Ringbone
Encyclopedia
Ringbone is exostosis
(bone growth) in the pastern or coffin joint of a horse
. In severe cases, the growth can encircle the bones, giving ringbone its name. It has been suggested by some authors that such a colloquial term, whilst commonly used, might be misleading and that it would be better to refer to this condition as osteoarthritis
of the inter-phalangeal
joints in ungulate
s (Rogers and Waldron, 1995: 34-35).
Ringbone can be classified by its location, with "high ringbone" occurring on the lower part of the large pastern bone or the upper part of the small pastern bone. "Low ringbone" occurs on the lower part of the small pastern
bone or the upper part of the coffin bone
. High ringbone is easier seen than low ringbone, as low ringbone occurs in the hoof of the horse. However, low ringbone may be seen if it becomes serious, as it creates a bony bump on the coronet
of the horse.
High ringbone: The horse will have a bony growth around the pastern area, and the pastern will have less mobility. The horse will show pain when the pastern joint is moved or rotated. Early cases will have a lameness
score of 1-2 out of 5, with little or no bony swelling seen, although possibly felt when compared to the opposite pastern. Lameness will worsen to a grade 2-3 on a scale of 5 as the ringbone worsens.
Low ringbone: The horse will have moderate lameness (grade 2-3), even in early cases, because of the closeness of the ringbone to the other structures in the hoof. When severe or very advanced, the bony growth will be able to be seen on the coronet.
Shoeing: The farrier
should balance the hoof and apply a shoe that supports the heels and allows for an easy breakover.
NSAIDs: or non-steroidal anti-inflammatory drugs help to alleviate the pain and reduce inflammation within and around the joints. Often NSAIDs make the horse comfortable enough to continue ridden work, which is good for the horse's overall health.
Joint injections: The pastern joint can be injected directly, typically with a form of corticosteroid and hyaluronic acid.
Extracorporeal Shockwave Therapy: A high intensity specialized percussion device can help to remodel new bone tissue and decrease pain.
Arthrodesis: the fusion of the two bones of the pastern joints eliminates the instability of the joint, and thus the inflammation. This procedure may then eliminate the horse's lameness as well. However, surgical alteration of the joint can promote the growth of bone in the area, which is cosmetically displeasing. Arthrodesis of the coffin joint is usually not performed due to the location of the joint (within the hoof) and because the coffin joint needs some mobility for the horse to move correctly (unlike the pastern joint, which is very still).
IRAP' Interleukin-1 Receptor Antagonist Protein (IRAP) blocks IL-1 from binding to tissues and inhibits the damaging consequences of IL-1.
Horses that are not performing strenuous work, such as jumping or working at speed, will probably be usable for years to come. However, horses competing in intense sports may not be able to continue at their previous level, as their pastern joints are constantly stressed.
Rogers, J and Waldron, T. 1995. "A Field Guide to Joint Disease in Archaeology". Chichester: John Wiley & Sons.
Exostosis
An exostosis is the formation of new bone on the surface of a bone. Exostoses can cause chronic pain ranging from mild to debilitatingly severe, depending on where they are located and what shape they are....
(bone growth) in the pastern or coffin joint of a horse
Horse
The horse is one of two extant subspecies of Equus ferus, or the wild horse. It is a single-hooved mammal belonging to the taxonomic family Equidae. The horse has evolved over the past 45 to 55 million years from a small multi-toed creature into the large, single-toed animal of today...
. In severe cases, the growth can encircle the bones, giving ringbone its name. It has been suggested by some authors that such a colloquial term, whilst commonly used, might be misleading and that it would be better to refer to this condition as osteoarthritis
Osteoarthritis
Osteoarthritis also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion...
of the inter-phalangeal
Phalanx bones
In anatomy, phalanx bones are those that form the fingers and toes. In primates such as humans and monkeys, the thumb and big toe have two phalanges, while the other fingers and toes consist of three. Phalanges are classified as long bones.The phalanges do not have individual names...
joints in ungulate
Ungulate
Ungulates are several groups of mammals, most of which use the tips of their toes, usually hoofed, to sustain their whole body weight while moving. They make up several orders of mammals, of which six to eight survive...
s (Rogers and Waldron, 1995: 34-35).
Ringbone can be classified by its location, with "high ringbone" occurring on the lower part of the large pastern bone or the upper part of the small pastern bone. "Low ringbone" occurs on the lower part of the small pastern
Pastern
The pastern is a part of the leg of a horse between the fetlock and the top of the hoof. It incorporates the long pastern bone and the short pastern bone , which are held together by two sets of paired ligaments to form the pastern joint...
bone or the upper part of the coffin bone
Pedal bone
The pedal bone, commonly known as the coffin bone , is the bottommost bone in the equine leg and is encased by the hoof capsule. Also known as the distal phalange, third phalange, third phalanx, or "P3"....
. High ringbone is easier seen than low ringbone, as low ringbone occurs in the hoof of the horse. However, low ringbone may be seen if it becomes serious, as it creates a bony bump on the coronet
Coronet
A coronet is a small crown consisting of ornaments fixed on a metal ring. Unlike a crown, a coronet never has arches.The word stems from the Old French coronete, a diminutive of coronne , itself from the Latin corona .Traditionally, such headgear is – as indicated by the German equivalent...
of the horse.
Causes of Ringbone
- Excessive tension on the tendons, ligaments, and jointJointA joint is the location at which two or more bones make contact. They are constructed to allow movement and provide mechanical support, and are classified structurally and functionally.-Classification:...
capsules of the pastern area can strain the periosteumPeriosteumPeriosteum is a membrane that lines the outer surface of all bones, except at the joints of long bones. Endosteum lines the inner surface of all bones....
. The body compensates by growing bone at the stresspoint. Strain on the extensor tendon, the superficial digital flexor tendon branches, the collateral ligaments, and the distal sesamoidean ligaments are all common factors. If these tissues are stretched or torn, and the joint is instabilized by the injury, new bone is produced to help to stabilize the joint.
- OsteoarthritisOsteoarthritisOsteoarthritis also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion...
(the endstage of degenerative joint disease) of the pastern or coffin joint is a very common cause of articular ringbone. Bone is then produced to try to immobilize the joint and to relieve the chronic inflammation of the joint capsule. This process may take years, and lamenessLameness (equine)Lameness in horses and other equidae is a term used to refer to any number of conditions where the animal fails to travel in a regular and sound manner on all four feet...
will continue until the joint is completely immobilized.
- Trauma to the periosteum can cause bone growth on the pastern bone. However, this is usually not progressive unless nearby soft tissue was also harmed and thus the joint instability was affected.
- Poor shoeingHorseshoeA horseshoe, is a fabricated product, normally made of metal, although sometimes made partially or wholly of modern synthetic materials, designed to protect a horse's hoof from wear and tear. Shoes are attached on the palmar surface of the hooves, usually nailed through the insensitive hoof wall...
and conformationEquine conformationEquine conformation evaluates the degree of correctness of a horse's bone structure, musculature, and its body proportions in relation to each other. Undesirable conformation can limit the ability to perform a specific task. Although there are several universal "faults," a horse's conformation is...
, such as long, sloping pasterns, upright pasterns, long-toes with low heels, pigeon toes, splay foot, or unbalanced feet may predispose the horse to ringbone, as they create uneven stress on the pastern and coffin joint, unequal tension on the soft tissues, or worsen the concussion that is absorbed by the pastern area.
Signs of Ringbone
Ringbone usually occurs in the front legs but can also be in the hind legs, and is usually worse in one leg than the other. Ringbone is most often found in mature horses, especially those in intensive training.High ringbone: The horse will have a bony growth around the pastern area, and the pastern will have less mobility. The horse will show pain when the pastern joint is moved or rotated. Early cases will have a lameness
Lameness (equine)
Lameness in horses and other equidae is a term used to refer to any number of conditions where the animal fails to travel in a regular and sound manner on all four feet...
score of 1-2 out of 5, with little or no bony swelling seen, although possibly felt when compared to the opposite pastern. Lameness will worsen to a grade 2-3 on a scale of 5 as the ringbone worsens.
Low ringbone: The horse will have moderate lameness (grade 2-3), even in early cases, because of the closeness of the ringbone to the other structures in the hoof. When severe or very advanced, the bony growth will be able to be seen on the coronet.
Treatment of Ringbone
Ringbone is degenerative (unless it is caused by direct trauma). Treatment works to slow down the progress of the bony changes and alleviate the horse's pain, rather than working to cure it.Shoeing: The farrier
Farrier
A farrier is a specialist in equine hoof care, including the trimming and balancing of horses' hooves and the placing of shoes on their hooves...
should balance the hoof and apply a shoe that supports the heels and allows for an easy breakover.
NSAIDs: or non-steroidal anti-inflammatory drugs help to alleviate the pain and reduce inflammation within and around the joints. Often NSAIDs make the horse comfortable enough to continue ridden work, which is good for the horse's overall health.
Joint injections: The pastern joint can be injected directly, typically with a form of corticosteroid and hyaluronic acid.
Extracorporeal Shockwave Therapy: A high intensity specialized percussion device can help to remodel new bone tissue and decrease pain.
Arthrodesis: the fusion of the two bones of the pastern joints eliminates the instability of the joint, and thus the inflammation. This procedure may then eliminate the horse's lameness as well. However, surgical alteration of the joint can promote the growth of bone in the area, which is cosmetically displeasing. Arthrodesis of the coffin joint is usually not performed due to the location of the joint (within the hoof) and because the coffin joint needs some mobility for the horse to move correctly (unlike the pastern joint, which is very still).
IRAP' Interleukin-1 Receptor Antagonist Protein (IRAP) blocks IL-1 from binding to tissues and inhibits the damaging consequences of IL-1.
Prognosis for Ringbone
If the ringbone is close to a joint, the prognosis for the horse's continued athletic use is not as good as if the ringbone is not near a joint. Ringbone that is progressing rapidly has a poorer prognosis as well.Horses that are not performing strenuous work, such as jumping or working at speed, will probably be usable for years to come. However, horses competing in intense sports may not be able to continue at their previous level, as their pastern joints are constantly stressed.
Sources
King, Christine, BVSc, MACVSc, and Mansmann, Richard, VDM, PhD. 1997. "Equine Lameness." Equine Research, Inc. Pages 694-699.Rogers, J and Waldron, T. 1995. "A Field Guide to Joint Disease in Archaeology". Chichester: John Wiley & Sons.