Re: [RC] Epiphysitis - Susan GarlinghouseCan someone give me more details on what epiphysitis is? Saw this mentioned in the post on joint disease and young horses (great post by the way, Susan G). Thanks. Epiphysitis is kind of a misnomer, since there is no actual active inflammation in the affected bones. "Physeal dysplasia" is what they taught us in vet school, and refers to a disruption of the physeal growth cartilages. In the previous post, there was a description of how bones normally form from endochondral 'plates' to mature, ossified bone, right? If something disrupts this process, then you get the classic symptoms of heat, pain, swelling and lameness and what has traditionally been called epiphysitis. So what can disrupt this ossification process---if the problem is in more than one limb, then a nutritional problem is mostly likely involved. If only one limb is involved, then trauma or some other abnormal biomechanical stressor moves higher on the list, though nutrition-related problems might still be a contributing factor. Genetics is also a big contributor, since there's much higher incidence in breeds that have been selected for rapid, early growth and large mature weights---but it *can* occur in any breed. It's absolutely untrue that DOD doesn't occur in Arabs. Incidence of DOD has also been traced to some specific (warmblood and standardbred) stallions, even though the stallion himself may not have ever had DOD problems. Due to my older horse's joint problems I began reading a whole lot on DJD and OCD. Don't know much about epiphysitis though. Is it hard swellings on the fetlock area? And is it caused by same things as DJD? Okay, let's straighten out the definitions. Sorry, this can get confusing, because there's a lot of overlap in terms and syndromes. In young horses, anything affecting normal bone development is very generally classified as DOD syndrome---developmental orthopedic disease. As commented on above, there are lots of different things that can cause DOD, including nutrition, genetics, premature birth, fracture, trauma, abnormal stressors from poor to grossly abnormal conformation, overwork, etc etc. DOD can affect any developing bone prior to 'closure' of the growth centers. You often see it along the long bones of the legs and causing problems at the joints of those long bones---stifle, hock, elbow, knees, etc. You can also see defects in the fetlock, but because those growth centers normally close at 2-3 months of age, there's less time for poor management to cause problems there (and the flip side of that is if the problem was present at birth, you have a much tighter window of opportunity for therapy to fix the problem). The take-home message here is that you can get DOD lesions at any growth center, and from a whole slew of causes, but lesions are more likely to occur at the ends of long bones, and where abnormal stress is likely to occur. As long as a growth center remains open, there's potential for lesions to develop there and cause problems. Remember that growth centers close from the bottom up---some of the most distal parts of the legs are closed at or soon after birth, moving up over months and years---some of the last areas to close are along the spinal vertebrae as late as 6-7 years. Yup, you can develop lesions here as well, causing either "wobbler's syndrome", various neurological syndromes or later DJD. Moving on to OCD, osteochondrosis and/or osteochondritis dissecans. OCD is a sub-type of DOD, but the two are NOT synonymous conditions. Osteochondrosis is a defect in the cartilagenous ossification center secondary to some event that disrupted blood supply to the area---again, trauma, abnormal stress, whatever. Without blood supply, there is an area of cartilage tissue that not only ceases to grow, but dies and becomes necrotic. This creates not only a cyst where bone should be, but can also affect the quality of bone that develops over and beyond that cyst. Example, if the cyst is underlying an area where a ridge of bone is supposed to develop, then the ridge may not completely or adequately form. Or, it may form abnormally, creating more abnormal stress on the joint when the horse is later put to work. Osteochrondritis dissecans is a type of osteochondrosis in which a bone or cartilage flap or fragment develops in the affected joint. Sometimes these fragments can break loose within the joint capsule and because the fragment is still deriving its nutrition from the synovial fluid, it continues to grow and thus becomes a "joint mouse" which must be removed surgically. Okay, so let's assume you have an adult horse that had some amount of a DOD problem during growth and has some area of abnormal bone development in a joint---let's say a hock. The horse starts a conditioning program for whatever discipline he's going to do. Whenever there's an area of instability in a joint, the body tries to stabilize by depositing calcium. Unfortunately, not always appropriately and if the calcium deposits cause a roughening of surfaces over which tendons, ligaments or joints are supposed to slide smoothly---voila, you have degenerative changes or DJD. Problems during growth aren't exclusively the reason for DJD later as an adult, just one scenario. Anything that creates abnormal stress and instability in a joint is also going to contribute to the same cascade of events. So DJD can be either the ultimate outcome of DOD problems as a youngster; or, can be the outcome of inappropriate exercise, poor shoeing, overriding, riding before the horse is ready for that level of stress, etc etc etc. You get the picture. Now I am so careful about what I am feeding my filly (Equine Junior Development by Purina and lots of grass hay) and making sure she has plenty of exercise, I just hope she will be fine :) Just remember there's a fine line between plenty of exercise and too much. Not enough exercise can also contribute to DOD, but so does too much forced exercise. Just one more argument for babies raised in pastures. Hope this helps. :-) Susan G =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= Ridecamp is a service of Endurance Net, http://www.endurance.net. Information, Policy, Disclaimer: http://www.endurance.net/Ridecamp Subscribe/Unsubscribe http://www.endurance.net/ridecamp/logon.asp Ride Long and Ride Safe!! =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
|