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Accessing the equine elbow joint: new insights on an old approach
  1. Raquel Y. A. Baccarin, MS, PhD
  1. Faculty of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo 05508-270, Brazil, e-mail:

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HORSES participate in several equestrian sport disciplines, and the musculoskeletal problems that can arise from these athletic performances pose new and constant challenges to the equine practitioner, especially regarding the diagnosis of lameness.

Often, a thorough clinical examination does not allow for precise identification of the source of pain. Furthermore, manipulative tests of the proximal limb joints are particularly non-specific and inconclusive. The same is true for muscle atrophies, although they are more severe when relating to pain originating from proximal limb disorders than those caused by distal limb-associated conditions (Dyson 2011). When facing such challenges, the practitioner must employ complementary techniques such as intra-articular analgesia to aid in the precise determination of the injury site.

Intra-articular analgesia of the elbow usually alleviates, but seldom eliminates, pain arising from this joint (Dyson 2011); nevertheless, the technique is extremely useful as a diagnostic tool in the equine species. Given the low prevalence of elbow-related pain in horses, intra-articular injections at this site are rare. Therefore, clinical experience with the procedure is also limited and papers discussing this technique, such as the one by Bodaan and others (2016) summarised on p 173 of this issue of Veterinary Record, have special relevance. The authors not only describe the available techniques to pursue analgesia of the humeroradioulnar joint but also explain the advantages and disadvantages of each approach, decreasing the probability of a false-negative or false-positive response to a joint block.

In adult horses, elbow lameness can be associated with direct trauma, falls or even collisions with objects or other horses. One of the possible consequences of these events is osteoarthritis, especially after fractures and collateral ligament injuries (Garvican and Clegg 2008), and osteoarthritis is more commonly found in older athletic horses. Lesions in the lateral collateral ligament are more frequently observed than …

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