equis - Articles
Pelvis: trauma – sacroiliac
Introduction
- Cause: chronic or acute traumatic injury to the sacroiliac ligament(s) and/or sacroiliac joint(s).
- Signs: poor performance, hindlimb lameness Musculoskeletal: gait evaluation , sacroiliac pain, restricted hindlimb action, asymmetry in hindquarters Musculoskeletal: physical examination - adult .
- Diagnosis: elimination of lower hindlimb source of lameness using perineural analgesia Hindlimb: perineural analgesia and intrasynovial anesthesia Hindlimb: joint anesthesia ; radiography Hindlimb: radiography ; scintigraphy Bone: scintigraphy .
- Treatment: rest; anti-inflammatories, phenylbutazone Phenylbutazone , flunixin meglumine Flunixin meglumine or ketoprofen Ketoprofen /vedaprofen Vedaprofen .
- Prognosis: guarded.
Presenting signs
- Hindlimb lameness.
Acute presentation
- Acute onset hindlimb lameness.
- Localized sensitivity to palpation of soft tissues over site and/or tuber sacrale.
Pathogenesis
Etiology
- Substantial trauma causing pelvic rotation or high stresses, eg fall, during transport, becoming cast in a confined space, rearing and falling backwards, catastrophic musculoskeletal injury during racing.
- Chronic joint trauma in performance horses.
Pathophysiology
- The dorsal sacroiliac ligament attaches to tuber sacrale and sacral spines, and blends into the medial border of ilium and the lateral border of sacrum.
- The ventral sacroiliac ligament surrounds the cranial aspect of the joint capsule running from the dorsal sacrum to the ilium.
- The sacroiliac and sacrosciatic ligaments form a strong ligamentous sling supporting the caudal vertebral column.
- The sacroiliac joint is the synovial articulation between the ventral wing of the ilium and the dorsal wing of the sacrum, providing support during weight bearing and helping to transfer hindlimb propulsive forces to the vertebral column.
- The sacroiliac joint is supported by the dorsal, ventral and interosseous sacroiliac ligaments.
- Substantial trauma is usually required to damage these structures owing to their being deep anatomically and protected by considerable muscle mass.
- Lesions:
- Complete sacroiliac ligament disruption.
- Uni/bilateral joint capsule disruption.
- Avulsion fractures of the sacroiliac ligament attachment sites.
- Sacroiliac joint laxity/instability.
- Sacroiliac joint subluxation/luxation.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Powell S (2011) Investigation of pelvic problems in horses. In Pract 33 (10), 518-524 VetMedResource.
- Varcoe-Cocks K, Sagar K N, Jeffcott L B & McGowan C M (2006) Pressure algometry to quantify muscle pain in racehorses with suspected sacroiliac dysfunction. Equine Vet J 38 (6), 558-562 PubMed.
- Kersten A A M & Edinger J (2004) Ultrasonographic examination of the equine sacroiliac region. Equine Vet J 36 (7), 602-608 PubMed.
- Dyson S et al (2003) The sacroiliac joints: evaluation using nuclear scintigraphy. Part 1: The normal horse. Equine Vet J 35 (3), 226-232 PubMed.
- Dyson S et al (2003) The sacroiliac joints: evaluation using nuclear scintigraphy. Part 2: Lame horses. Equine Vet J 35, 233-239 PubMed.
- Dyson S & Murray R (2003) Pain associated with the sacroiliac joint region: a clinical study of 74 horses. Equine Vet J 35 (3), 240-245 PubMed.
- Jeffcott L, Dalin G, Ekman S & Olssen S-E (1985) Sacroiliac lesions as a cause of chronic poor performance in competitive horses. Equine Vet J 17, 111-118 PubMed.
Other sources of information
- Dyson S J (2003) Diagnosis and Management of Sacroiliac Joint Injuries. In: Diagnosis & Management of Lameness in the Horse. Eds: Ross M W & Dyson S J. Saunders, USA. pp 501-508.