can progress to the extend of having a severe bone remodeling as you can see in this picture. Possible treatments include surgical arthrodesis (fusing the joint) or alcohol injections.

Distal lateral P1 condyle cyst

This radiograph shows a cyst in the proximal P2 and a small radiolucent line distal P1. If the horse is lame, treatments could vary from intra articular injetions if there is communication with the joint to surgical treatments such as screw placement

Normal centro distal P1 lucency

Distal central P1 lucency: normal finding

Fractures

Palmar P1 fracture

This particular fracture is minimally displaced. It can be treated conservatively or with surgical fixation

Sesamoid body fractures

This is a biaxial sesamoid fracture. This means both sesamoids were broken. Surgical repair is the ideal treatment for these fractures. However, this horse was treated conservatively and is living a happy life.

Catastrophic fetlock fractures