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There has arguably been considerable progress in recent years in our ability to more precisely identify the location and cause of lower limb lameness in horses, particularly for those owners or insurance companies prepared to invest money and time in the pursuit of a more detailed understanding of the site, nature and relevance of pathological changes. Greater use of regional and intrasynovial analgesia and the application of nuclear scintigraphy have allowed better localisation of injuries and sources of pain; cross sectional imaging techniques with better differentiation of soft tissue structures, including diagnostic ultrasound, computed tomography and magnetic resonance imaging, combined sometimes with minimally invasive direct endoscopy of synovial cavities, have allowed us to characterise the underlying pathological changes. But while such insight is clinically satisfying, it should ideally just be a step on the road to treatment and functional recovery. Progress in that regard has, perhaps inevitably, been slower, particularly where chronic lameness conditions are concerned. The clinician may be left pondering whether their diagnostic efforts are sometimes a process of proving why the horse may remain lame rather than providing a basis for successful therapeutic intervention.
Anti-inflammatory treatment remains a mainstay of the management of synovial pain and systemic NSAIDs …
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