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  Discussion on Ultrasound for diagnosing Stifle Injury
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New Member:
Mkuchta

Posted on Monday, Sep 1, 2003 - 11:22 pm:

My 13 yr old Standardbred gelding (retired pacer, used for trail riding and low leval dressage lessons) had sore stifles after going camping ~ 2 years ago. He had x rays and no OCD was seen in his stifles. His hocks showed a little. He was injected with cortisone and hyaluronic acid, however I didn't see much improvement. He was put on glucosamine and chronDrOitin sulfate and showed good improvement. He has been going very well until 5 weeks ago. I took him camping and he was ridden at the walk 1 to 2 hours for 3 days on slightly hilly land. After I got back he looked good at the walk and I didn't ride him for the next 3 days. When I did he was very lame at the trot. He rested his right hind leg a lot and his right stifle looked swollen. I'm not sure if the injury came from the camping trip or if he slipped and injured himself when he got back. The vet came out 3 days later . Grif is a recovered EPM horse and she immediately checked for signs of a recurrance. None were found and she did a flexion test and also noticed the swelling. Grif was put on decreasing amounts of bute for 3 weeks and had his stifle hosed off daily. She felt that it would be OK to turn him out.
It has been ~ 5 weeks now and I am noticing very little improvement. My vet felt that he could be at least 6 months recovering and suggested ultrasound to diagnose the problem if he showed no big improvement by October.
Here is my question: Will ultrasound be able to diagnose the problem? From reading other posts here it seems that horses with stifle injuries are on complete stall rest after their injuries. I am concerned about waiting until October for the ultrasound and also about turning my gelding out in the pasture. He is normally in an in and out stall which Iopen to the pasture daily. So- I will be speaking with my vet within the next few days and I need to know if there are any other questions I should be asking about. I would like to find out what is really wrong. Is the ultrasound likely to provide this info? Would it be better to have the ultrasound moved up? Is there anything to be gained by waiting until October? Thanks for your help.
Moderator:
DrO

Posted on Tuesday, Sep 2, 2003 - 10:20 am:

Every diagnostic procedure has limitations in every case. To complicate matters any diagnostic procedure may have differing limitations depending on the subject, operator, and equipment used. Even things like the environment in which the diagnostic procedure may effect the limits or value of the test. There are some conditions of the stifle in an experienced ultrasonographers hands using the approriate head configuration that are very easily diagnosed by US. On the other hand there are many conditions of the stifle that are diagnosable with US. It is one more step and until taken you don't know if it is the last step or not.

The article on Overview of Stifle Lameness helps explain the various conditions of the stifle and how they are diagnosed. Many acute injuries to the stifle, where the radiographs are normal, are desmitis's (trauma to a ligament). These structures are invariably further stressed with increaseing motion.
DrO
Member:
Mkuchta

Posted on Thursday, Sep 25, 2003 - 11:26 pm:

My horse has had a stifle injury for 8 weeks now. His first 3 steps at the trot look very lame but he improves after that. My vet believed it was tendon or ligament strain or damage and said he would take a long time to get better.
I had decided to get a second opinion for my other horse so I took this horse along also. This second vet has a lot of experience with racing STBS. Anyway, he said that if the problem were a tendon or ligament that the horse would still have swelling even after 5+ weeks and that it was probably some kind of arthritic flare-up. He suggested I start riding my horse slowly.

Well, I decided to have my regular vet do the ultrasound that she had suggested having if my horse wasn't improving. We got to her place and she decided that he was doing well enough that the ultrasound wouldn't show anything. She x rayed his hock and stifle and said they looked good (no arthritis). She felt my horse had a "soft tissue injury" that was improving and I should start riding him.
I'm glad to start riding him again but I"m still not clear on what is wrong with my horse. He still looks "off" to me and I am getting conflicting answers. He also rests his right hind leg which is something he has never done before. He has also been resting with his hind end backed up to and leaning against the water bucket in his stall. This has been going on for at least a year and my vet hasn't been able to explain why this is happening. This may not be related to his current problem but it's still a possibility. So these vets agreed that I could start riding but they had different opinions on what is wrong.

Anyway, here are my questions:
1. Is there anything else that can be done at this point to determine what is wrong with this horse?
2. My farrier wants to shoe my horse with a raised heel and square toe behind to help with breakover. Is this likely to help or will it place strain on some other part of his leg?
Thanks for your help!

Moderator:
DrO

Posted on Friday, Sep 26, 2003 - 7:01 am:

Hello Maureen,
The article on Overview of Stifle Lameness carefully explains the diagnostics steps, and yes there is more you can do.

Squared toes always makes breakover easier. As to whether a raised heel is a good idea depends on the horses conformation. The foot should be trimmed, and if necessary wedged, to achieve a properly balanced foot. To better understand this see, » Care for Horses » Hoof Care » Trimming and Preparing the Feet for Shoes.
DrO
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