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Disorders of the Hip in Horses

By

Peter Clegg

, MA, Vet MB, DipECVS, PhD, MRCVS, Veterinary Teaching Hospital, School of Veterinary Sciences, University of Liverpool

Last full review/revision Sep 2015 | Content last modified Jun 2016

Disorders of the coxofemoral joint are relatively rare causes of lameness in horses. Most cases are traumatic in origin, secondary to falls or being cast (within a stall) in recumbency, although septic arthropathies and developmental disorders of the joint have been occasionally reported. Regardless of the etiology of the primary disease, secondary osteoarthritis of the coxofemoral joint is a common sequela, which will frequently result in permanent lameness.

Lameness is the predominant presenting clinical sign of any coxofemoral disease. Although the lameness can be subtle, more frequently a moderate to severe lameness (non-weight-bearing) is seen at presentation. In severe cases, the horse will often stand with the limb partially flexed. With any degree of chronicity, atrophy of the muscles of the hindquarters, such as the gluteals and quadriceps, is often moderate to marked. In cases of coxofemoral subluxation, the leg will be held in a semi-flexed position with an obvious outward rotation of the stifle and toe and an inward rotation of the point of the hock. In complete coxofemoral luxations, the same rotational abnormality in limb position is observed, and additionally the leg will appear shorter, which is best identified by the point of the hock being displaced proximal to that of the contralateral limb. Most horses with coxofemoral pathology show some pain on proximal limb flexion or abduction. Rectal examination is generally unrewarding, although in some cases of acute fracture, a hematoma or alteration in the bony architecture is palpable per rectum. Intra-articular local anesthesia of the coxofemoral joint is frequently used to identify the joint as the cause of lameness, particularly in cases of chronic lameness. Although this technique can be technically challenging, ultrasonography can help guide needle placement.

Definitive diagnosis of coxofemoral pathology usually requires some form of diagnostic imaging. Bone scanning (nuclear scintigraphy) is commonly used to identify the coxofemoral joint as the site of pathology. This technique is highly sensitive for identification of the involvement of the joint but has a low specificity for identification of the pathology within the joint. Percutaneous ultrasonography can provide considerable information on the coxofemoral joint, although its use at this site is technically challenging. Radiography can be very rewarding, especially in smaller horses and ponies, although optimal views require general anesthesia. Because of the risk of using general anesthesia in horses with serious limb injuries, such imaging is only rarely performed. A number of techniques are available to radiograph the coxofemoral joint in the standing horse, using either a ventrodorsal or lateral oblique views. Arthroscopy of the coxofemoral joint is possible, although it is technically challenging in most adult horses and ponies; acceptable joint visualization can be obtained by most operators in foals.

OTHER TOPICS IN THIS CHAPTER
Lameness in Horses
Overview of Lameness in Horses
The Lameness Examination in Horses
Imaging Techniques in Equine Lameness
Arthroscopy in Equine Lameness
Regional Anesthesia in Equine Lameness
Disorders of the Foot in Horses
Osseous Cyst-like Lesions in the Distal Phalanx in Horses
Bruised Sole and Corns in Horses
Canker in Horses
Fracture of Navicular Bone in Horses
Fracture of Distal Phalanx in Horses
Keratoma in Horses
Laminitis in Horses
Navicular Disease in Horses
Pedal Osteitis in Horses
Puncture Wounds of the Foot in Horses
Pyramidal Disease in Horses
Quittor in Horses
Quarter Crack in Horses
Scratches in Horses
White Line Disease in Horses
Sheared Heels in Horses
Sidebone in Horses
Thrush in Horses
Disorders of the Pastern and Fetlock
Fractures of the First and Second Phalanx in Horses
Fractures of the Proximal Sesamoid Bones in Horses
Osteoarthritis of the Proximal Interphalangeal Joint in Horses
Palmar/Plantar Metacarpal/Metatarsal Nonadaptive Bone Remodeling in Horses
Sesamoiditis in Horses
Chronic Proliferative Synovitis in Horses
Digital Sheath Tenosynovitis in Horses
Disorders of the Metacarpus in Horses
Tendinitis in Horses
Suspensory Desmitis in Horses
Inferior Check Desmitis in Horses
Bucked Shins in Horses
Exostoses of the Second and Fourth Metacarpal Bones in Horses
Fractures of the Small Metacarpal (Splint) Bones in Horses
Fracture of the Third Metacarpal (Cannon) Bone in Horses
Disorders of the Carpus in Horses
Fracture of the Carpal Bones in Horses
Subchondral Bone Disease of the Third Carpal Bone in Horses
Tearing of the Medial Palmar Intercarpal Ligament in Horses
Osteoarthritis of the Carpus in Horses
Distal Radial Exostosis and Osteochondroma of the Distal Radius in Horses
Carpal Hygroma in Horses
Rupture of the Common Digital Extensor Tendon in Horses
Disorders of the Shoulder in Horses
Developmental Diseases of the Shoulder in Horses
Fractures of the Shoulder in Horses
Bicipital Bursitis in Horses
Infection of the Shoulder in Horses
Suprascapular Neuropathy in Horses
Osteoarthritis of the Shoulder in Horses
Disorders of the Elbow in Horses
Developmental Orthopedic Disease in the Elbow of Horses
Fractures of the Elbow in Horses
Osteoarthritis of the Elbow in Horses
Collateral Ligament Injury in the Elbow of Horses
Disorders of the Metatarsus in Horses
Bucked Shins/Dorsal Cortical Fractures of the Third Metatarsal Bone in Horses
Exostoses of the Metatarsal Bones in Horses
Diaphyseal Fracture of the Third Metatarsal Bone in Horses
Incomplete Longitudinal Fractures of the Plantar Aspect of the Third Metatarsal Bone in Horses
Focal Bone Reaction and Avulsion Fractures of the Third Metatarsal Bone in Horses
Fractures of the Second and Fourth Metatarsal Bones in Horses
Enostosis-like Lesions of the Third Metatarsal Bone in Horses
Disorders of the Tarsus in Horses
Failure of Ossification of the Distal Tarsal Bones in Horses
Osteoarthritis of the Distal Tarsal Joints in Horses
Osteoarthritis of the Talocalcaneal Joint in Horses
Osteoarthritis of the Tarsocrural Joint in Horses
Synovitis/Capsulitis of the Tarsocrural Joint in Horses
Osteochondrosis of the Tarsocrural Joint in Horses
Osteitis of the Calcaneus in Horses
Fractures of the Distal Tarsal Bones in Horses
Fracture of the Talus in Horses
Fracture of the Fibular Tarsal Bone (Calcaneus) in Horses
Fracture of the Lateral Malleolus of the Tibia in Horses
Tarsal Joint Luxation in Horses
Desmitis of the Collateral Ligaments of the Tarsus in Horses
Rupture of the Fibularis (Peroneus) Tertius in Horses
Stringhalt
Curb in Horses
Disorders of the Tarsal Sheath in Horses
False Thoroughpin in Horses
Luxation of the Superficial Digital Flexor Tendon from the Tuber Calcanei in Horses
Gastrocnemius Tendinitis in Horses
Calcaneal Bursitis in Horses
Capped Hock
Disorders of the Stifle in Horses
Osteochondrosis of the Stifle in Horses
Subchondral Cystic Lesions in Horses
Meniscus and Meniscal Ligament Injuries in Horses
Cranial and Caudal Cruciate Ligament Injuries in Horses
Collateral Ligament Injuries in Horses
Intermittent Upward Fixation of the Patella and Delayed Patella Release in Horses
Fragmentation of the Patella in Horses
Patellar Luxation in Horses
Patellar Ligament Injuries in Horses
Gonitis and Osteoarthritis in Horses
Chondromalacia of the Femoral Condyles in Horses
Fractures of the Stifle in Horses
Disorders of the Hip in Horses
Luxation of the Coxofemoral Joint in Horses
Pelvic Fracture in Horses
Osteoarthritis and other Coxofemoral Joint Diseases in Horses
Disorders of the Back and Pelvis in Horses
Spinal Processes and Associated Ligaments in Horses
Articular Process−Synovial Intervertebral Articulation Complexes in Horses
Vertebral Bodies and Discs in Horses
Muscle Strain and Soreness in Horses
Lumbosacral Junction Abnormalities in Horses
Sacroiliac Joint Abnormalities in Horses
Developmental Orthopedic Disease in Horses
Osteochondrosis in Horses
Physitis in Horses
Flexural Deformities in Horses
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Musculoskeletal Disorders in Large Animals
A seven-year-old Quarter horse gelding presents with a 1-week history of mild lameness. During the examination, the horse raises his head as he places weight on his left forelimb and drops it when placing weight on the right forelimb. Which limb is most likely affected in this horse?
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