Joint Pain STEVE: Joint pain in a horse is usually caused by trauma and/or chronic arthritis, either/or. Acutely, you’ll see a horse that will jam up a limb, and whether it be the carpus or the knee, fetlock, stifle, hocks. In the acute phase, it usually has quite a bit of local effusion into the joint, meaning that there’s swelling. This is typical after a horse has maybe jammed an ankle up or a hock up or whatever due to whatever activity they’ve been in. Or even when they get turned out, we see it in foals. A foal will be turned out, run around the pasture and come back in with a big, hot, swollen ankle that they didn’t have the day before or that day earlier, or a hock that’s effused and swollen, sore that they’re limping on, or a stifle that shows quite a bit of effusion that they’re walking gingerly on, or they have a gait deficit or limp on it. Usually it responds quite nicely to topical therapy, anti-inflammatories, a cold water hosing, this sort of thing. When it becomes a chronic problem over 3 or 4 or 5 days, and this effusion stays in there, then we need to look at the possibility of a fragment and/or the early signs of arthritis in that joint. Typically we’ll take a radiograph of the knee, or the carpus, fetlock, stifle, hock; and see if there is not a fragment. Or if it’s maybe, potentially if you have to go to the trouble, especially in the stifle, of ultrasounding and using another modality of diagnostics, to see if some of the soft tissue in that joint has either got a tear of the collateral ligaments or the ACL, which horses get as well, or if there’s a tear in the meniscus. Radiographically you can’t see it in horses because of its size, has not lent itself to a MRI, so we’ll use an ultrasound to look at the soft tissues to see if there’s not a defect in it, or a tear. And If that occurs, then obviously you have a more serious problem that may require surgery or long term rest or potential retiring if it’s an athlete. Most time, joint pain is elicited by effusion or fluid increase in that joint. By picking up and manipulating that joint and flexing it, where they’ll show discomfort or increased gait deficit after you flex them and trot them off on a flex and test, or basically just by discomfort, when you pick up a limb and by virtue of the amount of effusion, they show quite a bit of inability to flex it because of the amount of fluid in it. So therefore, it creates a tremendous amount of discomfort upon manipulation of the joint itself.