What is Ringbone?
by: Justin Edwards, DVM
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My
17-year-old Arab gelding has been diagnosed with ringbone. His
granddam and another of her offspring also had this disease. What
exactly is ringbone? Is it hereditary? What is its cause? My veterinarian
has done an exam and X rays and recommended Bute (phenylbutazone)
and regular exercise. Dana
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Ringbone, a
lameness disease of the pastern and coffin joints, is a degenerative
disorder that has no cure. Once the condition occurs, it's always
there and will progressively worsen. Fortunately, with treatment
and good management, the disease's progression can be slowed,
allowing the horse to remain competitive.
Ringbone causes
a circumferential enlargement at the level of the joint. High
ringbone refers to the pastern joint and low ringbone refers
to the coffin joint. The disease is similar to arthritis, with
the affected area showing bone spur formation (additional bone
buildup) and degenerative joint disease.
Articular ringbone
(affecting the joint surface) affects the cartilage and synovium
(joint lining), resulting in enlargement, pain, and stiffness
of the joint. Periarticular (near the joint) ringbone affects
the soft structures near the joint, such as ligaments and joint
capsules. These structures, when inflamed by trauma, laceration,
or sudden or chronic athletic strain, respond by stimulating
bony growth. Poor conformation for the athletic use of the horse
can also contribute to ringbone. We find that periarticular ringbone
is more common and more serious.
The first sign
of ringbone an owner usually sees is lameness that might be intermittent.
The tissues around the area might be soft and painful. As the
condition progresses, the area becomes firm, cool, and non-painful
to touch. In chronic cases, the horse might have swelling around
the pastern or on top of the coronary band.
Diagnosis is
based on a history of the problem and a lameness examination.
Consideration is taken of the external appearance, palpation
and manipulation of the joints, and radiographs. Prognosis depends
on the severity of the disease at the time of diagnosis, the
intensity of the horse's use, and the degree of management. Advanced
ringbone cases have a poor prognosis.
The foundation
of treatment is rest. Treatment success is related to the cause.
Bute might be more helpful in early stages; more aggressive treatments
include joint injection with hyaluronic acid, Adequan, and steroids,
or a combination of the three. Generally ringbone will progress
if the horse is used at the same pace.
Once in a while, changing the angles of the shoes with wedges under the heel
will help take pressure off the anterior aspect (front) of the joint. This
has improved pain in some horses. Surgical fusion (immobilization) of the pastern
joint can be performed if that is the primarily affected joint and serves to
eliminate the pain associated with the degenerative process.
