equis - Articles
Distal phalanx: pedal osteitis – non-septic
Introduction
- Cause: chronic inflammation of the distal phalanx often characterized by demineralization; usually secondary to other chronic foot problems.
- Signs: chronic, usually forelimb, lameness Musculoskeletal: gait evaluation either uni- or bi-lateral with history of pre-existing foot abnormalities.
- Diagnosis: foot and shoe examination Foot / shoe: examination , gait evaluation Musculoskeletal: gait evaluation , perineural analgesia Forelimb: perineural analgesia Hindlimb: perineural analgesia , radiography Forelimb: radiography
, scintigraphy Bone: scintigraphy . - Treatment: as for primary cause; corrective shoeing and trimming; NSAIDs; palmar digital neurectomy Palmar digital nerve: neurectomy .
- Prognosis: guarded, depending on primary cause.
Presenting signs
- Chronic, insidious variable mild-moderate lameness usually in the forelimb.
- Uni- or bi-lateral.
- Lameness may be increased after foot trimming/shoeing or exercise.
- Variety of foot abnormalities or problems may co-exist
Breed/Species predisposition
- Thoroughbreds Thoroughbred .
- Standardbreds Standardbred .
- Racing Quarterhorses Quarterhorse .
Pathogenesis
Etiology
- Primary non-septic pedal osteitis occurs rarely and is thought to result from severe solar concussion during exercise on hard surfaces.
- Secondary non-septic pedal osteitis is more common and may occur due to persistent inflammation secondary to laminitis Foot: laminitis , persistent solar bruising Foot: sole bruising , incorrect foot trimming and shoeing
, poor foot conformation Musculoskeletal: conformation and distal phalangeal fractures Distal phalanx: fractures .
Predisposing factors
General- Chronic hoof disease, eg persistent bruising, laminitis.
- Poor foot conformation Musculoskeletal: conformation :
- Long toe, low collapsed heels with flared quarters.
- Flattened sole.
- Thin, poor-quality horn.
- Excessive trimming or paring of the sole.
- Excessive exercise or inappropriate ground conditions, eg hard rocky surfaces or racetracks.
Pathophysiology
- Poorly-defined as a chronic inflammatory disorder of the distal phalanx, often characterized by demineralization and a range of radiographic changes in the distal phalanx.
- Two forms are described depending on their etiology:
- Non-septic.
- Septic Distal phalanx: pedal osteitis - septic .
- The distal phalanx has no medullary cavity and the term 'osteomyelitis' should not be used.
- Usually secondary to other chronic foot-related problems.
- Chronic inflammation and trauma to the bone of the distal phalanx → re-modeling of the bone and loss of mineral → osteoporosis.
- Chronic pain and disease → further removal of bone and mineral.
Diagnosis
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Treatment
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Prevention
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Outcomes
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Reeves M J et al (1989) Miscellaneous conditions of the equine foot. Vet Clin North Am Equine Pract 5 (1), 221-242 PubMed.
Other sources of information
- Butler et al (2000) Clinical Radiology of the Horse. 2nd edn. Blackwell Science, Oxford, UK. pp 43-46.
- Mayer W A (1989) Traumatic Pedal Osteitis in Racehorses. Proc AAEP 34, pp 417-419.