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Ringbone

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What is ringbone?

Ringbone is a general term that applies to bony enlargements (any new bone growths) below the fetlock. It is classified as being high (pastern joint area) or low (coffin joint area) ringbone and is commonly divided into either 'true' or 'false,' depending on its relationship to a joint. 'True' and 'false' are common terms for articular and periarticular, with articular meaning on the joint surface and periarticular meaning around the joint but not actually involving the joint surface. It is better to use the terms articular and periarticular than 'true' and 'false' because 'false' is also applied to uncalcified ringbone-like enlargements due to mineral imbalances of nutritional or hormonal origin. X-rays are required to differentiate between articular and periarticular ringbone. Ringbone can affect either the fore or hindlegs, but it is most common in the forelegs. Ringbone can occur in horses of any age.

What causes ringbone?

Direct injury, such as pulling and tearing of tendons and ligaments, is the cause of the majority of cases. Blows and cuts are also examples of trauma. Any type of injury that disturbs the bone covering (periosteum) of the coffin bone, short pastern bone or long pastern bone can result in ringbone. Poor conformation can predispose a horse to ringbone by increasing stress in this region. Base wide, base narrow, toe-in and toe-out conformation all increase stress on the joints and associated structures. Constant concussion on hard surfaces will have the same effect.

What are the signs of ringbone?

The initial signs, in most cases, are a generalized soreness and possibly heat in the area of the affected bone or joint.

How is ringbone treated?

The veterinarian will recommend complete rest.  Corticosteroid injections into the joint and phenylbutazone given systemically are also commonly used to control inflammation and thus relieve pain. However, with articular ringbone, treatment by intra-articular injection may lead to further joint destruction.
The veterinarian to alleviate pain in chronic cases sometimes performs neurectomies (severing nerves to desensitize the area). Casting of the limb is also used. With periarticular ringbone this treatment is designed to immobilize the joint until the inflammation subsides. In cases of high articular ringbone, articular cartilage is often surgically removed before the cast is applied. The object of this treatment is to fuse the joint, in hopes of prolonging limited usefulness of the animal. The veterinarian may advise corrective shoeing aimed at reducing the action of the joints. Roller motion shoes to shorten the animal's stride, and make an easier break-over, is an example.What is the prognosis in cases of ringbone? An animal affected with periarticular ringbone may be returned to serviceability if new bone growth is arrested early and there is no interference with joint action. Periarticular ringbone, therefore, has a guarded prognosis. The prognosis is poor in cases of articular ringbone because of the joint involvement. The goal of treatment for articular ringbone is simply to alleviate pain. This might be accomplished by surgical fusion of the bones of the joint as described in the modes of treatment above.
Ringbone is a condition in which there is usually a long period of time between the cause and the actual lesion. This is due to the nature of the disease, in which new bone growth occurs slowly. Lameness will also develop gradually when conformation is the cause. Of course, when trauma is the cause, lameness usually appears suddenly but is related to the trauma, not the new bony growths. In most cases of low ringbone there is swelling, heat and pain just above the coronary band. In fact, the hair on the coronary band will stand out at the front of the foot when extensive new bone growth is underlying this area. With high ringbone, the enlargement will be in the pastern region.

 

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